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Objective: The most suitable approach for resuscitation of septic shock, is still not known yet. There are some reports mentioning some correlation between the worsening results and positive fluid balance of patients having septic shock. This study aimed to identify this relationship. Methods: This retrospective study was conducted in Intensive Care Unit of Anesthesia and Reanimation between January 1st 2017 and December 31st 2017. The data of the patients were obtained from the medical records. The relationship between fluid balance and mortality was evaluated in all hospitalized patients with sepsis at intervals of 0-24 hours, 0-72 hours and 0-7 days. Results: We included 164 patients with sepsis in the study.. The area under the Receiver Operating Characteristic (ROC) curve was 0.794 at 24th hour (95% confidence interval (CI): 0.724-0.853 p=0.0001). The threshold value of fluid balance for mortality at 24th hour was found out to be >1700 mL (sensitivity: 73.61%, 95% CI: 61.9-83.3, specificity: 76.09%, 95% CI: 66.1-84.4). The area under the ROC curve was 0.823 at 72th hour (95% CI: 0.753-0.880 p=0.0001). The threshold value of fluid balance for mortality at 72th hour was found out to be >1600 mL (sensitivity: 86.15%, 95% CI: 75.3-93.5, specificity: 67.82%, 95% CI: 56.9-77.4). The area under the ROC curve was 0.823 on the 7th day (95% CI: 0.780-0.916 p=0.0001). The threshold value of fluid balance for mortality on the 7th day was found out to be >1910 mL (sensitivity: 100%, 95% CI: 92.7-100, specificity: 66.15%, 95%CI: 53.4-77.4). Conclusions: Daily positive fluid balance is strictly correlated with mortality thus, we think that it should be monitored as a predictor for mortality. |
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