WP-112: Exploring the User Experience with a Speech Recognition System for Smart TVs

<p>WP-112: Exploring the User Experience with a Speech Recognition System for Smart TVs</p

The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

<div><p>Background</p><p>Sepsis, including severe sepsis and septic shock, is a major cause of morbidity and mortality. Albumin and C-reactive protein (CRP) are considered as good diagnostic markers for sepsis. Thus, initial CRP and albumin levels were combined to ascertain their value as an independent predictor of 180-day mortality in patients with severe sepsis and septic shock.</p><p>Materials and Methods</p><p>We conducted a retrospective cohort study involving 670 patients (>18 years old) who were admitted to the emergency department and who had received a standardized resuscitation algorithm (early goal-directed therapy) for severe sepsis and septic shock, from November 2007 to February 2013, at a tertiary hospital in Seoul, Korea. The outcome measured was 180-day all-cause mortality. A multivariate Cox proportional hazard model was used to identify the independent risk factors for mortality. A receiver operating characteristic (ROC) curve analysis was conducted to compare the predictive accuracy of the CRP/albumin ratio at admission.</p><p>Results</p><p>The 180-day mortality was 28.35% (190/670). Based on the multivariate Cox proportional hazard analysis, age, the CRP/albumin ratio at admission (adjusted HR 1.06, 95% CI 1.03–1.10, p<0.001), lactate level at admission (adjusted HR 1.10, 95% CI 1.05–1.14, p<0.001), and the Sequential Organ Failure Assessment (SOFA) score at admission (adjusted HR 1.12, 95% CI 1.07–1.18, p<0.001) were independent predictors of 180-day mortality. The area under the curve of CRP alone and the CRP/albumin ratio at admission for 180-day mortality were 0.5620 (P<0.001) and 0.6211 (P<0.001), respectively.</p><p>Conclusion</p><p>The CRP/albumin ratio was an independent predictor of mortality in patients with severe sepsis or septic shock.</p></div

Baseline features of the enrolled patients.

<p>The data was divided into two groups according to survival status at 180 days. Data are expressed as the mean ± SD / median (Q1-Q3) or N (%).</p><p>Abbreviations</p><p>¹CRP, C-reactive protein</p><p>²WBC, white blood cell count</p><p>³BUN, blood urea nitrogen</p><p>⁴Cr, creatinine</p><p>⁵CVP, central venous pressure (Goal of CVP in EGDT protocol: 8-12mm Hg)</p><p>⁶MAP, mean arterial pressure(Goal of CVP in EGDT protocol: >65 and ≤90mm Hg) and</p><p>⁷SCvO₂, central venous oxygen saturation(Goal of CVP in EGDT protocol: >70%)</p><p>⁸DM, diabetes mellitus</p><p>⁹ COPD, chronic obstructive pulmonary disease</p><p>¹⁰CHF, congestive heart failure</p><p>¹¹CRF, chronic renal failure</p><p>¹²SOFA, sequential organ failure assessment.</p><p>^a the number of patients who had available data was 524</p><p>^b the number of patients who had available data was 596</p><p>^c the number of patients who had available data was 496</p><p>^d the number of patients who had available data was 148</p><p>^e the number of patients who had available data was 663.</p><p>Baseline features of the enrolled patients.</p

Receiver operating characteristic (ROC) curve of CRP and CRP/albumin ratio in predicting 180-day mortality.

<p>The area under curve (AUC) for the CRP/albumin ratio is higher compared to CRP alone (p<0.001).</p

Cox proportional hazards analysis for 180-day mortality (CRP/albumin ratio at admission).

<p>¹The hazard ratio (HR) for death is expressed per 1-y increase in age, female to male in gender, per 1 unit increase in the SOFA score, 1 mg/L increase in CRP, 1 g/dL decrease in albumin, 1 increase in CRP (mg/dL)/albumin(g/dL), 1 mmol/dL increase in lactate and having malignancy to having no malignancy.</p><p>The multivariate analysis was adjusted for covariates such as age, gender, CRP/albumin ratio, SOFA score, lactate level and having malignancy or not, for each variable. Abbreviations: SOFA, sequential organ failure assessment; CRP, C-reactive protein</p><p>Cox proportional hazards analysis for 180-day mortality (CRP/albumin ratio at admission).</p

Kaplan-Meier analysis of the cumulative percentage of surviving patients at 180-days according to the different CRP/albumin levels.

<p>Patients with higher levels of CRP/albumin ratio had a reduced survival rate. Solid line, CRP/albumin ratio ≤5.09; dashed line, CRP/albumin ratio >5.09.</p

Cox proportional hazards analysis for 180-day mortality (CRP/albumin ratio at 72 h after admission).

<p>¹The hazard ratio (HR) for death is expressed per 1-y increase in age, female to male in gender, per 1 score increase in the SOFA score, 1 mg/L increase in CRP, 1 g/L decrease in albumin, 1 increase in CRP(mg/dL)/albumin(g/L), 1 mmol/dL increase in lactate and having malignancy to having no malignancy.</p><p>The multivariate analysis was adjusted for covariates such as age, gender, CRP/albumin ratio, SOFA score, lactate level and having malignancy or not, for each variable. Abbreviation: SOFA, sequential organ failure assessment; CRP, C-reactive protein.</p><p>Cox proportional hazards analysis for 180-day mortality (CRP/albumin ratio at 72 h after admission).</p