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https://www.readbyqxmd.com/read/29227053/quantifying-the-funding-gap-for-management-of-traumatic-brain-injury-at-a-major-trauma-centre-in-south-africa
#1
V Y Kong, J J Odendaal, J L Bruce, G L Laing, E Jerome, B Sartorius, P Brysiewicz, D L Clarke
BACKGROUND: Trauma is an eminently preventable disease. However, prevention programs divert resources away from other priorities. Costing trauma related diseases helps policy makers to make decisions on re-source allocation. We used data from a prospective digital trauma registry to cost Traumatic Brain Injury (TBI) at our institution over a two-year period and to estimate the funding gap that exists in the care of TBI. METHOD: All patients who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI were identified from the Hybrid Electronic Medical Registry (HMER)...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29179572/when-and-why-do-neonatal-and-pediatric-critical-care-physicians-consult-palliative-care
#2
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Taryn Lindhorst, Ross Hays, Ardith Z Doorenbos
BACKGROUND: Parents of children admitted to neonatal and pediatric intensive care units (ICUs) are at increased risk of experiencing acute and post-traumatic stress disorder. The integration of palliative care may improve child and family outcomes, yet there remains a lack of information about indicators for specialty-level palliative care involvement in this setting. OBJECTIVE: To describe neonatal and pediatric critical care physician perspectives on indicators for when and why to involve palliative care consultants...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29148635/admission-patterns-and-outcomes-in-the-medical-intensive-care-unit-of-st-paul%C3%A2-s-hospital-millennium-medical-college-addis-ababa-ethiopia
#3
Seman Kedir, Abreham Berhane, Tola Bayisa, Tewodros Wuletaw
Background: Knowledge of the characteristics and outcomes of critically ill patients admitted to Medical Intensive Care Unit (MICU) helps with identification of priorities and the resources required to improve care. The objective of this study was to examine admission patterns and outcomes in MICU at St. Paul’s Hospital Millennium Medical College. Materials: A retrospective review of 1256 patients’ case notes who were admitted to the MICU at St. Paul’s Hospital Millennium Medical College from 2007 to 2012 was carried out...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29067985/point-prevalence-risk-factor-assessment-for-hospital-acquired-infections-in-a-tertiary-care-hospital-in-pune-india
#4
Velu Nair, A K Sahni, Dinesh Sharma, Naveen Grover, S Shankar, A Chakravarty, Seema Patrikar, Kailas Methe, S S Jaiswal, S S Dalal, Anupam Kapur, Rajesh Verma, Jyoti Prakash, Ashutosh Gupta, Anvita Bhansali, Deepak Batura, G Gopal Rao, D P Joshi, B K Chopra
BACKGROUND & OBJECTIVES: Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India. METHODS: A series of four cross-sectional point prevalence surveys were carried out between March and August 2014...
June 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28843069/new-onset-status-epilepticus-in-older-patients-clinical-characteristics-and-outcome
#5
M P Malter, R D Nass, T Kaluschke, G R Fink, L Burghaus, C Dohmen
PURPOSE: We here evaluated (1) the differential characteristics of status epilepticus (SE) in older (≥60 years) compared to younger adults (18-59 years). In particular, we were interested in (2) the proportion and characteristics of new onset SE in patients with no history of epilepsy (NOSE) in older compared to younger adults, and (3) predictive parameters for clinical outcome in older subjects with NOSE. METHODS: We performed a monocentric retrospective analysis of all adult patients (≥18years) admitted with SE to our tertiary care centre over a period of 10 years (2006-2015) to evaluate clinical characteristics and short-time outcome at discharge...
October 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28830479/costs-and-expected-gain-in-lifetime-health-from-intensive-care-versus-general-ward-care-of-30-712-individual-patients-a-distribution-weighted-cost-effectiveness-analysis
#6
Frode Lindemark, Øystein A Haaland, Reidar Kvåle, Hans Flaatten, Ole F Norheim, Kjell A Johansson
BACKGROUND: Clinicians, hospital managers, policy makers, and researchers are concerned about high costs, increased demand, and variation in priorities in the intensive care unit (ICU). The objectives of this modelling study are to describe the extra costs and expected health gains associated with admission to the ICU versus the general ward for 30,712 patients and the variation in cost-effectiveness estimates among subgroups and individuals, and to perform a distribution-weighted economic evaluation incorporating extra weighting to patients with high severity of disease...
August 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28806562/zika-virus-induced-neurological-critical-illness-in-latin-america-severe-guillain-barre-syndrome-and-encephalitis
#7
Ugarte Ubiergo Sebastián, Arenas Villamizar Angel Ricardo, Bruno C Alvarez, Angela Cubides, Angélica F Luna, Max Arroyo-Parejo, Cayri E Acuña, Agamenón V Quintero, Orlando Ch Villareal, Oscar S Pinillos, Elías Vieda, Manuel Bello, Susana Peña, Carmelo Dueñas-Castell, Gloria M V Rodriguez, Jorge L M Ranero, Rosa L M López, Sandra G Olaya, José C Vergara, Ana Tandazo, Juan P S Ospina, Igor M Leyton Soto, R A Fowler, John C Marshall
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS: Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS: Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#8
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28707497/complications-of-central-lines-in-neonates-admitted-to-a-level-iii-neonatal-intensive-care-unit
#9
Beatriz Nicolau Soares, Susana Pissarra, Ana Lídia Rouxinol-Dias, Sandra Costa, Hercília Guimarães
OBJECTIVE: To investigate the incidence and risk factors for central line related complications in neonates. METHODS: A retrospective cohort study of infants who underwent central line (CL) placement, from 1 July 2014 to 31 June 2016, was conducted in Neonatal Intensive Care Unit of Centro Hospitalar de São João. Infants hospitalized more than 2 d and CLs placed for more than 24 h were included. Patients' demographic characteristics, hospital data, and information on CLs were collected...
July 25, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28595669/surges-of-advanced-medical-support-associated-with-influenza-outbreaks
#10
J C King, J E Schweinle, R J Hatchett, Y Gao, R Lichenstein, J Zhou
We utilized de-identified data to evaluate increases in four outcomes during influenza outbreak periods (IOPs) including: hospitalization, intensive care unit admission, mechanical ventilation or death for adults aged 18 years or older with medically attended acute respiratory illnesses (MAARI) admitted to any of Maryland's 50 acute-care hospitals over 12 years. Weekly numbers of positive influenza tests in the Maryland area were obtained from the US Center for Disease Control and Prevention interactive website...
August 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28208967/early-discharge-of-preterm-infants-an-indian-perspective
#11
Ankit Soni, Sandeep Kadam, Anand Pandit, Sanjay Patole
INTRODUCTION: Early home discharge of preterm infants is a priority in developing countries due to bed shortage and poor socio-economic status. There is wide variation in home discharge policies for preterm infants. Limited data exists on optimal timing for discharging such infants. In view of the socio-economic and medico-legal importance of the issue, we aimed to study the outcomes of our ex-preterm infants discharged home 'early', to guide our clinical practice. AIM: To study the rates of re-admissions/mortality within 4 weeks after discharge in preterm (born <34 weeks) infants...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28173962/prevalence-of-healthcare-associated-infections-in-polish-adult-intensive-care-units-summary-data-from-the-ecdc-european-point-prevalence-survey-of-hospital-associated-infections-and-antimicrobial-use-in-poland-2012-2014
#12
A Deptuła, E Trejnowska, G Dubiel, M Żukowski, A Misiewska-Kaczur, T Ozorowski, W Hryniewicz
BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals...
January 4, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27826449/perspective-on-optimizing-clinical-trials-in-critical-care-how-to-puzzle-out-recurrent-failures
#13
REVIEW
Bruno François, Marc Clavel, Philippe Vignon, Pierre-François Laterre
BACKGROUND: Critical care is a complex field of medicine, especially because of its diversity and unpredictability. Mortality rates of the diseases are usually high and patients are critically ill, admitted in emergency, and often have several overlapping diseases. This makes research in critical care also complex because of patients' conditions and because of the numerous ethical and regulatory requirements and increasing global competition. Many clinical trials in critical care have thus failed and almost no drug has yet been developed to treat intensive care unit (ICU) patients...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27810565/frequency-and-predictors-of-acute-hospitalization-before-death-in-patients-with-glioblastoma
#14
Eli L Diamond, Katherine S Panageas, Alexis Dallara, Ariel Pollock, Allison J Applebaum, Alan C Carver, Elena Pentsova, Lisa M DeAngelis, Holly G Prigerson
CONTEXT: Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life are almost invariably a matter of "when," not a matter of "if." Optimizing symptom management and quality of life in later stages of disease is of the utmost priority. OBJECTIVES: To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM. METHODS: Case-control study comparing patients with GBM admitted to the hospital within one month of death to those without late hospital admission...
February 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27682491/-hospital-costs-and-related-influencing-factors-in-patients-with-acute-poisoning
#15
Y M Ye, F M Wang, C Jin, L L Zhou, D Q Chen
Objective: To investigate the hospital costs and related influencing factors in patients with acute poisoning. Methods: A retrospective analysis was performed for the general status and hospital costs of 373 patients with acute poisoning who were admitted to The Second Affiliated Hospital of Wenzhou Medical College from January 2009 to March 2015. The questionnaires were completed, the data were entered into Excel forms, and SPSS 18.0 was used to perform statistical analysis. Results: Among the 373 patients, 44...
July 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27635769/healthcare-provider-perceptions-of-causes-and-consequences-of-icu-capacity-strain-in-a-large-publicly-funded-integrated-health-region-a-qualitative-study
#16
Sean M Bagshaw, Dawn Opgenorth, Melissa Potestio, Stephanie E Hastings, Shelanne L Hepp, Elaine Gilfoyle, David McKinlay, Paul Boucher, Michael Meier, Jeanna Parsons-Leigh, R T Noel Gibney, David A Zygun, Henry T Stelfox
OBJECTIVES: Discrepancy in the supply-demand relationship for critical care services precipitates a strain on ICU capacity. Strain can lead to suboptimal quality of care and burnout among providers and contribute to inefficient health resource utilization. We engaged interprofessional healthcare providers to explore their perceptions of the sources, impact, and strategies to manage capacity strain. DESIGN: Qualitative study using a conventional thematic analysis...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27513536/mindfulness-and-coping-are-inversely-related-to-psychiatric-symptoms-in-patients-and-informal-caregivers-in-the-neuroscience-icu-implications-for-clinical-care
#17
Kelly M Shaffer, Eric Riklin, Jamie M Jacobs, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: To assess the correlation of psychosocial resiliency factors (mindfulness and coping) with symptoms of posttraumatic stress, anxiety, and depression in patients recently admitted to the neuroscience ICU and their primary informal caregivers. DESIGN: A descriptive, cross-sectional correlational study. SETTING: Neuroscience ICU in a major medical center. PARTICIPANTS: A total of 78 dyads of patients (total n = 81) and their primary caregivers (total n = 92) from June to December 2015...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27487912/a-simple-and-robust-bedside-model-for-mortality-risk-in-pediatric-patients-with-acute-respiratory-distress-syndrome
#18
MULTICENTER STUDY
Aaron C Spicer, Carolyn S Calfee, Matthew S Zinter, Robinder G Khemani, Victoria P Lo, Mustafa F Alkhouli, Benjamin E Orwoll, Ana L Graciano, Juan P Boriosi, James P Howard, Heidi R Flori, Michael A Matthay, Anil Sapru
OBJECTIVES: Despite declining mortality, acute respiratory distress syndrome is still involved in up to one third of pediatric intensive care deaths. The recently convened Pediatric Acute Lung Injury Consensus Conference has outlined research priorities for the field, which include the need for accurate bedside risk stratification of patients. We aimed to develop a simple yet robust model of mortality risk among pediatric patients with acute respiratory distress syndrome to facilitate the targeted application of high-risk investigational therapies and stratification for enrollment in clinical trials...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27389656/site-of-infection-and-mortality-in-patients-with-severe-sepsis-or-septic-shock-a-cohort-study-of-patients-admitted-to-a-danish-general-intensive-care-unit
#19
Vibeke Klastrup, Anne Mette Hvass, Julie Mackenhauer, Kurt Fuursted, Henrik Carl Schønheyder, Hans Kirkegaard
BACKGROUND: The search for the site of infection has high priority in patients with severe sepsis and septic shock. However, it is questionable whether mortality is associated with the specific site of infection in patients admitted to an intensive care unit (ICU). Therefore, the 30-day and 90-day mortalities in ICU patients admitted with suspected or confirmed community-acquired infection were studied. METHODS: A retrospective cohort study was conducted, including all adult patients admitted to a multi-specialty tertiary ICU with severe sepsis or septic shock from November 2008 to October 2010...
October 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27036102/development-of-an-algorithm-to-aid-triage-decisions-for-intensive-care-unit-admission-a-clinical-vignette-and-retrospective-cohort-study
#20
Joao Gabriel Rosa Ramos, Beatriz Perondi, Roger Daglius Dias, Leandro Costa Miranda, Claudio Cohen, Carlos Roberto Ribeiro Carvalho, Irineu Tadeu Velasco, Daniel Neves Forte
BACKGROUND: Intensive care unit (ICU) admission triage is performed routinely and is often based solely on clinical judgment, which could mask biases. A computerized algorithm to aid ICU triage decisions was developed to classify patients into the Society of Critical Care Medicine's prioritization system. In this study, we sought to evaluate the reliability and validity of this algorithm. METHODS: Nine senior physicians evaluated forty clinical vignettes based on real patients...
April 2, 2016: Critical Care: the Official Journal of the Critical Care Forum
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