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Báo cáo y học: "Chaotic nature of sepsis and multiple organ failure cannot be explained by linear statistical methods"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Chaotic nature of sepsis and multiple organ failure cannot be explained by linear statistical methods. | Available online http ccforum.eom content 12 2 417 Letter Chaotic nature of sepsis and multiple organ failure cannot be explained by linear statistical methods Sarah Saliba1 Yusuf Alper Kilic2 and Selman Uranues1 1 Universitatsklinik fur Chirurgie Sektion fur Chirurgische Forschung Auenbruggerplatz 29 8036 Graz Austria 2Hacettepe University Faculty of Medicine Department of General Surgery 06100 Hacettepe Ankara Turkey Corresponding author Yusuf Alper Kilic yusufa@hacettepe.edu.tr Published 22 April 2008 This article is online at http ccforum.com content 12 2 417 2008 BioMed Central Ltd Critical Care 2008 12 417 doi 10.1186 cc6856 Severe sepsis and septic shock represent a major cause of mortality in critical care. Even in patients who survived a clinical course complicated with multiple organ dysfunction leads to significant morbidity costs and use of already limited resources. That s why treatment of these patients requires timely mobilization of a logical and scientifically up-to-date plan. In critical care as in almost all disciplines of medicine the emphasis on the benefits of an evidence-based medicine approach has caused current guidelines to be based mostly on the results of prospective randomized clinical studies 1 . These studies mostly evaluate differences in mortality among treatment arms. But sepsis and multiple organ failure have a chaotic nature and treatment effects cannot be explained solely on the basis of differences in mortality. That s why we believe that the linear statistical methods currently used in clinical research are not enough to model this chaotic nature. Besides the complex pathophysiologic interactions within inflammatory cascade and coagulation a genetically determined predisposition for sepsis and septic shock is another reason that diverts the clinical course of sepsis and septic shock from one that is linearly predictable. Additionally there is a temporal and dynamic relationship between failing organ systems and therapeutic .