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A Simplified Mortality Score Using Delta Neutrophil Index and the Thrombotic Microangiopathy Score for Prognostication in Critically Ill Patients

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dc.contributor.author곽은경-
dc.contributor.author김세규-
dc.contributor.author김송이-
dc.contributor.author김영삼-
dc.contributor.author김은영-
dc.contributor.author박무석-
dc.contributor.author송주한-
dc.contributor.author임아영-
dc.contributor.author장준-
dc.contributor.author정경수-
dc.contributor.author정지예-
dc.date.accessioned2018-08-28T16:41:16Z-
dc.date.available2018-08-28T16:41:16Z-
dc.date.issued2018-
dc.identifier.issn1073-2322-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/161840-
dc.description.abstractBACKGROUND: This study was conducted to assess the prognostic value of a simplified mortality score (SMS) using the delta neutrophil index (DNI) and thrombotic microangiopathy (TMA) score, both easily obtained from the complete blood count, to identify critically ill patients at high risk of death. METHODS: This was a retrospective study performed in the medical ICU at Yonsei University College of Medicine from June 2015 to February 2016. The primary end point was 28-day all-cause mortality. Participants were divided into two groups: a training (n = 232) and a test (n = 57) set. We used Cox proportional-hazards analysis, Harrell's C index, and Kaplan-Meier survival analysis to derive the SMS and test its internal validity. RESULTS: We enrolled 289 patients. The 28-day mortality rate was 31.1% (n = 90). Nonsurvivors had higher APACHE II, SOFA, and TMA scores, and DNI. The SMS, derived by Cox proportional-hazards analysis, consisted of age, sex, DNI, and TMA score. We assigned a weighted point to each variable in the SMS, as follows: age + 11 if male + (2 x DNI) + (61 [TMA = 1], 76 [TMA = 2], 74 [TMA = 3], 26 [TMA = 4], 99 [TMA = 5]). Nonsurvivors had a higher median SMS than survivors, and the Harrell's C index was 0.660. Analysis of survival by risk group according to SMS (low, intermediate, high risk) showed a significant difference among these three groups (P < 0.001). We then investigated this SMS in the test set to determine internal validity; the results were similar to those of the training set. CONCLUSIONS: The SMS is a more rapid, simple prognostic score for predicting 28-day mortality and stratifying risk than the APACHE II or SOFA scores. However, external validation using a larger sample is needed.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherLippincott Williams & Wilkins-
dc.relation.isPartOfSHOCK-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleA Simplified Mortality Score Using Delta Neutrophil Index and the Thrombotic Microangiopathy Score for Prognostication in Critically Ill Patients-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorEun K Goag-
dc.contributor.googleauthorJong W Lee-
dc.contributor.googleauthorYun H Roh-
dc.contributor.googleauthorAh Y Leem-
dc.contributor.googleauthorSong Y Kim-
dc.contributor.googleauthorJoo H Song-
dc.contributor.googleauthorEun Y Kim-
dc.contributor.googleauthorJi Y Jung-
dc.contributor.googleauthorMoo S Park-
dc.contributor.googleauthorYoung S Kim-
dc.contributor.googleauthorSe K Kim-
dc.contributor.googleauthorJoon Chang-
dc.contributor.googleauthorKyung S Chung-
dc.identifier.doi10.1097/shk.0000000000000936-
dc.contributor.localIdA00178-
dc.contributor.localIdA00602-
dc.contributor.localIdA00626-
dc.contributor.localIdA00707-
dc.contributor.localIdA00811-
dc.contributor.localIdA01457-
dc.contributor.localIdA02062-
dc.contributor.localIdA03382-
dc.contributor.localIdA03472-
dc.contributor.localIdA03570-
dc.contributor.localIdA03735-
dc.relation.journalcodeJ02658-
dc.identifier.eissn1540-0514-
dc.identifier.pmid28682944-
dc.identifier.urlhttps://insights.ovid.com/crossref?an=00024382-201801000-00007-
dc.contributor.alternativeNameGoag, Eun Kyong-
dc.contributor.alternativeNameKim, Se Kyu-
dc.contributor.alternativeNameKim, Song Yi-
dc.contributor.alternativeNameKim, Young Sam-
dc.contributor.alternativeNameKim, Eun Young-
dc.contributor.alternativeNamePark, Moo Suk-
dc.contributor.alternativeNameSong, Joo Han-
dc.contributor.alternativeNameLeem, Ah Young-
dc.contributor.alternativeNameChang, Joon-
dc.contributor.alternativeNameJung, Kyung Soo-
dc.contributor.alternativeNameJung, Ji Ye-
dc.contributor.affiliatedAuthorGoag, Eun Kyong-
dc.contributor.affiliatedAuthorKim, Se Kyu-
dc.contributor.affiliatedAuthorKim, Song Yi-
dc.contributor.affiliatedAuthorKim, Young Sam-
dc.contributor.affiliatedAuthorKim, Eun Young-
dc.contributor.affiliatedAuthorPark, Moo Suk-
dc.contributor.affiliatedAuthorSong, Joo Han-
dc.contributor.affiliatedAuthorLeem, Ah Young-
dc.contributor.affiliatedAuthorChang, Joon-
dc.contributor.affiliatedAuthorJung, Kyung Soo-
dc.contributor.affiliatedAuthorJung, Ji Ye-
dc.citation.volume49-
dc.citation.number1-
dc.citation.startPage39-
dc.citation.endPage43-
dc.identifier.bibliographicCitationSHOCK, Vol.49(1) : 39-43, 2018-
dc.identifier.rimsid59432-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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