Skin mottling score and capillary refill time to assess mortality of septic shock since pre-hospital setting - 24/03/19
, Anastasia Saade, M.D., Ph.D. a, 1, Jean Pierre Tourtier, M.D., Ph.D. d, Papa Gueye, M.D., PhD e, Emmanuel Bloch-Laine, M.D. f, g, Patrick Ecollan, M.D. h, Pierre Carli, M.D., Ph.D. a, Benoît Vivien, M.D., Ph.D. aAbstract |
Objectives |
The early identification of septic shock patients at high risk of poor outcome is essential to early initiate optimal treatments and to decide on hospital admission. Biomarkers are often used to evaluate the severity. In prehospital settings, the availability of biomarkers, such as lactate, is restricted. In this context, clinical tools such as skin mottling score (SMS) and capillary refill time (CRT) are more suitable.
In this study, we describe prehospital SMS and CRT's ability to predict mortality of patients with septic shock initially cared in the prehospital setting by a mobile intensive care unit.
Methods |
Patients with septic shock who received prehospital medical care admitted to the intensive care unit were retrospectively analyzed.
Results |
Sixty-three patients were included. The origin of sepsis was mainly pulmonary (67%). Overall mortality reached 36%. No significant difference was observed in the duration of prehospital medical care between alive and deceased patients. Mean prehospital value of SMS was 3 ± 2 and mean prehospital value of CRT was 5 ± 1 s.
A significant association was found between mortality and prehospital SMS (p = 0.02, OR[CI95] = 1.50 [1.08–2.15]) and prehospital CRT (p = 0.04, OR[CI95] = 1.53 [1.04–2.37]).
After adjusting for confounding factors using propensity score, the relative risk of death was 6.58 for SMS > 2 and 2.03 for CRT > 4 s.
Conclusion |
In this study, we report an association between prehospital SMS and CRT, and mortality of patients with septic shock. SMS and CRT are simple tools that could be used to optimize the triage and to decide early intensive care admission.
Le texte complet de cet article est disponible en PDF.Keywords : Septic shock, Skin mottling score, Capillary refill time, Mortality, Pre-hospital setting
Plan
| ☆ | The authors declare no competing interests. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. |
Vol 37 - N° 4
P. 664-671 - avril 2019 Retour au numéro
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