Online ISSN: 2515-8260

Keywords : SOFA score

Comparison of serum magnesium levels and sequential organ failure assessment score in patients with systemic inflammatory response syndrome

Pranav Ravi Kulkarni, Ashok Raja, Ramkumar Murali, Jagadeesan Mohanan*, Prasanna Karthik Suthakaran, Kannan Rajendran, Mageshkumar Sivanesan, Damodharan Jayachandran

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 802-809

Systemic Inflammatory Response Syndrome (SIRS) is an inflammatory condition which affects multiple systems in the body and often occurs as a response which is immunologically mediated by the protective immune system to infectious agent. Magnesium plays a vital role in sepsis and systemic inflammatory response syndrome (SIRS) The aim of this study is to estimate the serum magnesium concentrations in patients with SIRS in the medical ICU, to correlate with prognosis of SIRS patients by comparision with sequential organ failure assessment scoring and to assess the clinical outcome.
This Observational analytical study was conducted in 100 patients admitted at the medical intensive care unit of Saveetha medical college and hospital, chennai who satisfy the diagnostic clinical criteria for SIRS. Detailed clinical examination was done for each patient. Serum magnesium levels were sent and the results were analysed.
In the study, 100 patients were included. The mean age of the study population was 42. 92 + 16. 69 years. 70 % of the patients in the study group were  male and 30 % were females. The mortality rate in the hypomagnesemia group was 81. 8% where as it was 14.3 % in the  normomagnesemia  group.  There was Significant mortality in the hypomagnesemia group when compared to the normomagnesemia group. The mean duration of ICU stay for patients in the hypomagnesemia group was 5. 424 days and in the  normomagnesemia group  it  was  5.286  days.  Among 66 patients with hypomagnesemia 50 patients required mechanical ventilation and it was 66 %. Among 28 patients in normomagnesemia group, 2 patients required ventilatory support.
Serum magnesium levels have prognostic value in  patients diagnosed as SIRS. Serum magnesium concentration shows association with increased mortality rate. There is significant greater need for mechanical ventilation and increased duration of stay under ventilator support in the patients with lower magnesium levels. There is a significant association in prognosticating the patients with SOFA scoring in hypomagnesemia and  magnesium correction may improve the outcomes in sepsis and SIRS patients.

Assessment of patients with sepsis and septic shock Using Procalcitonin and C-reactive Protein

Abdelhamid Mohammad Abdelhamid, Hassan Mohammad Mageed, Ghada Mohammad Abdel Razik,Sherif M. S. Mowafy .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 885-894

Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection inside ICU. The aim of the present study was to assess the Relation between levels of procalcitonin and C-reactive protein as markers with severity of sepsis and septic shock.
Patients and methods: This observational study was involved 60 patients who diagnosed with sepsis or septic shock and admitted to Surgical intensive care unit, Zagazig University Hospitals, Egypt. Procalcitonin and C-reactive protein levels were estimated in the 1st, 3rd, and 5th ICU day. APACHE II as well as SOFA Scores were estimated on ICU admission.
Results: Patients were classified according to the need for mechanical ventilation (MV group and non-MV group), CRP showed no significant difference between the two groups on the first day (100.51 and 83.21 mg/dl respectively- p=0.108). The remaining readings showed a significant rise in the patients that needed invasive mechanical ventilation. Serum PCT levels showed a significant rise in the MV group throughout the all study readings (p < 0.001). Likewise, SOFA score recordings were significantly higher in the MV patients (p < 0.001). On assessment of the predictors for vasopressor need, the highest sensitivity was reported for 3rd day CRP (84.1% - cut off = 62.01 mg/dl), and 5th  day PCT (84.1% - cutoff = 0.505 ng/ml). Slight decrease in sensitivity (81.8%) was reported with the application of 1st day PCT and 3rd day SOFA.
Conclusion: PCT and CRP can be used as a  prognostic markers for evaluating the prognosis of patients with sepsis and septic shock.regarding need for vasopressors the highest sensitivity was reported for 3rd day CRP and fifth day PCT, however the length of stay was found to be highly correlated with 3rd day PCT, also 1st day PCT value was better to Predict need for Mechanical ventilation.

Prognostic significance ofProcalcitonin, High sensitivity C-reactive proteinandwhite blood cell count incomparison withblood culture in ICU patients with Sepsis and Septic shock inatertiary care Hospital

Dr.Kondle Raghu; Dr. Krishnan Ramalingam

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2263-2270

Background: Sepsis is a life-threatening condition in ICU with high morbidity and
mortality. Biomarkers which can act as a predictor for diagnosis, prognosis, and patient
outcome in sepsis are needed.
Aim:Aim of the study is to compare the significance of hs-C-reactive Protein (CRP),
Procalcitonin, White blood cell count, and blood culture in patients with bloodstream
infections and compare their prognostic significance with blood cultures in sepsis.
Materials and Methods: This hospital based prospective observational study was conducted
between July 2018 to July 2019 forone year with 216 cases of sepsis. Serial determination
of Procalcitonin and CRP at admission and Day 6 was done. Data was analyzed check to
compare the prognostic significance of the PCT, CRP, and WBC count.
Results:A blood culture positivity rate of 50.9% was reported with male preponderance.
WBC count has significantly reduced after 72hrs of admission (p= 0.007). CRP levels have
significantly reduced on day 6 (p = 0.043) in comparison to at the time of admission (p=
0.032). The serial determination of PCT levels at admission and on day 6 (p= 0.032) was
found to be a better prognostic indicator in patients with sepsis than at the time of
admission. The significant patient outcome in terms of mortality and reduction in length of
hospital stay has been found (p= 0.018, p=0.002). The positive correlation of PCT and CRP
and SOFA score has been reported.
Conclusion: Prognostic significance was found for the biomarkers PCT, CRP, and WBC
count with significant patient outcomes in terms of mortality and hospital stay reduction