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Association Between Body Weight Variation and Survival and Other Adverse Events in Critically Ill Patients With Shock: A Multicenter Cohort Study of the OUTCOMEREA Network.
Gros, Antoine; Dupuis, Claire; Ruckly, Stéphane; Lautrette, Alexandre; Garrouste-Orgeas, Maité; Gainnier, Marc; Forel, Jean-Marie; Marcotte, Guillaume; Azoulay, Elie; Cohen, Yves; Schwebel, Carole; Argaud, Laurent; de Montmollin, Etienne; Siami, Shidasp; Goldgran-Toledano, Dany; Darmon, Michael; Timsit, Jean-Francois.
Afiliación
  • Gros A; Medical-Surgical Intensive Care Unit, André Mignot Hospital, Le Chesnay, France.
  • Dupuis C; UMR 1137 - IAME Team 5 - DeSCID: Decision SCiences in Infectious Diseases, control and care Inserm/University Paris Diderot, Sorbonne Paris Cité, Paris, France.
  • Ruckly S; Medical Intensive Care Unit, Bichat University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.
  • Lautrette A; ICU REsearch, Department of Biostatistics, Paris, France.
  • Garrouste-Orgeas M; Medical-Surgical Intensive Care Unit, Gabriel Montpied University hospital, Clermont-Ferrand, France.
  • Gainnier M; UMR 1137 - IAME Team 5 - DeSCID: Decision SCiences in Infectious Diseases, control and care Inserm/University Paris Diderot, Sorbonne Paris Cité, Paris, France.
  • Forel JM; French British Hospital Institute, Medical Unit, Levallois-Perret, France.
  • Marcotte G; Intensive Care Unit, La Timone University Hospital, Assistance Publique des Hôpitaux de Marseilles (AP-HM), Marseilles, France.
  • Azoulay E; Intensive care unit, Hôpital Nord University Hospital, Assistance Publique des Hôpitaux de Marseilles (AP-HM), Marseilles, France.
  • Cohen Y; Intensive care Unit, Edouard Herriot University Hospital, Lyon, France.
  • Schwebel C; Medical Intensive Care Unit, Saint-Louis University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.
  • Argaud L; Medical-Surgical Intensive Care Unit, Avicenne University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Bobigny, France.
  • de Montmollin E; Polyvalent ICU, Grenoble University Hospital, Pavillon Dauphine, Grenoble, France.
  • Siami S; Intensive care Unit, Edouard Herriot University Hospital, Lyon, France.
  • Goldgran-Toledano D; UMR 1137 - IAME Team 5 - DeSCID: Decision SCiences in Infectious Diseases, control and care Inserm/University Paris Diderot, Sorbonne Paris Cité, Paris, France.
  • Darmon M; Polyvalent ICU, Delafontaine Hospital, Saint-Denis, France.
  • Timsit JF; Polyvalent ICU, Centre Hospitalier Sud Essonne Dourdan-Etampes-Siège, Etampes, France.
Crit Care Med ; 46(10): e981-e987, 2018 10.
Article en En | MEDLINE | ID: mdl-30059364
OBJECTIVES: This study in critically ill patients with shock assessed the prognostic value of body weight variations occurring each day from day 3 to day 7 on the 30-day outcome in terms of mortality, occurrence of ventilator-associated pneumonia and of bedsore, and occurrence of length of stay. DESIGN: Retrospective analysis of data. Multivariate subdistribution survival models were used at each day, from day 3 to day 7. The impact of body weight variations on length of stay was estimated through a multivariate negative binomial regression model. SETTING: Prospective multicenter cohort study. PATIENTS: Critically ill patients admitted in ICU with shock and requiring mechanical ventilation within 48 hours. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Two-thousand three-hundred seventy-four patients were included. Their median body weight variations increased from 0.4 kg (interquartile range, 0-4.8 kg) on day 3 to 3 kg (interquartile range, -0.4 to 8.2 kg) on day 7. Categories of body weight variations were defined depending on body weight variations interquartiles: weight loss, no weight gain, moderate and severe weight gain. A severe weight gain tended to be associated with death at days 5 and 6 (day 5: subdistribution hazard ratio, 1.27; 95% CI, 0.99-1.63; p = 0.06 and day 6: subdistribution hazard ratio, 1.43; 95% CI, 1.08-1.89; p = 0.01), a weight loss tended to be associated with bedsore, and a severe gain between at days 5 and 6 was associated with ventilator-associated pneumonia. Any body weight variations were associated with an increased length of stay. CONCLUSIONS: In survivors at day 3, body weight variations during the first days of ICU stay might be a clinically relevant tool to prevent weight gain but also for prognostication of 30-day mortality, occurrence of ventilator-associated pneumonia, and occurrence of prolonged ICU stay.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Choque Séptico / Peso Corporal / Enfermedad Crítica / Sobrevivientes Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Crit Care Med Año: 2018 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Choque Séptico / Peso Corporal / Enfermedad Crítica / Sobrevivientes Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Crit Care Med Año: 2018 Tipo del documento: Article País de afiliación: Francia