keyword
https://read.qxmd.com/read/38249261/early-versus-late-initiation-of-hydrocortisone-in-patients-with-septic-shock-a-prospective-study
#21
JOURNAL ARTICLE
Moath Alsulami, Lamees Alrojaie, Abubker Omaer
Introduction The optimal timing of corticosteroid initiation in septic shock patients is debatable. The Surviving Sepsis Campaign Guidelines recommended adding hydrocortisone to septic shock patients who require a vasopressor with a dose of norepinephrine ≥ 0.25 mcg/kg/min for at least four hours. Nevertheless, the best time to initiate hydrocortisone remains uncertain. Objective Assessing the impact of early (≤3 hours) versus late (>3 hours) initiation of hydrocortisone in septic patients...
December 2023: Curēus
https://read.qxmd.com/read/38244762/incidence-and-case-ascertainment-of-treated-in-hospital-cardiac-arrest-events-in-a-national-quality-registry-a-comparison-of-reported-and-non-reported-events
#22
JOURNAL ARTICLE
Jennie Silverplats, Björn Äng, Marie-Louise Södersved Källestedt, Anneli Strömsöe
BACKGROUND: Approximately 2,500 in-hospital cardiac arrest (IHCA) events are reported annually to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) with an estimated incidence of 1.7/1,000 hospital admissions. The aim of this study was to evaluate the compliance in reporting IHCA events to the SRCR and to compare reported IHCA events with possible non-reported events, and to estimate IHCA incidence. METHODS: Fifteen diagnose codes, eight Classification of Care Measure codes, and two perioperative complication codes were used to find all treated IHCAs in 2018-2019 at six hospitals of varying sizes and resources...
January 18, 2024: Resuscitation
https://read.qxmd.com/read/38244252/combining-the-nurse-intuition-patient-deterioration-scale-with-the-national-early-warning-score-provides-more-net-benefit-in-predicting-serious-adverse-events-a-prospective-cohort-study-in-medical-surgical-and-geriatric-wards
#23
JOURNAL ARTICLE
Filip Haegdorens, Julie Lefebvre, Carolien Wils, Erik Franck, Peter Van Bogaert
OBJECTIVES: This prospective cohort study aimed to assess the predictive value of the Nurse Intuition Patient Deterioration Scale (NIPDS) combined with the National Early Warning Score (NEWS) for identifying serious adverse events in patients admitted to diverse hospital wards. RESEARCH METHODOLOGY/DESIGN: Data was collected between December 2020 and February 2021 in a 350-bed acute hospital near Brussels, Belgium. The study followed a prospective cohort design, employing NIPDS alongside NEWS for risk assessment...
January 19, 2024: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://read.qxmd.com/read/38236317/association-between-coronary-artery-disease-testing-in-patients-with-new-onset-heart-failure-and-heart-failure-readmission-and-mortality
#24
JOURNAL ARTICLE
Cheng-Wei Huang, Siamak Kohan, In-Lu Amy Liu, Janet S Lee, Nicole C Baghdasaryan, Joon S Park, Jessica D Vallejo, Christopher C Subject, Huong Nguyen, Ming-Sum Lee
BACKGROUND: In patients with new-onset heart failure (HF), coronary artery disease (CAD) testing remains underutilized. Whether widespread CAD testing in patients with new-onset HF leads to improved outcomes remains to be determined. OBJECTIVE: We sought to examine whether CAD testing, and its timing, among patients hospitalized with new-onset HF with reduced ejection fraction (HFrEF), is associated with improved outcomes. DESIGN: Retrospective cohort study...
January 18, 2024: Journal of General Internal Medicine
https://read.qxmd.com/read/38232707/interventions-performed-in-children-with-immunocompromised-conditions-in-the-pediatric-intensive-care-unit-within-48-hours-of-death
#25
JOURNAL ARTICLE
Anna Kegel, Jason Espinoza, April Rahrig, Tina Schade-Wills, Courtney M Rowan
Background: Understanding interventions preceding death in children with immunocompromised conditions is important to ensure a peaceful and dignified perideath experience. The aim of this study was to describe the number of interventions performed in the pediatric intensive care unit (PICU) within the 48 hours before death in this population. Methods: This was a single-center, retrospective cohort study of all children with an underlying oncologic, hematologic, or immunologic diagnosis admitted to the PICU for at least 72 hours between 2014 and 2021...
January 17, 2024: Journal of Palliative Medicine
https://read.qxmd.com/read/38227032/default-palliative-care-consultation-for-seriously-ill-hospitalized-patients-a-pragmatic-cluster-randomized-trial
#26
RANDOMIZED CONTROLLED TRIAL
Katherine R Courtright, Vanessa Madden, Brian Bayes, Marzana Chowdhury, Casey Whitman, Dylan S Small, Michael O Harhay, Suzanne Parra, Elizabeth Cooney-Zingman, Mary Ersek, Gabriel J Escobar, Sarah H Hill, Scott D Halpern
IMPORTANCE: Increasing inpatient palliative care delivery is prioritized, but large-scale, experimental evidence of its effectiveness is lacking. OBJECTIVE: To determine whether ordering palliative care consultation by default for seriously ill hospitalized patients without requiring greater palliative care staffing increased consultations and improved outcomes. DESIGN, SETTING, AND PARTICIPANTS: A pragmatic, stepped-wedge, cluster randomized trial was conducted among patients 65 years or older with advanced chronic obstructive pulmonary disease, dementia, or kidney failure admitted from March 21, 2016, through November 14, 2018, to 11 US hospitals...
January 16, 2024: JAMA
https://read.qxmd.com/read/38219811/cross-institution-natural-language-processing-for-reliable-clinical-association-studies-a-methodological-exploration
#27
JOURNAL ARTICLE
Madhumita Sushil, Atul J Butte, Ewoud Schuit, Maarten van Smeden, Artuur M Leeuwenberg
OBJECTIVE: Natural language processing (NLP) of clinical notes in electronic medical records is increasingly used to extract otherwise sparsely available patient characteristics, to assess their association with relevant health outcomes. Manual data curation is resource intensive and NLP methods make these studies more feasible. However, the methodology of using NLP methods reliably in clinical research is understudied. The objective of this study is to investigate how NLP models could be used to extract study variables (specifically: exposures) to reliably conduct exposure-outcome association studies...
January 12, 2024: Journal of Clinical Epidemiology
https://read.qxmd.com/read/38214155/surrogate-decision-making-after-stroke-in-a-community-setting-the-oasis-project
#28
JOURNAL ARTICLE
Darin B Zahuranec, Carmen Ortiz, Rebecca J Lank, Guanghao Zhang, Xu Shi, Erin Case, Lewis B Morgenstern
BACKGROUND: Patients with severe stroke often rely on surrogate decision-makers for life-sustaining treatment decisions. We investigated ethnic differences between Mexican Americans (MAs) and non-Hispanic White (NHW) individuals in surrogate reports of physician quality of communication and shared decision-making from the OASIS study (Outcomes Among Surrogate Decision Makers in Stroke) project. METHODS: Patients had ischemic stroke or intracerebral hemorrhage in Nueces County, TX...
March 2024: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/38157237/testing-a-culturally-tailored-advance-care-planning-intervention-my-way-for-an-american-indian-tribe-protocol-for-a-quasi-experimental-waitlist-control-design
#29
JOURNAL ARTICLE
Elizabeth Anderson, R Turner Goins, Emily A Haozous, April Schweinhart
BACKGROUND: American Indian and Alaska Native peoples experience poor end-of-life care, including more hospitalizations and lower use of hospice and do-not-resuscitate orders. Although advance care planning (ACP) can improve end-of-life care, ACP rates are disproportionately low in American Indians and Alaska Natives. OBJECTIVE: We culturally tailored and delivered an existing evidence-based ACP program for an American Indian tribal community. Here, we present the protocol for assessing the intervention's feasibility and efficacy...
December 29, 2023: JMIR Research Protocols
https://read.qxmd.com/read/38150077/the-impact-of-a-multidisciplinary-goals-of-care-program-on-unplanned-readmission-rates-at-a-comprehensive-cancer-center
#30
JOURNAL ARTICLE
Cerena Leung, Clark R Andersen, Kaycee Wilson, Nico Nortje, Marina George, Christopher Flowers, Eduardo Bruera, David Hui
PURPOSE: This study examined the 30-day unplanned readmission rate in the medical oncology population before and after the implementation of an institution-wide multicomponent interdisciplinary goals of care (myGOC) program. METHODS: This retrospective study compared the 30-day unplanned readmission rates in consecutive medical patients during the pre-implementation period (May 1, 2019, to December 31, 2019) and the post-implementation period (May 1, 2020, to December 31, 2020)...
December 27, 2023: Supportive Care in Cancer
https://read.qxmd.com/read/38126404/discussion-of-the-do-not-resuscitate-dnr-orders-with-the-family-caregivers-of-cancer-patients-an-example-from-a-major-cancer-center-in-saudi-arabia
#31
JOURNAL ARTICLE
Mohammad Z Al-Shahri, Mahmoud Sroor, Wael Ali Said Ghareeb, Suzan Alhassanin, Heba Aly Ateya
OBJECTIVES: To explore the views of the family caregivers (FCGs) about the "do-not-resuscitate" (DNR) discussions and decision-making processes that occurred during hospitalization in a Saudi cancer center. METHODS: In this cross-sectional survey, the FCGs of inpatients with advanced cancer completed a self-administered questionnaire soon after giving the patients a DNR status designation by their oncologists. RESULTS: Eighty-two FCGs participated in the study, with a median age of 36...
December 21, 2023: Palliative & Supportive Care
https://read.qxmd.com/read/38125770/the-associations-between-rapid-response-systems-and-their-components-with-patient-outcomes-a-scoping-review
#32
JOURNAL ARTICLE
Rebecca J Piasecki, Cheryl R Dennison Himmelfarb, Kelly T Gleason, Rachel M Justice, Elizabeth A Hunt
BACKGROUND: While rapid response systems have been widely implemented, their impact on patient outcomes remains unclear. Further understanding of their components-including medical emergency team triggers, medical emergency team member composition, additional roles in patient care beyond responding to medical emergency team events, and their involvement in "Do-Not-Resuscitate" order placement-may elucidate the relationship between rapid response systems and outcomes. OBJECTIVE: To explore how recent studies have examined rapid response system components in the context of relevant adverse patient outcomes, such as in-hospital cardiac arrests and hospital mortality...
December 2023: International journal of nursing studies advances
https://read.qxmd.com/read/38125687/the-co-existence-of-patent-omphalomesenteric-duct-and-omphalocele-in-patau-s-syndrome-in-saudi-arabia-a-case-report
#33
Badr Beyari, Yaser Alhassan, Aisha Gabra, Mohammed Awad, Ameen Alsaggaf
The pathophysiology of Patau's syndrome involves the triplication of chromosomes, leading to multiple comorbidities. An omphalocele is characterized by a protrusion of abdominal contents from the base of the umbilical cord through the peritoneum. An omphalomesenteric duct remnant occurs when there is a failure of duct closure that results in a diverticulum extending from the fetal midgut to the yolk sac. While congenital defects rarely occur simultaneously in patients with Patau's syndrome, this case report describes a newborn with Patau syndrome who presented with both an omphalocele and an omphalomesenteric duct remnant...
December 2023: Curēus
https://read.qxmd.com/read/38123353/race-and-socioeconomic-disparities-in-mortality-and-end-of-life-care-following-aneurysmal-subarachnoid-hemorrhage
#34
JOURNAL ARTICLE
Jean-Luc K Kabangu, Lane Fry, Adip G Bhargav, Cody Heskett, Sonia V Eden, Jeremy C Peterson, Paul J Camarata, Koji Ebersole
BACKGROUND: This study explores racial and socioeconomic disparities in aneurysmal subarachnoid hemorrhage (aSAH) care, highlighting the impact on treatment and outcomes. The study aims to shed light on inequities and inform strategies for reducing disparities in healthcare delivery. METHODS: In this cohort study the National Inpatient Sample database was queried for patient admissions with ruptured aSAH from 2016 to 2020. Multivariable analyses were performed estimating the impact of socioeconomic status and race on rates of acute treatment, functional outcomes, mortality, receipt of life-sustaining interventions (mechanical ventilation, tracheostomy, gastrostomy, and blood transfusions), and end-of-life care (palliative care and do not resuscitate)...
December 20, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/38106730/serratia-marcescens-endocarditis-in-prosthetic-valves
#35
Asma Jamil, Hari Sharma, Ruhma Ali, Alan Klukowicz, Abu Taha, Amy Paige, Sharath Bellary, Abbas Ahmed, Richard Miller, Priscilla Chow
Serratia marcescens endocarditis is a rare occurrence. We describe a case of Serratia endocarditis in a patient with a prosthetic valve. The clinical course was complicated by widespread embolic phenomena causing stroke, gangrene of extremities, and septic emboli to the lungs, spleen, and eyes. She was not considered suitable for surgery due to severe consumptive coagulopathy and thrombocytopenia in the setting of widespread emboli. The patient was transitioned to do not resuscitate status and discharged to a long-term care facility with a grave prognosis explained to the family...
November 2023: Curēus
https://read.qxmd.com/read/38087874/retrospective-review-of-the-code-status-of-individuals-with-down-syndrome-during-the-covid-19-era
#36
JOURNAL ARTICLE
Jennifer Jett, Alexander Fossi, Heather Blonsky, Wendy Ross, Sabra Townsend, Mary M Stephens, Brian Chicoine, Stephanie L Santoro
Code status is a label in the medical record indicating a patient's wishes for end-of-life (EOL) care in the event of a cardiopulmonary arrest. People with intellectual disabilities had a higher risk of both diagnosis and mortality from coronavirus infections (COVID-19) than the general population. Clinicians and disability advocates raised concerns that bias, diagnostic overshadowing, and ableism could impact the allocation of code status and treatment options, for patients with intellectual disabilities, including Down syndrome (DS)...
December 12, 2023: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://read.qxmd.com/read/38069656/express-epidemiology-and-outcomes-of-previously-healthy-critically-ill-patients-with-covid-19-a-population-based-cohort
#37
JOURNAL ARTICLE
Lavi Oud, John Garza
Comorbid conditions represent a major risk for severe illness among persons with COVID-19. Previously healthy people with COVID-19 can also develop severe illness, but are expected to have better outcomes than those with comorbid conditions. Nevertheless, recent data suggest that the former may have, counterintuitively, higher risk of death among those with non-COVID sepsis. However, the epidemiology and outcomes of previously healthy people among critically ill patients with COVID-19 are unknown. We used statewide data to identify ICU admissions aged ≥18 years in Texas with COVID-19 in 2020...
December 9, 2023: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://read.qxmd.com/read/38046937/patient-and-hospital-characteristics-associated-with-the-interhospital-transfer-of-adult-patients-with-sepsis
#38
JOURNAL ARTICLE
Uchenna R Ofoma, Tierney J Lanter, Elena Deych, Marin Kollef, Fei Wan, Karen E Joynt Maddox
IMPORTANCE: The interhospital transfer (IHT) of patients with sepsis to higher-capability hospitals may improve outcomes. Little is known about patient and hospital factors associated with sepsis IHT. OBJECTIVES: We evaluated patterns of hospitalization and IHT and determined patient and hospital factors associated with the IHT of adult patients with sepsis. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: A total of 349,938 adult patients with sepsis at 329 nonfederal hospitals in California, 2018-2019...
December 2023: Critical care explorations
https://read.qxmd.com/read/38033345/out-of-hospital-cardiac-arrest-in-residential-aged-care-facilities-is-independently-associated-with-lower-survival-in-perth-australia
#39
JOURNAL ARTICLE
Milena Talikowska, Stephen Ball, David Majewski, Jason Belcher, Rudolph Brits, Sheryl Gallant, Lyndall Finn, Judith Finn
AIM: To compare out-of-hospital cardiac arrest (OHCA) characteristics and outcomes between people aged ≥ 65 years who arrested in a residential aged care facility (RACF) versus a private residence in Perth, Australia. METHODS: We undertook a retrospective cohort study of OHCA cases attended by emergency medical services (EMS) in Perth, January 2018-December 2021. OHCA patient and event characteristics and survival outcomes were compared via univariate analysis...
December 2023: Resuscitation plus
https://read.qxmd.com/read/38020856/initiating-advance-care-planning-at-admission-a-brief-intervention-to-increase-goals-of-care-discussions-in-geriatric-trauma-patients-in-an-urban-level-i-trauma-center
#40
JOURNAL ARTICLE
Franchesca Hwang, Joohee Son, Kelsey Ensor, Nicole Goulet, Allison Brown, Jesse Victory, Leslie Tyrie
OBJECTIVES: The burden of geriatric trauma continues to rise. Older trauma patients experience higher morbidity and mortality and thus benefit from early goals of care (GOC) discussions and advance care planning (ACP). The American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) recommends holding a family meeting within 72 hours of admission when treating geriatric trauma patients. At our level I trauma center, we sought to increase early GOC discussions by implementing a new history and physical (H&P) note template for geriatric trauma patients...
2023: Trauma Surgery & Acute Care Open
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