Journal of critical care最新文献

英文中文

Evaluating the efficacy of large language models in predicting intensive care unit admission needs 评估大型语言模型预测重症监护病房入院需求的有效性

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-23 DOI: 10.1016/j.jcrc.2026.155446

Engin İhsan Turan , Abdurrahman Engin Baydemir , Zehra Polat Turan , Ayça Sultan Şahin

Background

Timely identification and transfer of critically ill patients to intensive care units (ICUs) are crucial to reducing morbidity and mortality. Delayed ICU admission is linked to higher mortality, emphasizing the need for efficient prediction systems. Artificial intelligence (AI) has shown promise in enhancing clinical decision-making. This study evaluates the efficacy of ChatGPT and Gemini AI models in predicting ICU admission needs.

Methods

This retrospective observational study analyzed data from 8043 ICU consultation cases in a tertiary hospital between January 2020 and June 2024. Clinical parameters included medication use, consultation details, ECG findings, imaging results, comorbidities, and laboratory values. Preprocessed and anonymized data were analyzed using ChatGPT and Gemini, with performance assessed through accuracy, Kappa statistic, Pearson Chi-square, and logistic regression.

Results

ChatGPT demonstrated strong predictive performance, achieving an accuracy of 93.8% and a Kappa statistic of 0.802, indicating substantial agreement with anesthesiologists' ICU decisions. Its predictions showed a highly significant association with actual clinical outcomes (Pearson Chi-Square = 5293.310, p < 0.001). Sensitivity and specificity analyses further confirmed ChatGPT's balanced performance in identifying both ICU and non-ICU patients. In contrast, Gemini showed more modest agreement with clinical decisions, with a Kappa value of 0.396, reflecting lower consistency despite producing correct classifications in a portion of cases.

Conclusion

ChatGPT demonstrated superior accuracy and reliability in predicting ICU needs compared to Gemini. Early identification of critically ill patients enables timely interventions, potentially reducing morbidity and mortality. Future studies should explore real-time AI integration into clinical workflows and validate findings through prospective research.

背景及时发现危重患者并将其转移到重症监护病房（icu）对于降低发病率和死亡率至关重要。延迟入住ICU与更高的死亡率有关，强调需要有效的预测系统。人工智能（AI）在增强临床决策方面显示出了希望。本研究评估ChatGPT和Gemini AI模型在预测ICU入院需求方面的有效性。方法回顾性观察分析2020年1月至2024年6月某三级医院ICU会诊病例8043例。临床参数包括药物使用、咨询细节、心电图表现、影像学结果、合并症和实验室值。使用ChatGPT和Gemini对预处理和匿名数据进行分析，并通过准确性、Kappa统计量、皮尔逊卡方和逻辑回归来评估性能。结果schatgpt具有较强的预测能力，准确率为93.8%，Kappa统计量为0.802，与麻醉医师的ICU决策基本一致。其预测结果显示与实际临床结果高度显著相关（Pearson卡方= 5293.310,p < 0.001）。敏感性和特异性分析进一步证实了ChatGPT在识别ICU和非ICU患者方面的平衡性能。相比之下，双子座对临床决策的一致性较低，Kappa值为0.396，尽管在部分病例中产生了正确的分类，但一致性较低。结论chatgpt预测ICU需求的准确性和可靠性优于Gemini。早期发现危重病人能够及时采取干预措施，从而有可能降低发病率和死亡率。未来的研究应探索将人工智能实时整合到临床工作流程中，并通过前瞻性研究验证研究结果。

{"title":"Evaluating the efficacy of large language models in predicting intensive care unit admission needs","authors":"Engin İhsan Turan , Abdurrahman Engin Baydemir , Zehra Polat Turan , Ayça Sultan Şahin","doi":"10.1016/j.jcrc.2026.155446","DOIUrl":"10.1016/j.jcrc.2026.155446","url":null,"abstract":"<div><h3>Background</h3><div>Timely identification and transfer of critically ill patients to intensive care units (ICUs) are crucial to reducing morbidity and mortality. Delayed ICU admission is linked to higher mortality, emphasizing the need for efficient prediction systems. Artificial intelligence (AI) has shown promise in enhancing clinical decision-making. This study evaluates the efficacy of ChatGPT and Gemini AI models in predicting ICU admission needs.</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed data from 8043 ICU consultation cases in a tertiary hospital between January 2020 and June 2024. Clinical parameters included medication use, consultation details, ECG findings, imaging results, comorbidities, and laboratory values. Preprocessed and anonymized data were analyzed using ChatGPT and Gemini, with performance assessed through accuracy, Kappa statistic, Pearson Chi-square, and logistic regression.</div></div><div><h3>Results</h3><div>ChatGPT demonstrated strong predictive performance, achieving an accuracy of 93.8% and a Kappa statistic of 0.802, indicating substantial agreement with anesthesiologists' ICU decisions. Its predictions showed a highly significant association with actual clinical outcomes (Pearson Chi-Square = 5293.310, <em>p</em> < 0.001). Sensitivity and specificity analyses further confirmed ChatGPT's balanced performance in identifying both ICU and non-ICU patients. In contrast, Gemini showed more modest agreement with clinical decisions, with a Kappa value of 0.396, reflecting lower consistency despite producing correct classifications in a portion of cases.</div></div><div><h3>Conclusion</h3><div>ChatGPT demonstrated superior accuracy and reliability in predicting ICU needs compared to Gemini. Early identification of critically ill patients enables timely interventions, potentially reducing morbidity and mortality. Future studies should explore real-time AI integration into clinical workflows and validate findings through prospective research.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155446"},"PeriodicalIF":2.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor: “External validation of eight different models to predict sepsis mortality in intensive care units” 致编辑的信：“预测重症监护病房败血症死亡率的八种不同模型的外部验证”

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-23 DOI: 10.1016/j.jcrc.2026.155460

Wing-Sum Chan , Yu-Chang Yeh

引用次数: 0

Letter to the editor: “The impact of ketamine on ICU mortality in patients with sepsis: A retrospective cohort study” 致编辑的信：“氯胺酮对脓毒症ICU患者死亡率的影响：一项回顾性队列研究”

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-23 DOI: 10.1016/j.jcrc.2026.155467

Mengdi Zhang

引用次数: 0

Patterns of opioid and sedative use in adult ICUs: Insights from the ALERT-ICU study on iatrogenic withdrawal syndrome 成人icu中阿片类药物和镇静剂使用模式：来自ALERT-ICU对医源性戒断综合征研究的见解

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-23 DOI: 10.1016/j.jcrc.2026.155444

Scott Bolesta , Kathryn E. Smith , Céline Gélinas , Marc M. Perreault , Lisa Burry , Rebekah Eadie , Federico C. Carini , Jamie Harpel , Ryan Stewart , Richard R. Riker , Brian L. Erstad , on behalf of the ALERT-ICU study investigators

Background

Iatrogenic withdrawal syndrome (IWS) can develop due to prolonged use of opioids and sedatives. This study aimed to evaluate the current usage patterns of these medications in adult ICUs and their potential link to IWS risk, hypothesizing that cumulative doses would increase with longer ICU stays.

Methods

This international, multicenter, observational, point-prevalence study included all patients aged 18 and older in adult ICUs who received parenteral opioids or sedatives in the previous 24 h. Data were collected on a selected day between June 1 and September 30, 2021, focusing on medication use over the preceding 24 h. The main outcome measure was the proportion of patients receiving regularly dosed parenteral opioids or sedatives for ≥72 h.

Results

A total of 1506 patients from 229 ICUs across 87 hospitals in 11 countries were analyzed. Among those on opioids or sedatives for ≥72 h, 52.4% received regularly dosed opioids, and 56.4% received sedatives. Continuous IV infusion was observed in 63.6% for opioids and 59.1% for sedatives. Median 24-h total doses were significantly higher in patients on opioids-sedatives for ≥72 h (p < 0.030). Additionally, significantly more patients on <72 h received >50% dose reductions (61% vs. 38%; p < 0.001) and initiated enteral medication (24% vs. 15%; p < 0.001).

Conclusion

Over half of adult ICU patients are administered regularly dosed parenteral opioids-sedatives for ≥72 h, often at higher doses, potentially increasing the risk of IWS.

背景：由于长期使用阿片类药物和镇静剂，可发生先天性戒断综合征（IWS）。本研究旨在评估成人ICU中这些药物的当前使用模式及其与IWS风险的潜在联系，并假设累积剂量会随着ICU住院时间的延长而增加。这项国际、多中心、观察性、点流行的研究纳入了所有18岁及以上在过去24小时内接受过静脉注射阿片类药物或镇静剂的成人icu患者。数据收集于2021年6月1日至9月30日之间的选定日期。主要结局指标为≥72小时内接受常规剂量阿片类药物或镇静剂的患者比例。结果分析了11个国家87家医院229家icu的1506例患者。在服用阿片类药物或镇静剂≥72 h的患者中，52.4%的患者接受常规阿片类药物治疗，56.4%的患者接受镇静剂治疗。阿片类药物持续静脉滴注率为63.6%，镇静剂持续静脉滴注率为59.1%。服用阿片类镇静剂≥72小时的患者24小时总剂量中位数显著高于服用阿片类镇静剂的患者（p < 0.030）。此外，更多的患者在72小时内接受了50%的剂量减少（61%对38%；p < 0.001）并开始肠内用药（24%对15%；p < 0.001）。结论超过一半的成人ICU患者常规给予≥72小时的静脉注射阿片类镇静剂，且通常剂量较高，可能增加IWS的风险。

{"title":"Patterns of opioid and sedative use in adult ICUs: Insights from the ALERT-ICU study on iatrogenic withdrawal syndrome","authors":"Scott Bolesta , Kathryn E. Smith , Céline Gélinas , Marc M. Perreault , Lisa Burry , Rebekah Eadie , Federico C. Carini , Jamie Harpel , Ryan Stewart , Richard R. Riker , Brian L. Erstad , on behalf of the ALERT-ICU study investigators","doi":"10.1016/j.jcrc.2026.155444","DOIUrl":"10.1016/j.jcrc.2026.155444","url":null,"abstract":"<div><h3>Background</h3><div>Iatrogenic withdrawal syndrome (IWS) can develop due to prolonged use of opioids and sedatives. This study aimed to evaluate the current usage patterns of these medications in adult ICUs and their potential link to IWS risk, hypothesizing that cumulative doses would increase with longer ICU stays.</div></div><div><h3>Methods</h3><div>This international, multicenter, observational, point-prevalence study included all patients aged 18 and older in adult ICUs who received parenteral opioids or sedatives in the previous 24 h. Data were collected on a selected day between June 1 and September 30, 2021, focusing on medication use over the preceding 24 h. The main outcome measure was the proportion of patients receiving regularly dosed parenteral opioids or sedatives for ≥72 h.</div></div><div><h3>Results</h3><div>A total of 1506 patients from 229 ICUs across 87 hospitals in 11 countries were analyzed. Among those on opioids or sedatives for ≥72 h, 52.4% received regularly dosed opioids, and 56.4% received sedatives. Continuous IV infusion was observed in 63.6% for opioids and 59.1% for sedatives. Median 24-h total doses were significantly higher in patients on opioids-sedatives for ≥72 h (<em>p</em> < 0.030). Additionally, significantly more patients on <72 h received >50% dose reductions (61% vs. 38%; <em>p</em> < 0.001) and initiated enteral medication (24% vs. 15%; p < 0.001).</div></div><div><h3>Conclusion</h3><div>Over half of adult ICU patients are administered regularly dosed parenteral opioids-sedatives for ≥72 h, often at higher doses, potentially increasing the risk of IWS.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155444"},"PeriodicalIF":2.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-23 DOI: 10.1016/j.jcrc.2026.155443

Khalia Ackermann, Nanda Aryal, Johanna Westbrook, Ling Li

Objectives

Among adult sepsis survivors we aimed to: (i) assess the rate of all-cause, sepsis or infection hospital readmissions, and (ii) identify associated risk factors.

Methods

Retrospective cohort study of adult sepsis survivors with an index hospital admission between Jan 1, 2015, and Jan 31, 2021, in any hospital in New South Wales, Australia. The primary outcome was all-cause, sepsis or infection readmission through the emergency department (ED) within 30 days. Secondary outcomes were 7- and 90-day readmissions. Risk factors were investigated using multivariable logistic regression modelling.

Results

Within 30 days, 18,731 (14.9%) of the 125,370 adult sepsis survivors had an all-cause readmission through the ED. Of these readmissions, 1910 (10.2%) had a sepsis diagnosis and 4790 (25.6%) had an infection diagnosis. Factors associated with a higher risk of sepsis or infection-related readmission within 30 days were male sex, not being married, and chronic pulmonary disease, liver disease, diabetes, renal disease, malignancies, or malignant tumour comorbidities. In contrast, factors associated with a lower risk of sepsis or infection-related readmission were being aged 16–44 years (compared to survivors aged >85 years), living in inner regional areas (compared to major cities), or living in the least socioeconomically disadvantaged area (compared to the most), and myocardial infarction, cerebrovascular disease, or peptic ulcer disease comorbidities.

Conclusion

Early and unexpected hospital readmissions are common in Australian sepsis survivors with almost 15% returning to hospital through the ED within 30 days, a third of which were for another sepsis or infection event.

在成年脓毒症幸存者中，我们的目的是：(i)评估全因、脓毒症或感染的再入院率，（ii）确定相关的危险因素。方法回顾性队列研究2015年1月1日至2021年1月31日期间在澳大利亚新南威尔士州任何一家医院住院的成人脓毒症幸存者。主要结局是全因、败血症或感染患者在30天内再次进入急诊科（ED）。次要结局为7天和90天再入院。使用多变量logistic回归模型调查危险因素。结果在30天内，125,370名成年脓毒症幸存者中有18,731人（14.9%）通过急诊科进行了全因再入院。其中1910人（10.2%）诊断为脓毒症，4790人（25.6%）诊断为感染。与30天内败血症或感染相关再入院风险较高的因素为男性、未婚、慢性肺病、肝病、糖尿病、肾病、恶性肿瘤或恶性肿瘤合并症。相比之下，与败血症或感染相关再入院风险较低相关的因素是年龄在16-44岁（与85岁的幸存者相比），生活在内陆地区（与主要城市相比），或生活在社会经济最不利的地区（与最不利地区相比），以及心肌梗死，脑血管疾病或消化性溃疡疾病合并症。结论在澳大利亚败血症幸存者中，早期和意外再入院很常见，近15%的患者在30天内通过急诊科返回医院，其中三分之一是由于另一次败血症或感染事件。

{"title":"Infection-related hospital readmissions after surviving sepsis: A retrospective population level study of adult sepsis survivors in Australia","authors":"Khalia Ackermann, Nanda Aryal, Johanna Westbrook, Ling Li","doi":"10.1016/j.jcrc.2026.155443","DOIUrl":"10.1016/j.jcrc.2026.155443","url":null,"abstract":"<div><h3>Objectives</h3><div>Among adult sepsis survivors we aimed to: (i) assess the rate of all-cause, sepsis or infection hospital readmissions, and (ii) identify associated risk factors.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of adult sepsis survivors with an index hospital admission between Jan 1, 2015, and Jan 31, 2021, in any hospital in New South Wales, Australia. The primary outcome was all-cause, sepsis or infection readmission through the emergency department (ED) within 30 days. Secondary outcomes were 7- and 90-day readmissions. Risk factors were investigated using multivariable logistic regression modelling.</div></div><div><h3>Results</h3><div>Within 30 days, 18,731 (14.9%) of the 125,370 adult sepsis survivors had an all-cause readmission through the ED. Of these readmissions, 1910 (10.2%) had a sepsis diagnosis and 4790 (25.6%) had an infection diagnosis. Factors associated with a higher risk of sepsis or infection-related readmission within 30 days were male sex, not being married, and chronic pulmonary disease, liver disease, diabetes, renal disease, malignancies, or malignant tumour comorbidities. In contrast, factors associated with a lower risk of sepsis or infection-related readmission were being aged 16–44 years (compared to survivors aged >85 years), living in inner regional areas (compared to major cities), or living in the least socioeconomically disadvantaged area (compared to the most), and myocardial infarction, cerebrovascular disease, or peptic ulcer disease comorbidities.</div></div><div><h3>Conclusion</h3><div>Early and unexpected hospital readmissions are common in Australian sepsis survivors with almost 15% returning to hospital through the ED within 30 days, a third of which were for another sepsis or infection event.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155443"},"PeriodicalIF":2.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Authors reply: “The clinical outcome of Montelukast versus co-enzyme Q10 in adult patients with sepsis: A randomized controlled clinical trial” 作者回复：“孟鲁司特与辅酶Q10在成人脓毒症患者中的临床效果：一项随机对照临床试验”

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-22 DOI: 10.1016/j.jcrc.2026.155447

Ghada Hussein ELadly , Salwa Omar Elkhattab Amin , Nagwa Ali Sabri , May Ahmed Shawki

引用次数: 0

Authors reply: “Associations of positive end-expiratory pressure (PEEP) with extubation failure and clinical outcomes in invasively ventilated patients with acute brain injury: A secondary analysis of the ENIO study” 作者回复：“急性脑损伤有创通气患者呼气末正压（PEEP）与拔管失败和临床结果的关系：ENIO研究的二次分析”

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-22 DOI: 10.1016/j.jcrc.2026.155449

Denise Battaglini , Raphael Cinotti , Karim Asehnoune , Andrea Loggini , Luca Montagnani , Lorenzo Ball , Francesca Gualdi , Patricia R.M. Rocco , Marcus J. Schultz , Nicolò Antonino Patroniti , Chiara Robba

引用次数: 0

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-22 DOI: 10.1016/j.jcrc.2026.155448

引用次数: 0

The impact of coagulopathy on prognosis in critically ill patients with sepsis: A nationwide cohort study 凝血功能障碍对脓毒症危重患者预后的影响：一项全国性队列研究

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-22 DOI: 10.1016/j.jcrc.2026.155436

Heonyeong Ha , Dong-gon Hyun , Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, on behalf of the Korean Sepsis Alliance (KSA) Investigators

Introduction

Coagulation impairment is frequently observed in patients with sepsis. However, the relationship between coagulopathy and outcomes in Korean sepsis patients remains poorly defined.

Methods

We analyzed a nationwide cohort of 13,827 sepsis patients from 15 hospitals in South Korea between September 2019 and December 2022. Patients were classified into three groups according to sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scores: SIC (−), SIC (+), and DIC (+). The primary outcome was 28-day mortality; the secondary outcome was the incidence of major bleeding events.

Results

Among 3217 patients, 1696 (52.7%) were in the SIC (−) group, 932 (29.0%) in the SIC (+) group, and 589 (18.3%) in the DIC (+) group. After adjustment for covariates, both the SIC (+) group (adjusted hazard ratio [aHR] 1.35, 95% confidence interval [CI] 1.16–1.58, p < 0.001) and the DIC (+) group (aHR 1.59, 95% CI 1.33–1.90, p < 0.001) showed significantly increased 28-day mortality. Major bleeding events, although infrequent across all groups, increased in the DIC (+) group (adjusted odds ratio [aOR] 2.02, 95% CI 1.03–3.88, p = 0.036); however, no significant increase was observed in the SIC (+) group (aOR 1.20, 95% CI 0.60–2.33, p = 0.600) compared with the SIC (−) group.

Conclusions

In this nationwide cohort, sepsis-induced coagulopathy was associated with higher 28-day mortality but not with a significantly increased risk of major bleeding.

在脓毒症患者中经常观察到凝血功能障碍。然而，韩国脓毒症患者凝血功能障碍与预后之间的关系仍不明确。方法：我们分析了2019年9月至2022年12月期间来自韩国15家医院的13827名脓毒症患者的全国队列。根据脓毒症诱导凝血病（SIC）和弥散性血管内凝血（DIC）评分将患者分为三组：SIC（−）、SIC（+）和DIC（+）。主要终点为28天死亡率；次要结局是主要出血事件的发生率。结果3217例患者中，SIC（−）组1696例（52.7%），SIC（+）组932例（29.0%），DIC（+）组589例（18.3%）。校正协变量后，SIC（+）组（校正风险比[aHR] 1.35, 95%可信区间[CI] 1.16-1.58, p < 0.001）和DIC（+）组（校正风险比[aHR] 1.59, 95% CI 1.33-1.90, p < 0.001）均显示28天死亡率显著增加。大出血事件虽然在所有组中都不常见，但在DIC（+）组中有所增加（校正优势比[aOR] 2.02, 95% CI 1.03-3.88, p = 0.036）；然而，与SIC（−）组相比，SIC（+）组无显著增加（aOR 1.20, 95% CI 0.60-2.33, p = 0.600）。结论：在这个全国性的队列中，败血症引起的凝血功能障碍与较高的28天死亡率相关，但与大出血风险的显著增加无关。

{"title":"The impact of coagulopathy on prognosis in critically ill patients with sepsis: A nationwide cohort study","authors":"Heonyeong Ha , Dong-gon Hyun , Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, on behalf of the Korean Sepsis Alliance (KSA) Investigators","doi":"10.1016/j.jcrc.2026.155436","DOIUrl":"10.1016/j.jcrc.2026.155436","url":null,"abstract":"<div><h3>Introduction</h3><div>Coagulation impairment is frequently observed in patients with sepsis. However, the relationship between coagulopathy and outcomes in Korean sepsis patients remains poorly defined.</div></div><div><h3>Methods</h3><div>We analyzed a nationwide cohort of 13,827 sepsis patients from 15 hospitals in South Korea between September 2019 and December 2022. Patients were classified into three groups according to sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scores: SIC (−), SIC (+), and DIC (+). The primary outcome was 28-day mortality; the secondary outcome was the incidence of major bleeding events.</div></div><div><h3>Results</h3><div>Among 3217 patients, 1696 (52.7%) were in the SIC (−) group, 932 (29.0%) in the SIC (+) group, and 589 (18.3%) in the DIC (+) group. After adjustment for covariates, both the SIC (+) group (adjusted hazard ratio [aHR] 1.35, 95% confidence interval [CI] 1.16–1.58, <em>p</em> < 0.001) and the DIC (+) group (aHR 1.59, 95% CI 1.33–1.90, p < 0.001) showed significantly increased 28-day mortality. Major bleeding events, although infrequent across all groups, increased in the DIC (+) group (adjusted odds ratio [aOR] 2.02, 95% CI 1.03–3.88, <em>p</em> = 0.036); however, no significant increase was observed in the SIC (+) group (aOR 1.20, 95% CI 0.60–2.33, <em>p</em> = 0.600) compared with the SIC (−) group.</div></div><div><h3>Conclusions</h3><div>In this nationwide cohort, sepsis-induced coagulopathy was associated with higher 28-day mortality but not with a significantly increased risk of major bleeding.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155436"},"PeriodicalIF":2.9,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on Machine learning survival analysis for predicting kidney disease progression in patients with acute kidney injury undergoing continuous kidney replacement therapy: An analysis of the LINKA database 机器学习生存分析预测急性肾损伤患者持续肾脏替代治疗的肾脏疾病进展：LINKA数据库的分析

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care

Pub Date : 2026-01-22 DOI: 10.1016/j.jcrc.2026.155456

Bo Song , Guoying Wang , Song Zhou

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of critical care

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀