MEDS score and Vitamin D status are independent predictors of mortality in a cohort of Internal Medicine patients with microbiological identified Sepsis

A. Mirijello, A. Tosoni, V. Zaccone, M. Impagnatiello, G. Passaro, C. V. Vallone, A. Cossari, G. Ventura, G. Gambassi, S. D. De Cosmo, A. Gasbarrini, G. Addolorato, R. Landolfi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: Sepsis is a life-threatening disease resulting from the interaction between pathogen and host response; its dysregulation causes organ dysfunction, high morbidity, and mortality. Despite the increase of septic patients admitted to Internal Medicine wards, data about clinical predictors of mortality in this setting are still lacking. The aim of this study was to evaluate the role of MEDS score and vitamin D as predictors of mortality (28-day and 90-day) in septic patients admitted to the Internal Medicine department. PATIENT S AND METHODS: Prospectively collected clinical data, lab tests including vitamin D, and clinical scores (SIRS, MEDS, SCS, REMS, SOFA, qSOFA) were retrospectively analyzed. Eightyeight microbiologically identified septic patients (median age 75 years old, IQR 65-82 years old; range 37-94 years old) were evaluated. RESULTS: Twenty-three patients (26.1%) died at 28 days, 33 (37.5%) died at 90 days. The logistic regression showed a positive effect of MEDS score (p=0.006; OR 1.24, 95% CI 1.08-1.49), and a negative effect of low vitamin D levels (p=0.008, OR 0.83, 95% CI 0.72-0.94) on mortality. Moreover, the cut-off of 7 points for MEDS score and of 7 ng/ml for vitamin D levels significantly predicted poor prognosis at 28 and 90 days. CONCLUSIONS: MEDS score and vitamin D levels represent independent predictors of mortality in a cohort of Internal Medicine septic patients. Further studies on larger samples are needed to confirm our results and to clarify the pathophysiological mechanisms at the basis of vitamin D deficiency as a predictor of mortality in septic patients.

Original languageEnglish
Pages (from-to)4033-4043
Number of pages11
JournalEuropean Review for Medical and Pharmacological Sciences
Volume23
Issue number9
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Internal Medicine
Vitamin D
Sepsis
Mortality
Host-Pathogen Interactions
Vitamin D Deficiency
Logistic Models
Morbidity

Keywords

  • Internal Medicine
  • MEDS
  • qSOFA
  • Sepsis
  • SOFA
  • Vitamin D

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

MEDS score and Vitamin D status are independent predictors of mortality in a cohort of Internal Medicine patients with microbiological identified Sepsis. / Mirijello, A.; Tosoni, A.; Zaccone, V.; Impagnatiello, M.; Passaro, G.; Vallone, C. V.; Cossari, A.; Ventura, G.; Gambassi, G.; De Cosmo, S. D.; Gasbarrini, A.; Addolorato, G.; Landolfi, R.

In: European Review for Medical and Pharmacological Sciences, Vol. 23, No. 9, 01.01.2019, p. 4033-4043.

Research output: Contribution to journalArticle

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title = "MEDS score and Vitamin D status are independent predictors of mortality in a cohort of Internal Medicine patients with microbiological identified Sepsis",
abstract = "OBJECTIVE: Sepsis is a life-threatening disease resulting from the interaction between pathogen and host response; its dysregulation causes organ dysfunction, high morbidity, and mortality. Despite the increase of septic patients admitted to Internal Medicine wards, data about clinical predictors of mortality in this setting are still lacking. The aim of this study was to evaluate the role of MEDS score and vitamin D as predictors of mortality (28-day and 90-day) in septic patients admitted to the Internal Medicine department. PATIENT S AND METHODS: Prospectively collected clinical data, lab tests including vitamin D, and clinical scores (SIRS, MEDS, SCS, REMS, SOFA, qSOFA) were retrospectively analyzed. Eightyeight microbiologically identified septic patients (median age 75 years old, IQR 65-82 years old; range 37-94 years old) were evaluated. RESULTS: Twenty-three patients (26.1{\%}) died at 28 days, 33 (37.5{\%}) died at 90 days. The logistic regression showed a positive effect of MEDS score (p=0.006; OR 1.24, 95{\%} CI 1.08-1.49), and a negative effect of low vitamin D levels (p=0.008, OR 0.83, 95{\%} CI 0.72-0.94) on mortality. Moreover, the cut-off of 7 points for MEDS score and of 7 ng/ml for vitamin D levels significantly predicted poor prognosis at 28 and 90 days. CONCLUSIONS: MEDS score and vitamin D levels represent independent predictors of mortality in a cohort of Internal Medicine septic patients. Further studies on larger samples are needed to confirm our results and to clarify the pathophysiological mechanisms at the basis of vitamin D deficiency as a predictor of mortality in septic patients.",
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T1 - MEDS score and Vitamin D status are independent predictors of mortality in a cohort of Internal Medicine patients with microbiological identified Sepsis

AU - Mirijello, A.

AU - Tosoni, A.

AU - Zaccone, V.

AU - Impagnatiello, M.

AU - Passaro, G.

AU - Vallone, C. V.

AU - Cossari, A.

AU - Ventura, G.

AU - Gambassi, G.

AU - De Cosmo, S. D.

AU - Gasbarrini, A.

AU - Addolorato, G.

AU - Landolfi, R.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - OBJECTIVE: Sepsis is a life-threatening disease resulting from the interaction between pathogen and host response; its dysregulation causes organ dysfunction, high morbidity, and mortality. Despite the increase of septic patients admitted to Internal Medicine wards, data about clinical predictors of mortality in this setting are still lacking. The aim of this study was to evaluate the role of MEDS score and vitamin D as predictors of mortality (28-day and 90-day) in septic patients admitted to the Internal Medicine department. PATIENT S AND METHODS: Prospectively collected clinical data, lab tests including vitamin D, and clinical scores (SIRS, MEDS, SCS, REMS, SOFA, qSOFA) were retrospectively analyzed. Eightyeight microbiologically identified septic patients (median age 75 years old, IQR 65-82 years old; range 37-94 years old) were evaluated. RESULTS: Twenty-three patients (26.1%) died at 28 days, 33 (37.5%) died at 90 days. The logistic regression showed a positive effect of MEDS score (p=0.006; OR 1.24, 95% CI 1.08-1.49), and a negative effect of low vitamin D levels (p=0.008, OR 0.83, 95% CI 0.72-0.94) on mortality. Moreover, the cut-off of 7 points for MEDS score and of 7 ng/ml for vitamin D levels significantly predicted poor prognosis at 28 and 90 days. CONCLUSIONS: MEDS score and vitamin D levels represent independent predictors of mortality in a cohort of Internal Medicine septic patients. Further studies on larger samples are needed to confirm our results and to clarify the pathophysiological mechanisms at the basis of vitamin D deficiency as a predictor of mortality in septic patients.

AB - OBJECTIVE: Sepsis is a life-threatening disease resulting from the interaction between pathogen and host response; its dysregulation causes organ dysfunction, high morbidity, and mortality. Despite the increase of septic patients admitted to Internal Medicine wards, data about clinical predictors of mortality in this setting are still lacking. The aim of this study was to evaluate the role of MEDS score and vitamin D as predictors of mortality (28-day and 90-day) in septic patients admitted to the Internal Medicine department. PATIENT S AND METHODS: Prospectively collected clinical data, lab tests including vitamin D, and clinical scores (SIRS, MEDS, SCS, REMS, SOFA, qSOFA) were retrospectively analyzed. Eightyeight microbiologically identified septic patients (median age 75 years old, IQR 65-82 years old; range 37-94 years old) were evaluated. RESULTS: Twenty-three patients (26.1%) died at 28 days, 33 (37.5%) died at 90 days. The logistic regression showed a positive effect of MEDS score (p=0.006; OR 1.24, 95% CI 1.08-1.49), and a negative effect of low vitamin D levels (p=0.008, OR 0.83, 95% CI 0.72-0.94) on mortality. Moreover, the cut-off of 7 points for MEDS score and of 7 ng/ml for vitamin D levels significantly predicted poor prognosis at 28 and 90 days. CONCLUSIONS: MEDS score and vitamin D levels represent independent predictors of mortality in a cohort of Internal Medicine septic patients. Further studies on larger samples are needed to confirm our results and to clarify the pathophysiological mechanisms at the basis of vitamin D deficiency as a predictor of mortality in septic patients.

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KW - SOFA

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