PMID- 10735409
OWN - NLM
STAT- MEDLINE
DCOM- 20000413
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 17
IP  - 1
DP  - 2000 Jan
TI  - Improved outcome of APACHE II score-defined escalating systemic inflammatory 
      response syndrome in patients post cardiac surgery in 1996 compared to 1988-1990: 
      the ESSICS-study pilot project.
PG  - 30-7
AB  - OBJECTIVE: Cardiac surgery using extracorporeal circulation leads to the release 
      of cytokines and subsequently to a systemic inflammatory response syndrome, which 
      is thought to be a negative prognostic factor for patients' outcome. A 
      stratification for the risk of an escalating systemic inflammatory response 
      syndrome had been achieved in a monocenter study carried out in 1988-1990, using 
      APACHE II scoring on the morning of the 1st postoperative day. We now 
      re-evaluated this concept prospectively in three independent centers. METHODS: 
      The APACHE II based risk stratification was put to test in three independent 
      heart surgery centers in the period from June to December 1996. Nine hundred and 
      forty-five patients after elective cardiac surgery (excluding heart 
      transplantation) with the assistance of the cardiopulmonary bypass were 
      prospectively monitored. RESULTS: We found an increase in mortality with higher 
      APACHE II score values determined on the 1st postoperative day. The mortality 
      rose to nearly 50% with an APACHE II score of > or = 28. Patients at high risk 
      for the development of a systemic inflammatory response syndrome (APACHE II score 
      > or = 24) significantly differed from patients at lower risk (APACHE II score < 
      19) in the duration of mechanical ventilation and extracorporeal circulation, age 
      and New York Heart Association (NYHA) classification (P < 0.05). CONCLUSION: The 
      APACHE II score determined on the morning of the 1st postoperative day helps 
      identifying the subgroup of patients with escalating systemic inflammatory 
      response syndrome. Comparison with the data obtained in the years 1988-1990, 
      suggests a better prognosis in the current trial for patients at high risk with a 
      similar degree of escalating systemic inflammatory response syndrome.
FAU - Kuhn, C
AU  - Kuhn C
AD  - Department of Medicine III, University of Halle-Wittenberg, Halle, Germany.
FAU - Muller-Werdan, U
AU  - Muller-Werdan U
FAU - Schmitt, D V
AU  - Schmitt DV
FAU - Lange, H
AU  - Lange H
FAU - Pilz, G
AU  - Pilz G
FAU - Kreuzer, E
AU  - Kreuzer E
FAU - Mohr, F W
AU  - Mohr FW
FAU - Zerkowski, H R
AU  - Zerkowski HR
FAU - Werdan, K
AU  - Werdan K
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - *APACHE
MH  - Aged
MH  - Cardiac Surgical Procedures/*adverse effects/mortality
MH  - Cardiopulmonary Bypass/adverse effects
MH  - Coronary Care Units
MH  - Elective Surgical Procedures
MH  - Germany/epidemiology
MH  - Hospital Mortality
MH  - Humans
MH  - Middle Aged
MH  - Pilot Projects
MH  - Prognosis
MH  - Prospective Studies
MH  - Survival Rate
MH  - Systemic Inflammatory Response Syndrome/*diagnosis/etiology/mortality
EDAT- 2000/03/29 09:00
MHDA- 2000/04/15 09:00
CRDT- 2000/03/29 09:00
PHST- 2000/03/29 09:00 [pubmed]
PHST- 2000/04/15 09:00 [medline]
PHST- 2000/03/29 09:00 [entrez]
AID - S1010-7940(99)00345-0 [pii]
AID - 10.1016/s1010-7940(99)00345-0 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2000 Jan;17(1):30-7. doi: 10.1016/s1010-7940(99)00345-0.