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https://www.readbyqxmd.com/read/27922344/predictors-of-mortality-in-a-paediatric-intensive-care-unit-in-kigali-rwanda
#1
Rosine Nyirasafari, Mark H Corden, Angélique Charlie Karambizi, Jean Claude Kabayiza, Jean Damascene Makuza, Rex Wong, Michael F Canarie
BACKGROUND: The enormous burden of critical illness in resource-limited settings has led to a growing interest in paediatric critical care in these regions. However, published data on the practice of critical care and patient outcomes in these settings are scant. OBJECTIVE: This study sought to identify risk factors associated with mortality in the newly established Paediatric Intensive Care Unit (PICU) at Kigali University Teaching Hospital (KUTH) in Rwanda and test the predictive ability of a newly devised mortality risk score, the modified PRISM (MP) score...
December 6, 2016: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/27899100/clinical-determinants-of-the-severity-of-middle-east-respiratory-syndrome-mers-a-systematic-review-and-meta-analysis
#2
Ryota Matsuyama, Hiroshi Nishiura, Satoshi Kutsuna, Kayoko Hayakawa, Norio Ohmagari
BACKGROUND: While the risk of severe complications of Middle East respiratory syndrome (MERS) and its determinants have been explored in previous studies, a systematic analysis of published articles with different designs and populations has yet to be conducted. The present study aimed to systematically review the risk of death associated with MERS as well as risk factors for associated complications. METHODS: PubMed and Web of Science databases were searched for clinical and epidemiological studies on confirmed cases of MERS...
November 29, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27895930/obstetric-patients-in-intensive-care-unit-perspective-from-a-teaching-hospital-in-pakistan
#3
Rahat Qureshi, Sheikh Irfan Ahmed, Amir Raza, Ayesha Khurshid, Uzma Chishti
OBJECTIVE: Review of obstetric cases admitted to the intensive care unit. DESIGN: Ten year retrospective review of individual patients' medical records. PARTICIPANTS: Records of obstetric patients admitted from 2005-2014. SETTING: Aga Khan University Hospital Karachi. MAIN OUTCOME MEASURES: Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality...
November 2016: JRSM Open
https://www.readbyqxmd.com/read/27895344/peri-operative-determinants-of-prolonged-cicu-stay-after-coronary-artery-bypass-graft-surgery-in-elderly-at-a-private-tertiary-care-hospital-a-case-control-study
#4
Fazal Wahab Khan, Shiraz Hashmi, Syed Saeed Naeem, Benish Fatima, Hashim Hanif, Mubashir Zareen, Saulat Hasnain Fatimi
OBJECTIVE: To explore peri-operative risk factors associated with prolonged stay in cardiac intensive care unit among patients undergoing isolated coronary artery bypass grafting. Methods: This retrospective case control study was conducted at the Aga Khan University Hospital, Karachi, comprised medical records of patients who had undergone cardiothoracic revascularisation surgery from January 2006 to December 2013. The patients were grouped into cases and controls at a ratio of 1:2 on the basis of length of stay at cardiac intensive care unit, i...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27893673/risk-factor-and-outcome-for-intra-abdominal-bleeding-in-patients-with-enterocutaneous-fistula
#5
Lei Wu, Jianan Ren, Qinjie Liu, Gefei Wang, Xiuwen Wu, Guosheng Gu, Guanwei Li, Kun Guo, Zhiwu Hong, Qiongyuan Hu, Huajian Ren, Jieshou Li
Intra-abdominal bleeding is a major and lethal complication in patients with enterocutaneous fistula (ECF) while few studies are involved in this aspect. In the present study, we aimed to investigate the risk factors and assessed the outcome for intra-abdominal bleeding in patients with ECF.A retrospective study was performed from October 2013 to October 2015. Medical records of 67 ECF patients with intra-abdominal bleeding and 134 ECF patients without intra-abdominal bleeding matched as controls were reviewed and analyzed...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#6
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27881149/antipsychotic-prescribing-patterns-during-and-after-critical-illness-a-prospective-cohort-study
#7
Jason E Tomichek, Joanna L Stollings, Pratik P Pandharipande, Rameela Chandrasekhar, E Wesley Ely, Timothy D Girard
BACKGROUND: Antipsychotics are used to treat delirium in the intensive care unit (ICU) despite unproven efficacy. We hypothesized that atypical antipsychotic treatment in the ICU is a risk factor for antipsychotic prescription at discharge, a practice that might increase risk since long-term use is associated with increased mortality. METHODS: After excluding patients on antipsychotics prior to admission, we examined antipsychotic use in a prospective cohort of ICU patients with acute respiratory failure and/or shock...
November 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27875774/risk-factors-for-acute-kidney-injury-in-critically-ill-patients-with-complicated-intra-abdominal-infection
#8
Alejandro Suarez-de-la-Rica, Víctor Anillo, Ana Montero, Carmen Hernandez-Gancedo, Araceli Lopez-Tofiño, Fernando Gilsanz, Emilio Maseda
PURPOSE: The aim was to determine the factors related to acute kidney injury (AKI) in surgical septic patients with complicated intra-abdominal infection (CIAI) and mortality associated to AKI. METHODS: An observational study was performed in patients with CIAI requiring surgery and ICU admission (June 2011-June 2013). Factors at admission associated with developing of AKI and renal replacement therapy (RRT) and association between mortality and AKI and RRT were studied...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27866108/clinical-characteristics-of-critically-ill-patients-with-suspected-influenza-during-the-2009-10-and-2013-14-outbreaks
#9
Miguel J Franquiz, Paul G Saleeb, Carl B Shanholtz, Jeffrey P Gonzales
PURPOSE: Pandemic influenza A pdm09 (pH1N1) virus was the predominant isolate identified during the 2009-10 and 2013-14 influenza outbreaks, causing significant morbidity and mortality. We describe clinical characteristics of critically ill patients during 2 pH1N1 outbreaks. METHODS: Single-center, retrospective cohort study of patients admitted to the intensive care unit receiving oseltamivir for suspected influenza during 2 outbreak periods. Demographics and comorbidities were collected from the medical record...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27864622/how-obesity-impacts-outcomes-of-infectious-diseases
#10
A Atamna, A Elis, E Gilady, L Gitter-Azulay, J Bishara
Obesity is associated with co-morbidities and increased risk of acquiring infections with worse outcomes. Paradoxically, a few studies indicate that obesity may have a decreased mortality in hospitalized patients with pneumonia. The objective of this study was to determine the impact of body mass index (BMI) on short-term all-cause mortality and clinical outcomes among hospitalized adults with pneumonia, urinary tract infections, skin and soft tissue infections, and bacteremia. The study cohort included 1437 consecutive patients who were admitted with infectious disease including pneumonia (717), urinary tract infection (506), bacteremia (69), and skin and soft tissue infections (145), and hospitalized in internal medical departments, during 2013-2015...
November 18, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27864615/the-effects-of-active-mobilisation-and-rehabilitation-in-icu-on-mortality-and-function-a-systematic-review
#11
REVIEW
Claire J Tipping, Meg Harrold, Anne Holland, Lorena Romero, Travis Nisbet, Carol L Hodgson
PURPOSE: Early active mobilisation and rehabilitation in the intensive care unit (ICU) is being used to prevent the long-term functional consequences of critical illness. This review aimed to determine the effect of active mobilisation and rehabilitation in the ICU on mortality, function, mobility, muscle strength, quality of life, days alive and out of hospital to 180 days, ICU and hospital lengths of stay, duration of mechanical ventilation and discharge destination, linking outcomes with the World Health Organization International Classification of Function Framework...
November 18, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27861180/improving-hospital-survival-and-reducing-brain-dysfunction-at-seven-california-community-hospitals-implementing-pad-guidelines-via-the-abcdef-bundle-in-6-064-patients
#12
Mary Ann Barnes-Daly, Gary Phillips, E Wesley Ely
OBJECTIVES: To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals. DESIGN: A prospective cohort quality improvement initiative involving ICU patients...
November 17, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843682/large-spontaneous-spinal-subdural-epidural-hematoma-after-epidural-anesthesia-for-caesarean-section-conservative-management-with-excellent-outcome
#13
Ioannis D Siasios, Kunal Vakharia, Kevin J Gibbons, Vassilios G Dimopoulos
BACKGROUND: Iatrogenic or spontaneous spinal hematomas are rarely seen and present with multiple symptoms that can be difficult to localize. Most spontaneous spinal hematomas are multifactorial, and the pathophysiology is varied. Here, we present a case of a scattered, multicomponent, combined subdural and epidural spinal hematoma that was managed conservatively. CASE DESCRIPTION: A 38-year-old woman came to the emergency department (ED) complaining of severe neck and back pain...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27842947/extracorporeal-support-during-bilateral-sequential-lung-transplantation-in-patients-with-pulmonary-hypertension-risk-factors-and-outcomes
#14
Pranav R Shah, Michael L Boisen, Daniel G Winger, Jose Marquez, Christian A Bermudez, Jay K Bhama, Norihisa Shigemura, Jonathan D'Cuhna, Kathirvel Subramaniam
OBJECTIVE: To identify preoperative predictors of extracorporeal support in patients with pulmonary hypertension (PH) undergoing bilateral sequential lung transplantation (LTx), and to examine outcomes associated with the use of extracorporeal support. DESIGN: Retrospective, observational study. SETTING: Single organ transplantation and tertiary care university medical center. PARTICIPANTS: Adults with PH (preoperative mean pulmonary artery pressure (mPAP)≥25 mmHg) who underwent primary bilateral sequential LTx during 2007 to 2013...
August 18, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27832254/association-of-risk-factors-mortality-and-care-costs-of-adults-with-acute-myeloid-leukemia-with-admission-to-the-intensive-care-unit
#15
Anna B Halpern, Eva Culakova, Roland B Walter, Gary H Lyman
Importance: Adults with acute myeloid leukemia (AML) commonly require support in the intensive care unit (ICU), but risk factors for admission to the ICU and adverse outcomes remain poorly defined. Objective: To examine risk factors, mortality, length of stay, and cost associated with admission to the ICU for patients with AML. Design, Setting, and Participants: This study extracted information from the University HealthSystem Consortium database on patients 18 years or older with AML who were hospitalized for any cause between January 1, 2004, and December 31, 2012...
November 10, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#16
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27823893/sepsis-clinical-criteria-in-emergency-department-patients-admitted-to-an-intensive-care-unit-an-external-validation-study-of-quick-sequential-organ-failure-assessment
#17
Michael D April, Jose Aguirre, Lloyd I Tannenbaum, Tyler Moore, Alexander Pingree, Robert E Thaxton, Daniel J Sessions, James H Lantry
BACKGROUND: Quick Sequential Organ Failure Assessment (qSOFA) is a prognostic score for patients with sepsis. OBJECTIVE: Our aim was to compare the area under the receiver operating curve (AUROC), sensitivity, specificity, and likelihood ratios of qSOFA vs. systemic inflammation response syndrome (SIRS) in predicting in-hospital mortality among emergency department (ED) patients with suspected infection admitted to intensive care units (ICUs). METHODS: We conducted a retrospective cohort chart review study of ED patients admitted to an ICU with suspected infection from August 1, 2012 to February 28, 2015...
November 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27821662/malnutrition-at-intensive-care-unit-admission-predicts-mortality-in-emergency-general-surgery-patients
#18
Joaquim M Havens, Alexandra B Columbus, Anupamaa J Seshadri, Olubode A Olufajo, Kris M Mogensen, James D Rawn, Ali Salim, Kenneth B Christopher
BACKGROUND: Emergency general surgery (EGS) patients are at an increased risk for morbidity and mortality compared with non-EGS patients. Limited information exists regarding the contribution of malnutrition to the outcome of critically ill patients who undergo EGS. We hypothesized that malnutrition would be associated with increased risk of 90-day all-cause mortality following intensive care unit (ICU) admission in EGS patients. MATERIALS AND METHODS: We performed an observational study of patients treated in medical and surgical ICUs at a single institution in Boston...
November 7, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27806150/patterns-of-care-in-hospitalized-vascular-surgery-patients-at-end-of-life
#19
Dale G Wilson, Sheena K Harris, Heidi Peck, Kyle Hart, Enjae Jung, Amir F Azarbal, Erica L Mitchell, Gregory J Landry, Gregory L Moneta
Importance: There is limited literature reporting circumstances surrounding end-of-life care in vascular surgery patients. Objective: To identify factors driving end-of-life decisions in vascular surgery patients. Design, Setting, and Participants: In this cohort study, medical records were reviewed for all vascular surgery patients at a tertiary care university hospital who died during their hospitalization from 2005 to 2014. Main Outcomes and Measures: Patient, family, and hospitalization variables potentially important to influencing end-of-life decisions...
November 2, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27805834/outcomes-after-rehospitalization-at-the-same-hospital-or-a-different-hospital-following-critical-illness
#20
May Hua, Michelle Ng Gong, Andrea Miltiades, Hannah Wunsch
RATIONALE: Intensive care unit (ICU) patients who receive mechanical ventilation are at high risk for early rehospitalization. Given their medical complexity, a lack of continuity of care may adversely affect outcomes during rehospitalization. OBJECTIVE: To determine whether outcomes differ for patients who are rehospitalized at a different hospital versus the hospital of the index ICU stay. METHODS: Retrospective cohort study of mechanically ventilated ICU patients rehospitalized within 30 days in New York State hospitals from 2008-2013...
November 2, 2016: American Journal of Respiratory and Critical Care Medicine
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