Journal of critical care
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Journal of critical care · Feb 2024
Impact of missing values on the ability of the acute physiology and chronic health evaluation III and Japan risk of death models to predict mortality.
This study assessed model performance of the Acute Physiology and Chronic Health Evaluation (APACHE) III and Japan Risk of Death (JROD) when degraded by the number and category of missing variables. We also examined the impact of missing data on predicted mortality for facilities with missing physiological variables. ⋯ An increased number of missing physiological variables resulted in falsely low predicted mortality rates and high SMRs.
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Journal of critical care · Feb 2024
Comment Letter Multicenter Study Observational StudyLetters to editor: "Association of plasma volume status with outcomes in hospitalized Covid-19 ARDS patients: A retrospective multicenter observational study".
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Journal of critical care · Feb 2024
Previously healthy adults among septic patients: Population-level epidemiology and outcomes.
Previously healthy adults with community-onset sepsis were recently reported to have, counterintuitively, higher short-term mortality than those with comorbid conditions. However, the population-level generalizability of this finding and its applicability to all hospitalized septic patients are unclear. ⋯ Previously healthy septic patients had lower short-term mortality compared to those with comorbid conditions.
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Journal of critical care · Feb 2024
LetterA modified Gamblegram for the visual representation of acid-base disorders according to the Stewart-Figge approach.
The Gamblegram consists of two bars, each of which represents the sum of the charges of individual positively and negatively charged ions and is commonly used for visualizing changes in acid-base and electrolyte charges. However, according to the Stewart-Figge theory, the metabolic independent acid-base variables include the strong ion difference ([SID]) and the total concentrations of weak acids (albumin and inorganic phosphate), which are not shown in the conventional Gamblegram. ⋯ To overcome this problem the following modifications are proposed: 1) The positive bar is represented exclusively by strong ion difference ([SID]) 2) The negative bar is comprised of [HCO3̄], unmeasured ion charge ([X]) and albumin and inorganic phosphate charges which are considered proportional to their total concentrations assuming a standard pH of 7.4 (0.28⋅[Albumin] (g/l) and 1.8⋅[Phosphate] (mmol/l), respectively). The proposed method treats [HCO3̄] as a global index of the metabolic acid-base status, whose concentration is expressed as a function of the Stewart-Figge independent acid-base variables ([SID], [Albumin], [Phosphate] and [X]).