Raising concerns about the Sepsis-3 definitions.
*Data Accuracy; *Infections; *Organ dysfunction; *Sepsis; *Septic shock; *Severity of Illness Index; Arterial Pressure; Consensus; Glasgow Coma Scale; Humans; Infection; Organ Dysfunction Scores; Publishing; Sensitivity and Specificity; Sepsis; Sepsis/*classification/mortality; Validation Studies
The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.
Sartelli Massimo; Kluger Yoram; Ansaloni Luca; Hardcastle Timothy C; Rello Jordi; Watkins Richard R; Bassetti Matteo; Giamarellou Eleni; Coccolini Federico; Abu-Zidan Fikri M; Adesunkanmi Abdulrashid K; Augustin Goran; Baiocchi Gian L; Bala Miklosh; Baraket Oussema; Beltran Marcelo A; Jusoh Asri Che; Demetrashvili Zaza; De Simone Belinda; de Souza Hamilton P; Cui Yunfeng; Davies R Justin; Dhingra Sameer; Diaz Jose J; Di Saverio Salomone; Dogjani Agron; Elmangory Mutasim M; Enani Mushira A; Ferrada Paula; Fraga Gustavo P; Frattima Sabrina; Ghnnam Wagih; Gomes Carlos A; Kanj Souha S; Karamarkovic Aleksandar; Kenig Jakub; Khamis Faryal; Khokha Vladimir; Koike Kaoru; Kok Kenneth Y Y; Isik Arda; Labricciosa Francesco M; Latifi Rifat; Lee Jae G; Litvin Andrey; Machain Gustavo M; Manzano-Nunez Ramiro; Major Piotr; Marwah Sanjay; McFarlane Michael; Memish Ziad A; Mesina Cristian; Moore Ernest E; Moore Frederick A; Naidoo Noel; Negoi Ionut; Ofori-Asenso Richard; Olaoye Iyiade; Ordonez Carlos A; Ouadii Mouaqit; Paolillo Ciro; Picetti Edoardo; Pintar Tadeja; Ponce-de-Leon Alfredo; Pupelis Guntars; Reis Tarcisio; Sakakushev Boris; Kafil Hossein Samadi; Sato Norio; Shah Jay N; Siribumrungwong Boonying; Talving Peep; Trana Cristian; Ulrych Jan; Yuan Kuo-Ching; Catena Fausto
World journal of emergency surgery : WJES
2018
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s13017-018-0165-6" target="_blank" rel="noreferrer noopener">10.1186/s13017-018-0165-6</a>
Prolonged Clostridium difficile Infection May Be Associated With Vitamin D Deficiency.
*adult; *gastroenterology; *immunonutrition; *life cycle; *nutrition; *research and diseases; *sepsis; *vitamins; 80 and over; 80 and Over; Aged; Clostridium Infections – Etiology; Clostridium Infections – Mortality; Clostridium Infections – Physiopathology; Clostridium Infections/*etiology/mortality/physiopathology; Diarrhea – Microbiology; Diarrhea – Physiopathology; Diarrhea/microbiology/physiopathology; Female; Humans; Iatrogenic Disease – Epidemiology; Iatrogenic Disease/epidemiology; Length of Stay; Male; Middle Age; Middle Aged; Nutritional Status; Psychological Tests; Recurrence; Retrospective Design; Retrospective Studies; Sepsis – Epidemiology; Sepsis/epidemiology; Severity of Illness Index; Severity of Illness Indices; Vitamin D; Vitamin D – Blood; Vitamin D Deficiency – Blood; Vitamin D Deficiency – Complications; Vitamin D Deficiency/blood/*complications; Vitamin D/analogs & derivatives/blood
BACKGROUND: Clostridium difficile infection (CDI) is one of the leading causes of hospital-acquired infections, creating a financial burden for the U.S. healthcare system. Reports suggest that vitamin D-deficient CDI patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. The objective here was to evaluate the relationship between vitamin D level and CDI recurrence. MATERIALS AND METHODS: A retrospective chart review was conducted for 112 patients with vitamin D level drawn within 3 months of CDI diagnosis. Recurrence, severity of disease, 30-day mortality, and course of CDI were assessed. RESULTS: The vitamin D-deficient group included 56 patients, and the normal group included 56 patients. The mean age of vitamin D-deficient and -sufficient groups was 68 +/- 15.7 and 71 +/- 14.4 years, respectively. The mean 25(OH) D level in the deficient group was 11.7 +/- 4.6 ng/mL, and it was 36.2 +/- 16.2 ng/mL in the normal group. A longer course of diarrhea was apparent in the vitamin D-deficient group compared to the normal group: 6.1 days (95% confidence interval [CI], 4.9-7.2) vs 4.2 days (95% CI, 3.5-4.9; P = .01). Sepsis rate was 24% in vitamin D-deficient group and 13% in normal group (P = .03). There were no differences in CDI recurrence, length of stay, severity of illness, and mortality with respect to vitamin D status. CONCLUSION: There may be an association between course of diarrhea and increased rate of sepsis in vitamin D-deficient CDI patients.
Wong Ken Koon; Lee Rebecca; Watkins Richard R; Haller Nairmeen A
JPEN. Journal of parenteral and enteral nutrition
2016
2016-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0148607114568121" target="_blank" rel="noreferrer noopener">10.1177/0148607114568121</a>