title: Individual Organ Failure and Concomitant Risk of Mortality Differs According to the Type of Admission to ICU - A Retrospective Study of SOFA Score of 23,795 Patients.
abstract: BACKGROUND
  Organ dysfunction or failure after the first days of ICU treatment and subsequent mortality with respect to the type of intensive care unit (ICU) admission is poorly elucidated. Therefore we analyzed the association of ICU mortality and admission for medical (M), scheduled surgery (ScS) or unscheduled surgery (US) patients mirrored by the occurrence of organ dysfunction/failure (OD/OF) after the first 72h of ICU stay.
  
  
  METHODS
  For this retrospective cohort study (23,795 patients; DIVI registry; German Interdisciplinary Association for Intensive Care Medicine (DIVI)) organ dysfunction or failure were derived from the Sequential Organ Failure Assessment (SOFA) score (excluding the Glasgow Coma Scale). SOFA scores were collected on admission to ICU and 72h later. For patients with a length of stay of at least five days, a multivariate analysis was performed for individual OD/OF on day three.
  
  
  RESULTS
  M patients had the lowest prevalence of cardiovascular failure (M 31%; ScS 35%; US 38%), and the highest prevalence of respiratory (M 24%; ScS 13%; US 17%) and renal failure (M 10%; ScS 6%; US 7%). Risk of death was highest for M- and ScS-patients in those with respiratory failure (OR; M 2.4; ScS 2.4; US 1.4) and for surgical patients with renal failure (OR; M 1.7; ScS 2.7; US 2.4).
  
  
  CONCLUSIONS
  The dynamic evolution of OD/OF within 72h after ICU admission and mortality differed between patients depending on their types of admission. This has to be considered to exclude a systematic bias during multi-center trials.
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
authors.forename: Tobias M
authors.initials: TM
authors.lastname: Bingold
authors.affiliation: Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Ostmerheimerstrasse 200, D-51109 Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Zacharowski
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Meybohm
authors.affiliation: Trauma Surgery Department, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Waydhas
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Eberhard Karls Universität, D-72076 Tübingen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenberger
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
authors.forename: Bertram
authors.initials: B
authors.lastname: Scheller
mesh_terms: D000328:Adult; D000368:Aged; D003953:Diagnosis-Related Groups; D005260:Female; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000401:mortality*; D006470:Hemorrhage / Q000401:mortality; D017052:Hospital Mortality; D006761:Hospitals / Q000145:classification; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007388:Internal Medicine; D007902:Length of Stay / Q000706:statistics & numerical data; D017093:Liver Failure / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009102:Multiple Organ Failure / Q000401:mortality; D015999:Multivariate Analysis; D063305:Organ Dysfunction Scores; D009928:Organ Specificity; D015995:Prevalence; D012042:Registries; D051437:Renal Insufficiency / Q000401:mortality*; D012131:Respiratory Insufficiency / Q000401:mortality*; D012189:Retrospective Studies; D012306:Risk; D013514:Surgical Procedures, Operative