Supplementary Material for: Diagnostic and Prognostic Performance of Serum Albumin and Cholinesterase in Patients with Sepsis and Septic Shock

Background: Despite improved risk stratification tools and identification of novel biomarkers, sepsis-related mortality has not significantly improved during the past years. Objective: This study investigates the diagnostic and prognostic role of the serum albumin and cholinesterase (ChE) in patients with sepsis and septic shock. Methods: Consecutive patients with sepsis and septic shock from 2019 to 2021 were included. Blood samples were retrieved from day of disease onset (day 1), day 2,3,5 and 7. Firstly, the diagnostic value of the serum albumin for the diagnosis of a septic shock was compared to the ChE. Secondly, the prognostic value of the serum albumin and the ChE for 30-day all-cause mortality was tested. Results: A total of 239 patients were included. With an area under the curve (AUC) of 0.641 to 0.762 on day 3 and 5, the ChE revealed a moderate but better diagnostic discrimination between sepsis and septic shock than the serum albumin. Furthermore, the ChE was able to discriminate between non-survivors and survivors of the 30-day time inter-val (range of AUC 0.612 to 0.686). Patients with a ChE below the median had higher rates of 30-days all-cause mortality in comparison to patients with a ChE above the median (65% vs. 42%, log rank p = 0.001; HR = 1.820; 95% CI 1.273 – 2.601; p = 0.001). Conclusion: The ChE reflects a reliable diagnostic and prognostic tool in patients with sepsis and septic shock

Supplementary Material for: What Kind of Patients Receive Inpatient and Day-Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany?

Introduction: Germany is one of the few countries with a medical specialty of psychosomatic medicine and psychotherapy and many treatment resources of this kind. Objective: This observational study describes the psychosomatic treatment programs as well as a large sample of day-hospital and inpatients in great detail using structured diagnostic interviews. Methods: Mental disorders were diagnosed according to ICD-10 and DSM-IV by means of Mini-DIPS and SCID-II. In addition to the case records, a modified version of the CSSRI was employed to collect demographic data and service use. The PHQ-D was used to assess depression, anxiety, and somatization. Results: 2,094 patients from 19 departments participated in the study after giving informed consent. The sample consisted of a high proportion of “complex patients” with high comorbidity of mental and somatic diseases, severe psychopathology, and considerable social and occupational dysfunction including more than 50 days of sick leave per year in half of the sample. The most frequent diagnoses were depression, somatoform and anxiety disorders, eating disorders, personality disorders, and somato-psychic conditions. Conclusions: Inpatient and day-hospital treatment in German university departments of psychosomatic medicine and psychotherapy is an intensive multimodal treatment for complex patients with high comorbidity and social as well as occupational dysfunction