A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

First evaluation of the cookie-cutter sharks (Isistius sp.) predation pattern on different cetacean species in Martinique

International audienceCookie-cutter sharks (Isistius sp.) are small squaloid sharks that live in tropical and sub-tropical oceans. Their name comes from their unique tactic of feeding, which enables them to parasitize marine mega-fauna, like cetaceans. Due to their morphological and anatomical characteristics, they are responsible of crater-like wounds on the skin of marine mammals. Little is known on Isistius sp. around the globe especially in Martinique, which represents a potential habitat. The main goal of this study was to assess the impact of cookie-cutter sharks on cetaceans by determining (1) seasonal changes in the occurrence of bites, (2) intra- and interspecific differences in frequencies and locations of bites among the different species of cetaceans, and (3) link behavior patterns of both cookie-cutter sharks and cetaceans. Data were collected from a 3-year photo-identification database of Cetaceans in Caribbean coast of Martinique. 431 wounds of various stages on 396 individuals from nine species of marine mammals were recorded. Results did not show any significant variation in the occurrence of wounds between seasons. Intermediate state was more important, most injuries were observed on the SCF (Superior Central Flank) (62.40%) and in a lesser extent on young individuals (3.25%). The predation of cookie-cutter sharks on different cetacean species has been confirmed consistently in Martinique. Further studies are required with both scientists and fishermen to better understand their specific role in this marine ecosystem

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology