Search results

1

Black smoke air pollution and daily non-accidental mortality in Nis, Serbia

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Bogdanovic D., Nikic D., Milosevic Z., Stankovic A.

Open Medicine

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2006

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vol. 1

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issue 3

292-297

EN

The short-term effects of ambient black smoke concentrations on total non-accidental, cardiovascular and respiratory mortalities in Nis, during the 2000-2003 period, were investigated. Daily measurements for black smoke (BS), as well as the daily number of deaths have been collected. Generalised linear models extending Poisson regression were applied. The e.ects of time trend, seasonal variations, days of the week, temperature, humidity and air pressure were adjusted. The per cent increase in the daily number of total deaths associated with a 10 μg/m3 increase in BS was 1.13% (0.08–2.20%). The e.ect size was slightly higher for cardiovascular mortality (1.25%, 95% CI: 0.53–1.97%). There was no signi.cant association between air pollution and respiratory mortality. These results indicate that current levels of ambient BS have signi.cant e.ects on total and cardiovascular mortalities in Nis.

2

Incidence and etiology of mortality in polytrauma patients: an analysis of material from Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, over a period of 3 years (2017–2019)

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Ciechanowicz D., Samojło N., Kozłowski J., Pakulski C., Żyluk A.

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vol. 92(4)

1-6

EN

Introduction: The pattern of traumatic death is a subject of great interest in the worldwide literature. Most studies have aimed to improve trauma care and raise awareness of avoidable fatal complications. Aim: The objective of the present study was an epidemiological and clinical analysis of causes of traumatic death of patients treated at the Multitrauma Centre of the University Teaching Hospital No 1 in Szczecin, over a period of 3 years (2017–2019). Material and methods: The study material comprised medical data of 32 patients with a mean age of 63 years, who died due to polytrauma injury. The time of death form admission to the Multitrauma Centre, primary cause of death, spectrum and sites of injuries, as well as method of treatment (operative or conservative) were variables considered in the analysis. Results: The predominant mechanisms of injury were traffic accidents – 22 cases (69%) followed by falls from a height 8 (25%) and other mechanism – 2 cases (6%). The most common primary cause of death was brain injury – 17 patients (53%) followed by pelvic or spinal fractures – 5 (16%). The predominant constituents of polytrauma were bony injuries (pelvis, spine and limbs) – 28 cases (87%), followed by head injuries – 25 (78%), chest – 24 (75%) and abdominal injuries – 17 (53%). Eighteen patients (56%) required operative treatment; craniotomy for brain injuries was the most commonly performed – in 11 patients, followed by laparotomy – in 5. Five other patients underwent an endovascular procedure – pelvic artery embolization. Twelve patients (38%) died in the first two days from admission to the trauma center, 5 (16%) in the first week and 15 over one week form admission. Conclusions: Head injuries, pelvic fractures with associated retroperitoneal bleeding and severe injuries affecting several body parts were identified as the most dangerous for the survival of polytrauma patients. A trend to decrease mortality due to hemorrhagic shock was observed, but it remains unchanged for central nervous system injuries.

3

Prevalence and outcome of infections in intensive care units of a tertiary care hospital in north India.

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Malik S. S., Maqbool M., Rafi A., Kokab N.

Critical Care Innovations

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2022

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vol. 5

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issue 2

20-28

EN

INTRODUCTION: Infection is a major cause of morbidity and mortality in Intensive Care Units (ICUs), more so in resource limited ICUs of low and lower-middle income countries. However relatively little information is available about epidemiology and outcome of such infections in our part of the world. The point was to provide information about the prevalence and outcome of primary and secondary (nosocomial) infections in ICUs. MATERIAL AND METHODS: 257 adult patients admitted in medical and surgical ICUs over a period of 9 months were enrolled in the study. Patients fulfilling sepsis 3 criteria were categorized under “prevalence of the infections” and patients who developed infections after 48 hours of admission in ICUs were categorized under “secondary (nosocomial) infections”. Sequential Organ Failure Assessment score (SOFA score) was calculated at admission and after 72 hours of ICU stay. The patients were followed for 30 days. RESULTS: Patients were distributed in two groups: 153 (59.5%) medical ICU and 104 surgical ICU patients. Prevalence of primary infection was significantly higher in medical ICU patients (p value < 0.05). A total of 93(60.8%) patients in medical ICU and 50(48.1%) patients in surgical ICU were admitted as primary infections (p value < 0.001). Secondary (nosocomial) infections occurred in 30 (19.6%) patients in medical ICU and 15 (14.4%) patients in surgical ICU (p-value 0.283). The average length of stay was 14 days in patients with nosocomial infections and 3.5 days for patients without secondary infections (p-value < 0.001). Out of total of 188 infected patients, 80 (42.5%) died whereas 17 (24.6%) of the 69 patients without infection expired (p-value 0.008). 112 patients with mean SOFA score of 11.35 ± 2.71 expired while as 145 patients with mean SOFA score of 5.84 ± 1.92 survived (p value < 0.001). CONCLUSIONS: The prevalence of infections was more in medical ICU than in surgical ICU. The nosocomial infections significantly increase the average length of stay in ICUs. Mortality was significantly more in patients admitted with infection in Intensive Care Units. The higher the SOFA score, greater the mortality.

PL

WSTĘP: Zakażenie jest główną przyczyną zachorowalności i śmiertelności na oddziałach intensywnej opieki medycznej (OIOM), zwłaszcza na oddziałach intensywnej opieki medycznej o ograniczonych zasobach w krajach o niskich i średnich dochodach. Jednak stosunkowo niewiele informacji jest dostępnych na temat epidemiologii i skutków takich zakażeń w naszej części świata. Chodziło o dostarczenie informacji na temat częstości występowania i wyników pierwotnych i wtórnych (szpitalnych) zakażeń na OIT. MATERIAŁ I METODY: Do badania włączono 257 dorosłych pacjentów przyjmowanych na OAiIT zachowawcze i chirurgiczne w okresie 9 miesięcy. Pacjentów spełniających kryteria sepsy 3 zakwalifikowano do kategorii „występowanie zakażeń”, a pacjentów, u których doszło do zakażenia po 48 godzinach przyjęcia na OIT, do kategorii „zakażenia wtórne (szpitalne)”. Punktację Sekwencyjnej Oceny Niewydolności Narządów (SOFA) obliczono przy przyjęciu i po 72 godzinach pobytu na OIT. Pacjenci byli obserwowani przez 30 dni. WYNIKI: Pacjenci zostali podzieleni na dwie grupy: 153 (59,5%) na OIT i 104 na OIT chirurgicznie. Częstość występowania pierwotnej infekcji była istotnie wyższa u pacjentów na OIT (wartość p < 0,05). Łącznie 93 (60,8%) pacjentów na OIT i 50 (48,1%) pacjentów na OIOM chirurgicznym zostało przyjętych jako infekcje pierwotne (wartość p < 0,001). Zakażenia wtórne (szpitalne) wystąpiły u 30 (19,6%) pacjentów na OIOM-ie medycznym i 15 (14,4%) pacjentów na OIOM-ie chirurgicznym (wartość p 0,283). Średnia długość pobytu wyniosła 14 dni u pacjentów z zakażeniami szpitalnymi i 3,5 dnia u pacjentów bez zakażeń wtórnych (wartość p < 0,001). Spośród 188 zakażonych pacjentów 80 (42,5%) zmarło, podczas gdy 17 (24,6%) z 69 pacjentów zmarło bez infekcji (wartość p 0,008). 112 pacjentów ze średnią punktacją SOFA 11,35 ± 2,71 zmarło, a przeżyło 145 pacjentów ze średnim wynikiem SOFA 5,84 ± 1,92 (wartość p < 0,001). WNIOSKI: Częstość występowania zakażeń była większa na OIOM-ie medycznym niż na OIOM-ie chirurgicznym. Zakażenia szpitalne istotnie wydłużają przeciętną długość pobytu na OIT. Śmiertelność była istotnie wyższa u pacjentów przyjętych z infekcją na Oddziałach Intensywnej Terapii. Im wyższy wynik SOFA, tym większa śmiertelność.

4

Association of glycosylated hemoglobin with mortality of patients in intensive care unit: a prospective observation study

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Kumar D. S., Wasnik S. B., Yadav A., Yadav R.

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issue 1

24-33

EN

INTRODUCTION: Glycated hemoglobin (HbA1c) is the most commonly used clinical test to estimate mean blood glucose during the past 2 to 3 months. In addition to diagnostic purposes, the HbA1c level also predicts diabetes complications. The aim of this study was to determine the association of glycosylated hemoglobin with mortality in intensive care unit (ICU). MATERIALS AND METHODS: A prospective observational study was conducted in the ICU with a total of 281 patients. These patients were classified into two groups based on their HbA1c levels: one group with HbA1c level < 6.5 % and another group with HbA1c level ≥ 6.5%. The following data were collected during the study period. Clinical details and scores such as the APACHE II score (Acute Physiology and Chronic Health Assessment) and daily SOFA (Sequential Organ Failure Assessment) scores for the period of stay in the ICU. ICU morbidities as the need for mechanical ventilation, the use of inotropes / vasopressors, the length of stay in the ICU, and the requirement of renal replacement therapy (RRT). The outcome measures were ICU mortality and 28-day mortality. RESULTS: Of 281 patients admitted to the ICU for more than 48 hours, 157 patients (55.9%) had HbA1c levels < 6.5%, with the remaining 124 (44.1%) had levels ≥ 6.5%. ICU mortality was present in 107 (38.07%) cases. ICU mortality was higher in patients in the HbA1c ≥ 6.5% group compared to the HbA1c < 6.5% group. This was statistically significant (p-value <0.001). Mortality at 28 days was observed in 125 (44.48%) cases. Patients with an HbA1c value ≥ 6.5%, there was a higher mortality at 28 days compared to patients with an HbA1c value < 6.5%. This was found to be statistically significant (p-value <0.001). CONCLUSIONS: The study showed that glycated hemoglobin levels (HbA1c) levels ≥ 6.5% had a significantly higher mortality rate compared to the patient in the HbA1c level < 6.5%.

5

Omphalocele, Gastroschisis: Epidemiology, Survival, and Mortality in Imam Khomeini Hospital, Ahvaz-Iran

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Askarpour S., Ostadian N., Javaherizadeh H., Chabi S.

Polish Journal of Surgery

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2012

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vol. 84

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issue 2

82-85

EN

Gastroschisis and omphalocele are the most common malformation of the anterior abdominal wall.The aim of the study was to determine the abdominal wall defect frequencies, survival, and mortalities in Ahvaz, Khuzestan province of Iran.Materiał and methods. All cases born with omphalocele or gastroschisis whom born in Imam Khomeini hospital, were included in this study. Duration of study was 3 years from April 2005. All patients treated at Imam Khomeini hospital in Ahwaz, Iran.Results. Among 15321 consecutive births, 42 patients had abdominal wall deformity. Overall incidence was 27.41 per 10,000 live births. Of all cases, 18 (42.9%) of cases were male and 24 (57.1%) were female. Of all cases, 21.7% of patients with omphalocele and 10% patients with gastroschisis had other anomalies. Of all cases, 71.8% of patients with omphalocele and 60% with gastroschisis underwent surgery. The type of anomaly (omphalocele and gastroschisis) had correlation with post operation prognosis significantly (p<0.001). Of 66.7% of patients under went surgery, 46.4% with mesh and 53.6% without mesh performed. 80% of patients with omphalocele and 20% with gastroschisis were lived.Conclusions: In our study, mortality was significantly higher in cases with gastroschisis than cases with omphalocele

6

Evaluating the Prognostic Value of Selected Prognostic Scales in Patients Operated on Due to Peritonitis

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Paduszyńska K., Kaczka K., Dworzyńska A., Sieniawski K., Pomorski L.

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vol. 86

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issue 9

422-428

EN

The aim of the study was to assess the usefulness of prognostic scales: ASA (American Society of Anesthesiologist), MPI (Meinheim Peritonitis Index), MOFS (the Multiple Organ Failure Score) and SPI (the Simple Prognostic Index) in the prognosis of the course of disease in patients operated on for peritonitis. Material and methods. The study was conducted in the Clinical Department of General and Oncological Surgery of the Medical University in Łódź between January 2009 to December 2010. During this period 263 patients were operated on for peritonitis. Before surgery all patients were classifed into particular groups according to the above mentioned prognostic scales according to their criteria. Results. There were 29 (11%) deaths. ASA ≥4 (p<0.0001), MPI >30 (p<0.0001) MOFS ≥2 (p<0.0001), SPI II, III, IV (p<0.0001) were important risk factors of death. Conclusions. 1. ASA, MPI, MOFS and SPI scales are of high signifcance in predicting the outcome in patients operated on for peritonitis. 2. The ASA scale in spite and due to its simplicity is adequate enough to be used in everyday practice in patients operated on for peritonitis. 3. The MPI scale is most suitable in the scientifc aims and in comparing the outcomes of patients operated on for peritonitis.

7

Nutritional predictors of mortality in prevalent peritoneal dialysis patients

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Malgorzewicz S., Chmielewski M., Kaczkan M., Borek P., Lichodziejewska-Niemierko M., Rutkowski B.

Acta Biochimica Polonica

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2016

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vol. 63

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issue 1

111-115

EN

Malnutrition remains one of the major predictors of mortality in peritoneal dialysis (PD) patients. The aim of the study was to evaluate the nutritional status of prevalent PD patients, and to determine the best predictors of outcome among anthropometric and laboratory indices of nutrition. The study included 106 prevalent PD patients from a single university-based unit. Anthropometric assessment at baseline included: body mass, body mass index (BMI), skinfold thickness, lean body mass (LBM), content of body fat (%F), mid-arm muscle circumference (MAMC). Laboratory analysis comprised of albumin and total cholesterol. Additionally, each patient underwent a subjective global assessment (SGA). The patients were followed for 36 months. Survival analyses were made with the Kaplan-Meier survival curve and the Cox proportional hazard model. Following SGA, malnutrition was diagnosed in 30 (28%) patients. Importantly, eight of the malnourished patients (27%) were nevertheless overweight or obese. Body weight and BMI showed complete lack of association with the outcome. In Kaplan-Meier analysis low: LBM, MAMC, albumin and cholesterol were significantly related to mortality. Cox analysis revealed that, following adjustment, LBM below median was independently associated with poor outcome (hazard ratio [HR] 3.15, 95% confidence interval [CI] 1.17-8.49, p=0.02). Moreover, the lowest quartile of total cholesterol showed independent association with mortality (HR 8.68, CI 2.14-35.21, p<0.01). Malnutrition is prevalent in patients undergoing PD, and overweight/obesity does not preclude its appearance. The most valuable nutritional indices in predicting outcome in this cohort were LBM and total cholesterol concentration.

8

The usefulness of the Mannheim Peritonitis index score in assessing the condition of patients treated for peritonitis

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Budzyński P., Dworak J., Natkaniec M., Pędziwiatr M., Major P., Migaczewski M., Matłok M., Budzyński A.

Polish Journal of Surgery

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2015

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vol. 87

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issue 6

301-306

EN

The aim of the study was to verify the Mannheim Peritonitis Index (MPI) suitability to determine the probability of death among patients in Polish population operated due to peritonitis and to assess the possibility of using the Index to determine the risk of postoperative complications, relaparotomy and need for postoperative hospitalization in intensive care unit. Material and methods. Retrospective analysis covered 168 patients (M: F = 83: 85, mean age = 48.45 years, SD ± 22.2) treated for peritonitis. The MPI score was calculated for each patient. According to MPI results, patients were divided to the appropriate groups (<21, 21‑29, > 29) and within analyzed. The statistical analysis used Chi-square, Mann Withney U and Kolmogorov-Smirnov test. The best cut-off point for MPI was calculated on the basis of ROC analisys. Results. Mortality in the study group was 13.1%. In groups <21, 21‑29 and > 29 points according to MPI mortality was 1.75%, 28.13% and 50% respectively, the difference was statistically significant (p = 0.0124). Significant differences were observed in mortality depending on the diagnosis. Based on the ROC curve the cut-off point was identified as 32 with an accuracy of 85.9% and AUC = 81%. There has been a significant correlation between the MPI count and and the occurrence of: cardio-respiratory failure, acidosis, electrolyte imbalance, surgical wound complications, the need for treatment in the intensive care unit after surgery. Conclusions. The MPI is a simple and effective predictor of death among patients operated due to peritonitis. It can also provide assistance in assessing the risk of postoperative complications and the need for treatment in the intensive care unit.

9

Serum levels of the S100B protein and neuron-specific enolase are associated with mortality in critically ill patients

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Duda I., Krzych Ł., Jędrzejowska-Szypułka H., Lewin-Kowalik J.

Acta Biochimica Polonica

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2017

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vol. 64

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issue 4

647-652

EN

Introduction. Evaluation of the prognostic potential of the S100B protein and neuron-specific enolase (NSE) as predictors of mortality in critically ill patients in intensive care units (ICU). Materials and Methods. The study was conducted on 62 patients. Basic clinical variables and blood samples for S100B and NSE level testing were obtained during the first four days after admission. Mortality was described as the patient's death during hospitalization in the ICU. Results. 35% of the patients had died. The level of S100B and NSE was significantly higher in non-survivors in comparison with survivors (p=0.007 and p=0.02, respectively). Mortality risk was significantly higher in patients with higher levels of biomarkers than the reference values for S100B (OR 9.00; 95% CI 2.38-33.99; p<0.001) as well as for NSE (OR 5.75; 95%CI 1.31-25.27; p=0.016). Receiver operating characteristic proved that S100B is a better mortality predictor than NSE (AUC 0.76 for S100B and 0.68 for NSE). From all the other variables, the Apache II score turned out to be the only significant predictor of mortality (AUC 0.88). Conclusion. There is a significant correlation between mortality in the ICU and increased serum concentration of S100B and NSE. This correlation is stronger for S100B. Testing for serum levels of S100B and NSE may be useful for prediction of treatment outcomes in the ICU patients.

10

Correlation of vitamin D deficiency with mortality in critically ill patients admitted to the intensive care unit

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Joshi V. M., Wasnik S. B., Yadav A., Yadav R.

|

EN

INTRODUCTION: Vitamin D, which is a fat-soluble vitamin, plays a key role in enhancing the intestinal absorption of calcium, magnesium and phosphate. In severely ill patients, vitamin D can adversely affect immune and metabolic functions, contributing to poorer outcomes. The aim of this study was to correlate vitamin D with mortality in critically ill patients. MATERIALS AND METHODS: prospective observational study was conducted, involving 162 patients in an intensive care unit (ICU). 162 patients were divided into two groups according to vitamin D Deficiency Group levels ≤ 20 ng/ml and Non vitamin D deficiency group levels <20 ng / ml and non-vitamin D deficiency group B levels > 20ng/ml. Data collected during the study included the APACHE II (acute physiology and chronic health evaluation) score at ICU admission, SOFA (sequential organ failure assessment) scores throughout the ICU stay, the need for mechanical ventilation, inotropic support, length of stay in ICU, and ICU outcomes, which were classified as either discharge or mortality. RESULTS: Of the 162 patient admitted to ICU, the prevalence of vitamin D deficiency in this study was 140 (86.4%) and nondeficient 22 (13.6%). The mortality rate in the vitamin D deficient group was 40% compared to 18.18% in the nondeficient group. The difference in mortality in both groups for mortality was statistically significant (p-value < 0.05). Vitamin D deficiency was not associated as an independent risk factor for ICU mortality [Odds ratio (OR) 1.220, 95% CI (0.825- 1.805) (p-value -0.320)]. CONCLUSIONS: The vitamin D-deficient group had a significantly higher mortality rate compared to the patient in the nondeficient group. But vitamin D deficiency was not found to be an independent risk factor for mortality.

11

The 30-day mortality predictor role of c-reactive protein/albumin ratio in critically ill COPD patients

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Cırık M. Ö., Baldemir R., Doğanay G. E., Ünver M., Avcı S.

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XX

INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that develops due to inflammation in the airways. The aim of this study is to demonstrate the effectiveness of c-reactive protein/albumin ratio (CAR) as a 30-day mortality indicator in COPD patients admitted to ICU. MATERIAL AND METHODS: A total of 235 COPD patients with available data between January 2018 and December 2018 were included in this retrospective cohort study. Demographics, APACHE II, Charlson comorbidity index (CCI), SOFA score, CAR and outcomes were evaluated. RESULTS: 87 (37%) of the cases were female and 148 (63%) were male. Their ages ranged from 26 to 95 years, with an average of 70.9± 11.4. The non-survivors had significantly higher APACHE II, CCI, SOFA score, procalcitonin, creatinine, mechanical ventilation (MV) time, WBC, CRP and CAR compared to the survivors (p˂0.05). Albumin and prealbumin were significantly lower (p˂0.05) in non-survivors. In the univariate model; age, sepsis, inotropic support, APACHE II score, CCI, SOFA, procalcitonin, creatinine, MV time, WBC, CRP, albumin, prealbumin and CAR were observed to be significantly effective (p˂0.05) in predicting 30-day mortality. In the multivariate reduced model; inotropic support, SOFA, WBC and prealbumin value exhibited significant independent (p<0.05) effectiveness in predicting 30-day mortality. Albumin, CRP, CAR, APACHE II, SOFA and CCI value were observed to be significant in predicting mortality (p=0.000). CONCLUSIONS: In the study, the predictive power of APACHE II score, CCI, SOFA score, albumin and prealbumin values alone was found to be significantly higher than that of the CAR.

12

1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results

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Krawczyk M., Grąt M., Barski K., Ligocka J., Antczak A., Kornasiewicz O., Skalski M., Patkowski W., Nyckowski P., Zieniewicz K., Grzelak I., Pawlak J., Alsharabi A., Wróblewski T., Paluszkiewicz R., Najnigier B., Dudek K., Remiszewski P., Smoter P., Grodzicki M., Korba M., Kotulski M., Cieślak B., Kalinowski P., Gierej P., Frączek M., Rdzanek Ł., Stankiewicz R., Kobryń K., Nazarewski Ł., Leonowicz D., Urban-Lechowicz M., Skwarek A., Giercuszkiewicz D., Paczkowska A., Piwowarska J., Gelo R., Andruszkiewicz P., Brudkowska A., Andrzejewska R., Niewiński G., Kilińska B., Zarzycka A., Nowak R., Kosiński C., Korta T., Ołdakowska-Jedynak U., Sańko-Resmer J., Foroncewicz B., Ziółkowski J., Mucha K., Senatorski G., Pączek L., Habior A., Lechowicz R., Polański S., Leowska E., Pacho R., Andrzejewska M., Rowiński O., Kozieł S., Żurakowski J., Ziarkiewicz-Wróblewska B., Górnicka B., Hevelke P., Michałowicz B., Karwowski A., Szczerbań J.

Polish Journal of Surgery

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2012

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vol. 84

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issue 6

304-312

EN

The aim of the study was to analyze indications and results of the first one thousand liver transplantations at Chair and Clinic of General, Transplantation and Liver Surgery, Medical University of Warsaw.Material and methods. Data from 1000 transplantations (944 patients) performed at Chair and Clinic of General, Transplantation and Liver Surgery between 1994 and 2011 were analyzed retrospectively. These included 943 first transplantations and 55 retransplantations and 2 re-retransplantations. Frequency of particular indications for first transplantation and retransplantations was established. Perioperative mortality was defined as death within 30 days after the transplantation. Kaplan-Meier survival analysis was used to estimate 5-year patient and graft survival.Results. The most common indications for first transplantation included: liver failure caused by hepatitis C infection (27.8%) and hepatitis B infection (18%) and alcoholic liver disease (17.7%). Early (< 6 months) and late (> 6 months) retransplantations were dominated by hepatic artery thrombosis (54.3%) and recurrence of the underlying disease (45%). Perioperative mortality rate was 8.9% for first transplantations and 34.5% for retransplantations. Five-year patient and graft survival rate was 74.3% and 71%, respectively, after first transplantations and 54.7% and 52.9%, respectively, after retransplantations.Conclusions. Development of liver transplantation program provided more than 1000 transplantations and excellent long-term results. Liver failure caused by hepatitis C and B infections remains the most common cause of liver transplantation and structure of other indications is consistent with European data.

13

An analysis of causes of trauma, spectrum of injuries and treatment outcomes in patients treated at Multitrauma Centre of the University Teaching Hospital No 1 in Szczecin in 2015. Comparison of results from years 2015 and 2007

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Dziubiński D., Abramczyk U., Ciechanowicz D., Kozłowski J., Pakulski C., Żyluk A.

Polish Journal of Surgery

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2019

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vol. 91(4)

29-35

EN

Introduction: Multitrauma is defined as injury involving two or more different body parts, with a condition that at least one of these injuries is life-threatening. They represent serious traumas, requiring treatment in the intensive care units and frequently surgical intervention. Aim: The objective of this study was epidemiological and clinical analysis of patients treated in 2015 year in Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, and comparison the results with outcomes of similar study conducted in the same Centre in 2007 year. Material: Clinical material comprised medical notes of 82 patients, 52 men (63%) and 30 women (37%), with a mean age of 44 years, who sustained multitrauma injuries. An analysis included causes of traumas, spectrum of injuries, involvement of body parts, methods and outcomes of the treatment. Results: The most common cause of multitrauma was traffic accident – 45 cases (55%), followed by fall from height – 22 (27%) and other mechanism – 15 (18%). The most frequent component of multitrauma made bone fractures (spine, pelvis, limbs) – 64 cases (78%), followed by head traumas – 63 (77%), chest – 53 (65%) and abdominal 30 (36%) injuries. A total of 48 patients (58%) required surgical intervention, the most frequently fixation of bone fractures – 24 patients (29%), repair of abdominal and head injuries – 18 (22%) either. Of 82 treated patients 64 (78%) survived and 18 (22%) died. A mean period of stay in Multitrauma Centre was 23 days for survived patients and 17 days for those who died. Comparing to similar analysis conducted 8 years earlier, a change in involvement of particular body parts comprising multitrauma injury was observed: number of head injuries increased of 14%, number of chest traumas and bone fractures decreased of 21% and 11%, respectively. The survival rate improved of 10%.

14

Lactate / albumin ratio as prognostic tool for risk stratification in septic patients admitted to ICU

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Mourya V., Gupta R., Yadav A., Yadav R.

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EN

INTRODUCTION: Sepsis stands as the primary cause behind intensive care unit (ICU) admissions. The most critical parameters in sepsis management have been shown to be early recognition. Management delays have been associated with increased mortality and morbidity The aim of this study is to study the lactate/albumin (L/A) ratio as prognostic tool for risk stratification in septic patients admitted to ICU. MATERIALS AND METHODS: This prospective observational study was conducted with100 patients. Admitted in ICU with sepsis and septic shock were studied. Serum lactate/albumin ratio was calculated at the time of admission. Apache 2 and SOFA score was calculated at admission. All patients received initial treatment according standard protocol. All patients were followed up till discharge. An adverse outcome in terms of in hospital mortality, length of ICU stays and inotropic support was used in this study. RESULTS: Lactate/albumin ratio >1.5(AUC 0.89) correctly predicted in-hospital mortality among 27% patients with sensitivity and specificity of 90% and 78.6% respectively (p value =0.001). Lactate/albumin ratio <1.50 (AUC 0.73) correctly predicted length of ICU stays <72 hours among 17% patients with sensitivity and specificity of 85% and 58.8% respectively (p value =0.001). Lactate/albumin ratio >1.50 (AUC 0.91) correctly predicted requiring inotropic support among 36% patients with sensitivity and specificity of 83.7% and 89.5% respectively (p value =0.001). CONCLUSIONS: We concluded that lactate/albumin ratio was a stronger parameter than lactate, albumin, APACHE score and SOFA alone in predicting mortality, length of ICU stay and requiring noradrenaline inotropic support among sepsis patients in the ICU.

15

Risk factors of 30-day mortality following surgery for colorectal cance

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Mik M., Dziki Ł., Trzciński R., Dziki A.

Polish Journal of Surgery

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2016

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vol. 88(1)

26-31

EN

The 30-day mortality is one of the factors reflecting the quality of treatment. All these efforts focused on decreasing 30-day mortality will directly improve quality of care. The aim of the study was to identify risk factors of 30-day postoperative mortality in a cohort of patients operated on for colorectal cancer in one tertiary colorectal centre. Material and methods. Patients operated on due to colorectal cancer (CRC) between 2008 and 2014 were included in the study. 30-day mortality was assessed as an endpoint of the retrospective study. All records were collected from prospective database. Results. 1744 patients were operated on due to CRC. The 30-day mortality was noted in 65 patients (3.5%). In multivariable analyses we revealed that spread disease and poor general condition at admission were risk factors of 30-day mortality: OR 2.35; 2.01‑2.57 95%CI, p=0.03 and OR 2.18; 1.95‑2.41 95% CI; p=0.01, respectively. Emergency surgery significantly increased the risk of 30-day mortality: OR 2.64; 2.45‑2.87 95%CI; p=0.009. Low serum albumin concentration level and diabetes mellitus were additional risk factors for 30-day mortality, OR 1.65; 1.52‑1.78 95%CI; p=0.01 and OR 1.67; 1.41‑1.82 95%CI; p=0.03, respectively. Mortality was significantly higher after resection procedures than after only palliative operations: 4.21% vs 1.57%; p=0.002. Conclusions. Emergent patients, patients with advanced disease and in poor general state have to be assessed by multidisciplinary team to prepare them to operation. Additionally to reduce the risk of 30-day mortality decision of extend of surgery should be made by experienced surgeons.

16

Trefoil factor 3 as a marker of intestinal cell damage during sepsis

88%

Žurek J., Kýr M., Vavřina M., Fedora M.

Open Medicine

|

2014

|

vol. 10

|

issue 1

EN

Objective: Gastrointestinal dysfunction or gut failure frequently occurs in seriously ill patients and can be responsible for multi-organ failure. Trefoil factor 3 (TFF3) was characterized for its role in reconstitution of an epithelial barrier after mucosal injury in the jejunum. The aims of our study was an analysis of TFF3 levels dynamics in patients with sepsis and the correlation of TFF3 with severity of sepsis and mortality. Methods: Prospective observational study, a ten days evaluation period in children aged 0-19 years with systemic inflammatory response syndrome or septic state. Blood tests to determine levels of TFF3 were obtained as long as the patient met the criteria for systemic inflammatory response syndrome or sepsis. Results: Analysis of dynamics revealed steady levels of TFF3 during the 10 day period evaluated. TFF3 levels could not differentiate between various septic conditions in patients until a marked organ dysfunction developed. Higher Area Under Curve was noticed between control group and patients with sepsis. We could not make any strong conclusions based on mortality model. Conclusions: Levels of TFF3 are elevated in paediatric patients with sepsis through organ dysfunction.

17

Breast cancer incidence and mortality in Lower Silesia (Poland) between 1984 and 2003 - trends and perspectives

88%

Bębenek M., Pudełko M., Błaszczyk J.

Open Medicine

|

2007

|

vol. 2

|

issue 2

208-215

EN

The purpose of the study was to determine the epidemiological characteristics of breast cancers diagnosed among Lower Silesian women between 1984 and 2003. Data from the Lower Silesian Cancer Registry on the incidence and mortality of breast neoplasms in the Lower Silesian province were analyzed. The annual number of breast cancers and cancer-related deaths increased markedly between 1984 and 2003. The non-standardized coefficients of incidence in the large cities of Wroclaw, Legnica, and Walbrzych were markedly higher than in the other counties of the province. The number of tumors detected with diameters ≤5 cm increased from 57% in 1984 to 81% in 2003. The increasing incidence of breast cancer seemed to be mostly related to the socioeconomic characteristics of Lower Silesian women. Although a down-staging due to better care reflects some positive trends, the outlook for breast cancer in Lower Silesia remains unfavorable.

18

TERMITICIDAL ACTIVITY OF CHITOSAN ON PAPER

88%

Muryeti M., Pratiwi F. E., Yuniastuti R. T., Mulyani E. B.

Progress on Chemistry and Application of Chitin and its Derivatives

|

2020

|

vol. 25

164 - 173

EN

Termites are insects that can damage buildings, paper and plants. Termites are controlled by using termiticides (chemicals). Besides polluting the environment, termiticides may have harmful effects to organisms, including humans, and destroy metal. The use of chemicals will be environmentally and economically profitless. A joint effort to utilize biodegradable material will help to reduce the negative impacts of termiticides. One of the materials that can use to control termites is chitosan. The purpose of this study was to determine the termiticidal activity of chitosan on paper against termites. The termiticidal activity test followed method JIS K 1571 2004. The resistance of paper to termite damage was determined by calculating the percentage of weight loss and termite mortality rate. The following concentrations of chitosan in acetic acid were used: 0.5%, 1%, 1.5% and 2%. The test result showed that weight loss percentages were 20.49%, 16.37%, 15.77% and 10.80%, respectively. On the other hand, the weight loss percentage of paper without chitosan was 32.69%, which shows that termites do not favour chitosan used in the paper. The activity of termites was successfully inhibited when the concentration of chitosan was increased, and the percentage of paper weight loss decreased from 10.80% to 20.49%. Paper without chitosan had a termite mortality rate of 18.3%; The addition of chitosan increased termite mortality to 28.2%–30.4%. The percentage of weight loss decreased with increasing termite mortality. The termite mortality rate show that chitosan is nontoxic and potential as biotermiticide for paper.

19

The level of fecal calprotectin significantly correlates with Clostridium difficile infection severity

88%

Dróżdż M., Biesiada G., Pituch H., Wultańska D., Obuch-Woszczatyński P., Piotrowski M., Kędzierska J., Michalak M., Garlicki A., Czepiel J., Dróżdż M., Biesiada G., Pituch H., Wultańska D., Obuch-Woszczatyński P., Piotrowski M., Kędzierska J., Michalak M., Garlicki A., Czepiel J.

Folia Medica Cracoviensia

|

2019

|

vol. 59

|

issue 3

20

Risk of complications and 30-day mortality after laparoscopic and open appendectomy in a Danish region, 1998-2007; a population-based study of 18,426 patients

88%

Bregendahl S., Nørgaard M., Laurberg S., Jepsen P.

Polish Journal of Surgery

|

2013

|

vol. 85

|

issue 7

395-400

EN

Acute appendicitis is the most common abdominal surgical emergency, but population-based data on the risk of complications after laparoscopic appendectomy (LA) and open appendectomy (OA) are scarce. The aim of the study was to describe the risk of complications and mortality after appendectomy for acute appendicitis during a 10-year period, and to compare outcomes after LA and OA. Material and methods. Using population-based registry data, we conducted a historical cohort study in a Danish region (population 2,000,000) including all patients who underwent appendectomy for acute appendicitis during the period of 1998-2007. We used logistic regression to compare the risk of complications and 30-day mortality between LA and OA, adjusting for gender, age, severity of appendicitis, time of surgery, and calendar year. Analyses were stratified for severity of appendicitis and time period. Results. We included 18,426 patients. From 1998 to 2007 the use of LA rose from 12% to 61%, while the risk of surgically-treated complications fell from 5.7% to 3.2%, the risk of intra-abdominal infections fell from 2.4% to 1.1% and 30-day mortality fell from 0.30% to 0.23%. LA was associated with a lower risk of surgically-treated complications (adjusted odds ratio for LA vs. OA=0.70 (95% CI, 0.57-0.85), intraabdominal infections (OR=0.74 [95% CI, 0.55-0.99]) and mortality (OR=0.48 [95% CI, 0.18-1.30]). LA was safer than OA for simple and complicated appendicitis throughout the study period. Conclusions. Risk of complications and 30-day mortality decreased in Denmark between 1998 and 2007 concurrently with implementation of LA. The risk of complications was lower after LA than after OA

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Trefoil factor 3 as a marker of intestinal cell damage during sepsis

Breast cancer incidence and mortality in Lower Silesia (Poland) between 1984 and 2003 - trends and perspectives

TERMITICIDAL ACTIVITY OF CHITOSAN ON PAPER

The level of fecal calprotectin significantly correlates with Clostridium difficile infection severity

Risk of complications and 30-day mortality after laparoscopic and open appendectomy in a Danish region, 1998-2007; a population-based study of 18,426 patients