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Browsing by Author "Vincent, JL"

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  • Comparison of European ICU Patients in 2012 (ICON) Versus 2002 (SOAP)
    Publication . Vincent, JL; Lefrant, JY; Kotfis, K; Nanchal, R; Martin-Loeches, I; Wittebole, X; Sakka, S; Pickkers, P; Moreno, R; Sakr, Y
    Purpose: To evaluate differences in the characteristics and outcomes of intensive care unit (ICU) patients over time. Methods: We reviewed all epidemiological data, including comorbidities, types and severity of organ failure, interventions, lengths of stay and outcome, for patients from the Sepsis Occurrence in Acutely ill Patients (SOAP) study, an observational study conducted in European intensive care units in 2002, and the Intensive Care Over Nations (ICON) audit, a survey of intensive care unit patients conducted in 2012. Results: We compared the 3147 patients from the SOAP study with the 4852 patients from the ICON audit admitted to intensive care units in the same countries as those in the SOAP study. The ICON patients were older (62.5 ± 17.0 vs. 60.6 ± 17.4 years) and had higher severity scores than the SOAP patients. The proportion of patients with sepsis at any time during the intensive care unit stay was slightly higher in the ICON study (31.9 vs. 29.6%, p = 0.03). In multilevel analysis, the adjusted odds of ICU mortality were significantly lower for ICON patients than for SOAP patients, particularly in patients with sepsis [OR 0.45 (0.35-0.59), p < 0.001]. Conclusions: Over the 10-year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU mortality were lower in our 2012 cohort compared to our 2002 cohort, particularly in patients with sepsis.
    2018Journal article Open access Show more
  • Equilibrating SSC Guidelines with Individualized Care
    Publication . Vincent, JL; Singer, M; Einav, S; Moreno, R; Wendon, J; Teboul, JL; Bakker, J; Hernandez, G; Annane, D; de Man, A; Monnet, X; Ranieri, V; Hamzaoui, O; Takala, J; Juffermans, N; Chiche, JD; Myatra, S; De Backer, D
    2021-11Other Open access Show more
  • Preoperative Abnormalities in Serum Sodium Concentrations Are Associated with Higher in-Hospital Mortality in Patients Undergoing Major Surgery
    Publication . Cecconi, M; Hochrieser, H; Chew, M; Grocott, M; Hoeft, A; Hoste, A; Jammer, I; Posch, M; Metnitz, P; Pelosi, P; Moreno, R; Pearse, RM; Vincent, JL; Rhodes, A
    BACKGROUND: Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS: This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 539 patients undergoing inpatient non-cardiac surgery. Patients were included in this study if they had a recorded value of preoperative serum sodium within the 28 days immediately before surgery. Data describing preoperative risk factors and serum sodium concentrations were analysed to investigate the relationship with in-hospital mortality using univariate and multivariate logistic regression techniques. RESULTS: Of 35 816 (77.0%) patients from the EuSOS database, 21 943 (61.3%) had normal values of serum sodium (138-142 mmol litre(-1)) before surgery, 8538 (23.8%) had hyponatraemia (serum sodium ≤137 mmol litre(-1)) and 5335 (14.9%) had hypernatraemia (serum sodium ≥143 mmol litre(-1)). After adjustment for potential confounding factors, moderate to severe hypernatraemia (serum sodium concentration ≥150 mmol litre(-1)) was independently associated with mortality [odds ratio 3.4 (95% confidence interval 2.0-6.0), P<0.0001]. Hyponatraemia was not associated with mortality. CONCLUSIONS: Preoperative abnormalities in serum sodium concentrations are common, and hypernatraemia is associated with increased mortality after surgery. Abnormalities of serum sodium concentration may be an important biomarker of perioperative risk resulting from co-morbid disease.
    2016-01Journal article Open access Show more
  • 2023Journal article Open access Show more
  • The Sequential Organ Failure Assessment (SOFA) Score: Has the Time Come for an Update?
    Publication . Moreno, R; Rhodes, A; Piquilloud, L; Hernandez, G; Takala, J; Gershengorn, H; Tavares, M; Coopersmith, C; Myatra, S; Singer, M; Rezende, E; Prescott, H; Soares, M; Timsit, JF; de Lange, D; Jung, C; De Waele, J; Martin, G; Summers, C; Azoulay, E; Fujii, T; McLean, A; Vincent, JL
    The Sequential Organ Failure Assessment (SOFA) score was developed more than 25 years ago to provide a simple method of assessing and monitoring organ dysfunction in critically ill patients. Changes in clinical practice over the last few decades, with new interventions and a greater focus on non-invasive monitoring systems, mean it is time to update the SOFA score. As a first step in this process, we propose some possible new variables that could be included in a SOFA 2.0. By so doing, we hope to stimulate debate and discussion to move toward a new, properly validated score that will be fit for modern practice.
    2023-01Journal article Open access Show more