title: [A retrospective clinical study of sixty-three cases with persistent inflammation immunosuppression and catabolism syndrome].
abstract: Objective:To study the clinical characteristics and prognosis of patients with persistent inflammation immunosuppression and catabolism syndrome (PICS) in ICU.Methods:A total of 126 patients admitted to ICU (ICU stay of more than 10 days, age≥18 years) between January 2014 to December 2014 were retrospectively studied.Data were collected from electronic medical records including demographics, underlying disease, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, Sequential Organ Failure Assessment (SOFA) score, laboratory parameters, ICU acquired infections and clinical outcome.Results:The overall incidence of PICS in ICU patients (ICU stay of more than 10 days) was 50.0%(63/126). There were no significant differences in baseline data such as gender, age, APACHEⅡscore, SOFA score and underlying diseases between the two groups(allP>0.05). Compared with the non-PICS group, there were more patients with gastrointestinal perforation in the PICS group (P=0.042), however, the medical or surgical admission did not differ between the two groups(P>0.05). During the stay in ICU, the PICS group showed a higher risk of developing acquired infections compared with the non-PICS group[PICS 63.5%(40/63) vs non-PICS 23.8%(15/63);P<0.001]. The infections were more caused by Candida in the PICS group than the non-PICS group [PICS 22.4%(11/49) vs non-PICS 2/17;P=0.003]. Moreover, the PICS group experienced longer stay in ICU[PICS(31.6±28.8) days vs non-PICS (20.4±11.3) days;P=0.0046] and higher ICU mortality [PICS 28.6%(18/63) vs non-PICS 6.3%(4/63),P=0.001].Conclusion:PICS is a common manifestation of patients who stay in ICU more than 10 days, which is associated with high risk of ICU acquired infections, prolonged length of stay and high mortality.
authors.affiliation: Department of Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: R Y
authors.initials: RY
authors.lastname: Ding
authors.forename: J N
authors.initials: JN
authors.lastname: Qiu
authors.forename: B Y
authors.initials: BY
authors.lastname: Liu
authors.forename: X X
authors.initials: XX
authors.lastname: Li
authors.forename: Y N
authors.initials: YN
authors.lastname: Sun
authors.forename: Y J
authors.initials: YJ
authors.lastname: Liang
authors.forename: D M
authors.initials: DM
authors.lastname: Zhao
authors.forename: R
authors.initials: R
authors.lastname: Zhu
authors.forename: Z D
authors.initials: ZD
authors.lastname: Zhang
authors.forename: X C
authors.initials: XC
authors.lastname: Ma
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D015994:Incidence; D007249:Inflammation / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008660:Metabolism; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000145:classification / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D013577:Syndrome