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Fluid accumulation threshold measured by acute body weight change after admission in general surgical intensive care units: how much should be concerning?

Overview of attention for article published in Therapeutics and Clinical Risk Management, July 2015
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Title
Fluid accumulation threshold measured by acute body weight change after admission in general surgical intensive care units: how much should be concerning?
Published in
Therapeutics and Clinical Risk Management, July 2015
DOI 10.2147/tcrm.s86409
Pubmed ID
Authors

Kaweesak Chittawatanarat, Todsaporn Pichiya, Kamtone Chandacham, Tidarat Jirapongchareonlap, Narain Chotirosniramit

Abstract

The objective of this study (ClinicalTrials.gov: NCT01351506) was to identify the threshold level of fluid accumulation measured by acute body weight (BW) change during the first week in a general surgical intensive care unit (ICU), which is associated with ICU mortality and other adverse outcomes. Four hundred sixty-five patients were prospectively followed for a 28-day period. The maximum BW change threshold during the first week was evaluated by the maximum percentage change in BW from the ICU admission weight (Max%ΔBW). Daily screening of adverse events in the ICU were recorded. The cutoff point of Max%ΔBW on ICU mortality was defined by considering the area under the receiver operating characteristic (ROC) curve, intersection of the sensitivity and specificity, and the Youden Index. Univariable and multivariable regression analyses were used to demonstrate the associations. Statistical significance was defined as P<0.05. The appropriate cutoff value of Max%ΔBW threshold was 5%. Regarding the multivariable regression model, in overall patients, the occurrence of the following adverse events (expressed as adjusted odds ratio [95% confidence interval]) were significantly associated with a Max%ΔBW of >5%: ICU mortality (2.38 [1.25-4.54]) (P=0.008), ICU mortality in patients without renal replacement therapy (RRT) (2.47 [1.21-5.06]) (P=0.013), reintubation within 72 hours (2.51 [1.04-6.00]) (P=0.039), RRT requirement (2.67 [1.13-6.33]) (P=0.026), and delirium (1.97 [1.08-3.57]) (P=0.025). Regarding the postoperative subgroup, a Max%ΔBW value of more than 5% was significantly associated with: ICU mortality (3.87 [1.38-10.85]) (P=0.010), ICU mortality in patients without RRT (6.32 [1.85-21.64]) (P=0.003), reintubation within 72 hours (4.44 [1.30-15.16]) (P=0.017), and vasopressor requirement (2.04 [1.04-4.01]) (P=0.037). Fluid accumulation, measured as acute BW change of more than the threshold of 5% during the first week of ICU admission, is associated with adverse outcomes of higher ICU mortality, especially in the patients without RRT, with reintubation within 72 hours, with RRT requirement, with vasopressor requirement, and with delirium. Some of these effects were higher in postoperative patients. This threshold value might be an indicator for caution during fluid management in surgical ICU.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 25 100%

Demographic breakdown

Readers by professional status Count As %
Other 7 28%
Unspecified 4 16%
Lecturer 2 8%
Student > Postgraduate 2 8%
Student > Master 2 8%
Other 3 12%
Unknown 5 20%
Readers by discipline Count As %
Medicine and Dentistry 15 60%
Unspecified 4 16%
Nursing and Health Professions 2 8%
Computer Science 1 4%
Engineering 1 4%
Other 0 0%
Unknown 2 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 August 2015.
All research outputs
#15,340,815
of 22,818,766 outputs
Outputs from Therapeutics and Clinical Risk Management
#868
of 1,264 outputs
Outputs of similar age
#153,934
of 263,416 outputs
Outputs of similar age from Therapeutics and Clinical Risk Management
#39
of 48 outputs
Altmetric has tracked 22,818,766 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,264 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.5. This one is in the 24th percentile – i.e., 24% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 263,416 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 48 others from the same source and published within six weeks on either side of this one. This one is in the 4th percentile – i.e., 4% of its contemporaries scored the same or lower than it.