The impact of norepinephrine dose reporting heterogeneity on mortality prediction in septic shock patients

Simple item page
dc.article.number216
dc.catalogadorpau
dc.contributor.authorMorales, Sebastian
dc.contributor.authorWendel-Garcia, Pedro D.
dc.contributor.authorIbarra-Estrada, Miguel
dc.contributor.authorJung, Christian
dc.contributor.authorCastro, Ricardo
dc.contributor.authorRetamal, Jaime
dc.contributor.authorCortinez, Luis I.
dc.contributor.authorSeverino, Nicolás
dc.contributor.authorKiavialaitis, Greta E.
dc.contributor.authorOspina-Tascón, Gustavo
dc.contributor.authorBakker, Jan
dc.contributor.authorHernández, Glenn
dc.contributor.authorKattan, Eduardo
dc.date.accessioned2024-07-22T16:19:31Z
dc.date.available2024-07-22T16:19:31Z
dc.date.issued2024-07-03
dc.date.updated2024-07-07T00:05:57Z
dc.description.abstractBackground: Norepinephrine (NE) is a cornerstone drug in the management of septic shock, with its dose being used clinically as a marker of disease severity and as mortality predictor. However, variations in NE dose reporting either as salt formulations or base molecule may lead to misinterpretation of mortality risks and hinder the process of care. Methods: We conducted a retrospective analysis of the MIMIC-IV database to assess the impact of NE dose reporting heterogeneity on mortality prediction in a cohort of septic shock patients. NE doses were converted from the base molecule to equivalent salt doses, and their ability to predict 28-day mortality at common severity dose cut-offs was compared. Results: 4086 eligible patients with septic shock were identified, with a median age of 68 [57–78] years, an admission SOFA score of 7 [6–10], and lactate at diagnosis of 3.2 [2.4–5.1] mmol/L. Median peak NE dose at day 1 was 0.24 [0.12–0.42] μg/kg/min, with a 28-day mortality of 39.3%. The NE dose showed significant heterogeneity in mortality prediction depending on which formulation was reported, with doses reported as bitartrate and tartrate presenting 65 (95% CI 79–43)% and 67 (95% CI 80–47)% lower ORs than base molecule, respectively. This divergence in prediction widened at increasing NE doses. When using a 1 μg/kg/min threshold, predicted mortality was 54 (95% CI 52–56)% and 83 (95% CI 80–87)% for tartrate formulation and base molecule, respectively. Conclusions: Heterogeneous reporting of NE doses significantly affects mortality prediction in septic shock. Standardizing NE dose reporting as base molecule could enhance risk stratification and improve processes of care. These findings underscore the importance of consistent NE dose reporting practices in critical care settings.
dc.fechaingreso.objetodigital2024-07-22
dc.identifier.citationCritical Care. 2024 Jul 03;28(1):216
dc.identifier.doi10.1186/s13054-024-05011-0
dc.identifier.urihttps://doi.org/10.1186/s13054-024-05011-0
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/87197
dc.information.autorucEscuela de Medicina; Morales, Sebastian; S/I; 1067023
dc.information.autorucEscuela de Medicina; Castro, Ricardo; 0000-0002-0978-9891; 4537
dc.information.autorucEscuela de Medicina; Retamal, Jaime; 0000-0002-6817-3659; 175147
dc.information.autorucEscuela de Medicina; Cortinez, Luis I.; 0000-0001-8544-8768; 79356
dc.information.autorucEscuela de Medicina; Severino, Nicolás; 0000-0002-9950-3606; 149398
dc.information.autorucEscuela de Medicina; Bakker, Jan; 0000-0003-2236-7391; 1044227
dc.information.autorucEscuela de Medicina; Hernández, Glenn; 0000-0002-3032-4087; 98874
dc.information.autorucEscuela de Medicina; Kattan, Eduardo; 0000-0002-1997-6893; 172152
dc.language.isoen
dc.nota.accesocontenido completo
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseCC BY 4.0 ATTRIBUTION 4.0 INTERNATIONAL
dc.subjectNorepinephrine
dc.subjectNorepinephrine formulation
dc.subjectMortality prediction
dc.subjectSeptic shock
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleThe impact of norepinephrine dose reporting heterogeneity on mortality prediction in septic shock patients
dc.typeartículo
sipa.codpersvinculados1067023
sipa.codpersvinculados4537
sipa.codpersvinculados175147
sipa.codpersvinculados79356
sipa.codpersvinculados149398
sipa.codpersvinculados1044227
sipa.codpersvinculados98874
sipa.codpersvinculados172152
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
13054_2024_Article_5011.pdf
Size:
1.26 MB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.98 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Artículos de revistas