Systematic comparison of routine laboratory measurements with in-hospital mortality: ICU-Labome, a large cohort study of critically ill patients

Clinical Chemistry and Laboratory Medicine : CCLM
Edris M AlkozaiMaarten W Nijsten

Abstract

In intensive care unit (ICU) patients, many laboratory measurements can be deranged when compared with the standard reference interval (RI). The assumption that larger derangements are associated with worse outcome may not always be correct. The ICU-Labome study systematically evaluated the univariate association of routine laboratory measurements with outcome. We studied the 35 most frequent blood-based measurements in adults admitted ≥6 h to our ICU between 1992 and 2013. Measurements were from the first 14 ICU days and before ICU admission. Various metrics, including variability, were related with hospital survival. ICU- based RIs were derived from measurements obtained at ICU discharge in patients who were not readmitted to the ICU and survived for >1 year. In 49,464 patients (cardiothoracic surgery 43%), we assessed >20·106 measurements. ICU readmissions, in-hospital and 1-year mortality were 13%, 14% and 19%, respectively. On ICU admission, lactate had the strongest relation with hospital mortality. Variability was independently related with hospital mortality in 30 of 35 measurements, and 16 of 35 measurements displayed a U-shaped outcome-relation. Medians of 14 of 35 ICU-based ranges were outside the standard RI. Remark...Continue Reading

References

Aug 1, 1992·Scandinavian Journal of Gastroenterology·H KobayashiH Takagi
Jan 1, 1991·European Journal of Applied Physiology and Occupational Physiology·J B HansenB Osterud
Oct 1, 1995·Critical Care Medicine·J C MarshallW J Sibbald
Dec 22, 1999·International Journal of Epidemiology·P RoystonW Sauerbrei
Sep 21, 2001·Critical Reviews in Clinical Laboratory Sciences·J B Whitfield
Jan 27, 2004·The Annals of Pharmacotherapy·Grant E Sklar, Malar Subramaniam
Nov 11, 2006·Arteriosclerosis, Thrombosis, and Vascular Biology·Douglas S LeeRamachandran S Vasan
May 15, 2007·The Journal of Trauma·Johanna M M NijboerMaarten W N Nijsten
Jul 8, 2008·Clinical Chemistry and Laboratory Medicine : CCLM·Axel StachonMichael Krieg
Jul 19, 2008·The New England Journal of Medicine·Kennon J Heard
Mar 27, 2013·Critical Care Medicine·Brian W PickeringMark T Keegan
May 15, 2013·Annals of Intensive Care·Jan BakkerTim C Jansen
Jun 19, 2013·Critical Care : the Official Journal of the Critical Care Forum·Simon FinferTom Van Herpe
Apr 8, 2014·Journal of Critical Care·Lot Van de MoortelJoris Delanghe
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
Mar 18, 2016·Annals of Intensive Care·Annemieke Oude Lansink-HartgringMaarten W Nijsten
Aug 16, 2016·Critical Care : the Official Journal of the Critical Care Forum·Jean-Louis VincentFabio S Taccone

❮ Previous
Next ❯

Citations

Jun 4, 2019·Journal of Hepatology·Christian de TymowskiUNKNOWN PRONOBURN group

❮ Previous
Next ❯

Methods Mentioned

BETA
Transfection

Software Mentioned

Powerpoint
SPSS
Excel

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.