title: Prognosis of patients with shock receiving vasopressors.
abstract: BACKGROUND
  Consensus guidelines suggested that both dopamine and norepinephrine may be used, but specific doses are not recommended. The aim of this study is to determine the predictive role of vasopressors in patients with shock in intensive care unit.
  
  
  METHODS
  One hundred and twenty-two patients, who had received vasopressors for 1 hour or more in intensive care unit (ICU) between October 2008 and October 2011, were included. There were 85 men and 37 women, with a median age of 65 years (55-73 years). Their clinical data were retrospectively collected and analyzed.
  
  
  RESULTS
  The median simplified acute physiological score 3 (SAPS 3) was 50 (42-55). Multivariate analysis showed that septic shock (P=0.018, relative risk: 4.094; 95% confidential interval: 1.274-13.156), SAPS 3 score at ICU admission (P=0.028, relative risk: 1.079; 95% confidential interval: 1.008-1.155), and norepinephrine administration (P<0.001, relative risk: 9.353; 95% confidential interval: 2.667-32.807) were independent predictors of ICU death. Receiver operating characteristic curve analysis demonstrated that administration of norepinephrine ≥0.7 μg/kg per minute resulted in a sensitivity of 75.9% and a specificity of 90.3% for the likelihood of ICU death. In patients who received norepinephrine ≥0.7 μg/kg per minute there was more ICU death (71.4% vs. 44.8%) and in-hospital death (76.2% vs. 48.3%) than in those who received norepinephrine <0.7 μg/kg per minute. These patients had also a decreased 510-day survival rate compared with those who received norepinephrine <0.7 μg/kg per minute (19.2% vs. 64.2%).
  
  
  CONCLUSIONS
  Septic shock, SAPS 3 score at ICU admission, and norepinephrine administration were independent predictors of ICU death for patients with shock. Patients who received norepinephrine ≥0.7 μg/kg per minute had an increased ICU mortality, an increased in-hospital mortality, and a decreased 510-day survival rate.
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Xue-Zhong
authors.initials: XZ
authors.lastname: Xing
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Chu-Lin
authors.initials: CL
authors.lastname: Huang
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Quan-Hui
authors.initials: QH
authors.lastname: Yang
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Shi-Ning
authors.initials: SN
authors.lastname: Qu
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Qing-Ling
authors.initials: QL
authors.lastname: Xiao
authors.affiliation: Department of Intensive Care Unit, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Ke-Lin
authors.initials: KL
authors.lastname: Sun
keywords: Intensive care; Shock; Vasopressors