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https://www.readbyqxmd.com/read/28079604/prior-use-of-calcium-channel-blockers-is-associated-with-decreased-mortality-in-critically-ill-patients-with-sepsis-a-prospective-observational-study
#1
Maryse A Wiewel, Lonneke A van Vught, Brendon P Scicluna, Arie J Hoogendijk, Jos F Frencken, Aeilko H Zwinderman, Janneke Horn, Olaf L Cremer, Marc J Bonten, Marcus J Schultz, Tom van der Poll
OBJECTIVES: Experimental studies suggest that calcium channel blockers can improve sepsis outcome. The aim of this study was to determine the association between prior use of calcium channel blockers and the outcome of patients admitted to the ICU with sepsis. DESIGN: A prospective observational study. SETTING: The ICUs of two tertiary care hospitals in the Netherlands. PATIENTS: In total, 1,060 consecutive patients admitted with sepsis were analyzed, 18...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#2
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28062972/predictive-performance-of-the-quick-sequential-organ-failure-assessment-score-as-a-screening-tool-for-sepsis-mortality-and-intensive-care-unit-admission-in-patients-with-febrile-neutropenia
#3
Minsoo Kim, Shin Ahn, Won Young Kim, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, Kyung Soo Lim
PURPOSE: In Sepsis-3, the quick Sequential Organ Failure Assessment (qSOFA) score was developed as criteria to use for recognizing patients who may have poor outcomes. This study was performed to evaluate the predictive performance of the qSOFA score as a screening tool for sepsis, mortality, and intensive care unit (ICU) admission in patients with febrile neutropenia (FN). We also tried to compare its performance with that of the systemic inflammatory response syndrome (SIRS) criteria and Multinational Association of Supportive Care in Cancer (MASCC) score for FN...
January 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28054195/innovative-power-of-health-care-organisations-affects-it-adoption-a-bi-national-health-it-benchmark-comparing-austria-and-germany
#4
Jens Hüsers, Ursula Hübner, Moritz Esdar, Elske Ammenwerth, Werner O Hackl, Laura Naumann, Jan David Liebe
Multinational health IT benchmarks foster cross-country learning and have been employed at various levels, e.g. OECD and Nordic countries. A bi-national benchmark study conducted in 2007 revealed a significantly higher adoption of health IT in Austria compared to Germany, two countries with comparable healthcare systems. We now investigated whether these differences still persisted. We further studied whether these differences were associated with hospital intrinsic factors, i.e. the innovative power of the organisation and hospital demographics...
February 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28049363/circulating-chromogranin-b-levels-in-patients-with-acute-respiratory-failure-data-from-the-finnali-study
#5
Peder Langeland Myhre, Mats Stridsberg, Rita Linko, Marjatta Okkonen, Ståle Nygård, Geir Christensen, Ville Pettilä, Torbjørn Omland, Helge Røsjø
PURPOSE: Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown. METHODS: We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days...
January 3, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28049251/validation-of-the-pediatric-index-of-mortality-3-in-a-single-pediatric-intensive-care-unit-in-korea
#6
Ok Jeong Lee, Minyoung Jung, Minji Kim, Hae Kyoung Yang, Joongbum Cho
To compare mortality rate, the adjustment of case-mix variables is needed. The Pediatric Index of Mortality (PIM) 3 score is a widely used case-mix adjustment system of a pediatric intensive care unit (ICU), but there has been no validation study of it in Korea. We aim to validate the PIM3 in a Korean pediatric ICU, and extend the validation of the score from those aged 0-16 to 0-18 years, as patients aged 16-18 years are admitted to pediatric ICU in Korea. A retrospective cohort study of 1,710 patients was conducted in a tertiary pediatric ICU...
February 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28030507/defining-multiple-organ-failure-after-major-trauma-a-comparison-of-the-denver-sequential-organ-failure-assessment-and-marshall-scoring-systems
#7
Lynn Hutchings, Peter Watkinson, J Duncan Young, Keith Willett
BACKGROUND: Postinjury multiple organ failure (MOF) remains a significant cause of morbidity and mortality. A large number of scoring systems have been proposed to define MOF, with no gold-standard. The purpose of this study was to compare three commonly used scores - the Denver PostInjury Multiple Organ Failure Score, the Sequential Organ Failure Assessment (SOFA) and the Marshall Multiple Organ Dysfunction Score - by descriptive analysis of the populations described by each score, and their predictive ability for mortality...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030491/severe-injuries-associated-with-skiing-and-snowboarding-a-national-trauma-data-bank-study
#8
Amory de Roulet, Kenji Inaba, Aaron Strumwasser, Konstantinos Chouliaras, Demetrios Demetriades
BACKGROUND: Injuries following skiing and snowboarding accidents lead to an estimated 7,000 hospital admissions annually and present a significant burden to the health care system. The epidemiology, injury patterns, hospital resource utilization, and outcomes associated with these severe injuries need further characterization. METHODS: The National Trauma Data Bank was queried for the period 2007-2014 for admissions with injury severity score (ISS) >15 and ICD-9 codes 885...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28011419/implications-of-the-new-sepsis-definition-on-research-and-practice
#9
EDITORIAL
Brian C Peach
INTRODUCTION: The Society of Critical-Care Medicine and the European Society of Intensive Care Medicine recently announced a marked change in the sepsis definition. A task force of 19 sepsis clinicians and researchers made the change based on advances in the pathobiological understanding of the septic process. SUMMARY OF CHANGE: The task force determined that there were numerous justifications for a revision of the sepsis definition, which are outlined in this article...
November 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28005711/trauma-system-regionalization-improves-mortality-in-patients-requiring-trauma-laparotomy
#10
David Schechtman, Jack C He, Brenda M Zosa, Debra Allen, Jeffrey A Claridge
INTRODUCTION: This study evaluates the impact of a regional trauma network (RTN) on patient survival, intensive care unit (ICU) length of stay, and hospital length of stay in patients who required trauma laparotomy. METHODS: Patients who required trauma laparotomy from January 2008 to December 2013 were analyzed. Patients admitted during 2008-2009 and 2011-2013 were designated as pre-RTN and RTN groups, respectively. The primary outcome was mortality. RESULTS: A total of 569 patients were analyzed, 231 patients were pre-RTN, and 338 were in the RTN group...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27998608/a-score-to-estimate-30-day-mortality-after-intensive-care-admission-after-cardiac-surgery
#11
Yoan Lamarche, Mahsa Elmi-Sarabi, Lillian Ding, James G Abel, Demetrios Sirounis, André Y Denault
OBJECTIVE: Several risk-scoring systems have been developed to predict surgical mortality and complications in cardiac surgical patients, but none of the current systems include factors related to the intraoperative period. The purpose of this study was to develop a score that incorporates both preoperative and intraoperative factors so that it could be used for patients admitted to a cardiac surgical intensive care unit (ICU) immediately after surgery. METHOD: Preoperative and intraoperative data from 30,350 patients in four hospitals were used to build a multiple logistic regression model estimating 30-day mortality after cardiac surgery...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27982112/usefulness-of-cha2ds2-vasc-scoring-systems-for-predicting-risk-of-perioperative-embolism-in-patients-of-cardiac-myxomas-underwent-surgical-treatment
#12
Liang Yin, Jing Wang, Wei Li, Xinyu Ling, Qian Xue, Yufeng Zhang, Zhinong Wang
Cardiac myxomas are rare but manifested with risk of embolism and often cause unexpected symptoms or sudden death. We retrospectively collected the medical records of patients diagnosed of cardiac myxomas at the cardiac center of our university. Overall 465 patients were included in this study, patients in the embolism group had significantly higher CHA2DS2-VASc scores (P = 0.005). In embolic group, stroke was recorded in 110 (77.14%) patients, while embolic events in the limbs were observed in 10 (2.15%) and 9(1...
December 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27936199/circulating-microvesicles-are-elevated-acutely-following-major-burns-injury-and-associated-with-clinical-severity
#13
Kieran P O'Dea, John R Porter, Nikhil Tirlapur, Umar Katbeh, Suveer Singh, Jonathan M Handy, Masao Takata
Microvesicles are cell-derived signaling particles emerging as important mediators and biomarkers of systemic inflammation, but their production in severe burn injury patients has not been described. In this pilot investigation, we measured circulating microvesicle levels following severe burns, with severe sepsis patients as a comparator group. We hypothesized that levels of circulating vascular cell-derived microvesicles are elevated acutely following burns injury, mirroring clinical severity due to the early onset and prevalence of systemic inflammatory response syndrome (SIRS) in these patients...
2016: PloS One
https://www.readbyqxmd.com/read/27933180/serum-levels-of-immunoglobulins-and-severity-of-community-acquired-pneumonia
#14
Mari C de la Torre, Pere Torán, Mateu Serra-Prat, Elisabet Palomera, Estel Güell, Ester Vendrell, Joan Carles Yébenes, Antoni Torres, Jordi Almirall
INSTRUCTION: There is evidence of a relationship between severity of infection and inflammatory response of the immune system. The objective is to assess serum levels of immunoglobulins and to establish its relationship with severity of community-acquired pneumonia (CAP) and clinical outcome. METHODS: This was an observational and cross-sectional study in which 3 groups of patients diagnosed with CAP were compared: patients treated in the outpatient setting (n=54), patients requiring in-patient care (hospital ward) (n=173), and patients requiring admission to the intensive care unit (ICU) (n=191)...
2016: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/27911103/tools-for-outcome-prediction-in-patients-with-community-acquired-pneumonia
#15
Faheem Khan, Mark B Owens, Marcos Restrepo, Pedro Povoa, Ignacio Martin-Loeches
Community-acquired pneumonia (CAP) is one of the most common causes of mortality world-wide. The mortality rate of patients with CAP is influenced by the severity of the disease, treatment failure and the requirement for hospitalization and/or intensive care unit (ICU) management, all of which may be predicted by biomarkers and clinical scoring systems. Areas covered: We review the recent literature examining the efficacy of established and newly-developed clinical scores, biological and inflammatory markers such as C-Reactive protein (CRP), procalcitonin (PCT) and Interleukin-6 (IL-6), whether used alone or in conjunction with clinical severity scores to assess the severity of CAP, predict treatment failure, guide acute in-hospital or ICU admission and predict mortality...
December 12, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27906871/performance-of-icd-based-injury-severity-measures-used-to-predict-in-hospital-mortality-and-intensive-care-admission-among-traumatic-brain-injured-patients
#16
Mathieu Gagné, Lynne Moore, Marie-Josée Sirois, Marc Simard, Claudia Beaudoin, Brice Lionel Batomen Kuimi
BACKGROUND: The International Classification of Diseases (ICD) is the main classification system used for population-based traumatic brain injury (TBI) surveillance activities but does not contain direct information on injury severity. ICD-based injury severity measures can be empirically derived or mapped to the Abbreviated Injury Scale, but no single approach has been formally recommended for TBI. OBJECTIVE: To compare the accuracy of different ICD-based injury severity measures for predicting in-hospital mortality and intensive care unit (ICU) admission in TBI patients...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#17
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902615/the-prognostic-significance-of-the-birmingham-vasculitis-activity-score-bvas-with-systemic-vasculitis-patients-transferred-to-the-intensive-care-unit-icu
#18
Federico Biscetti, Angela Carbonella, Federico Parisi, Silvia Laura Bosello, Franco Schiavon, Roberto Padoan, Elisa Gremese, Gianfranco Ferraccioli
Systemic vasculitides represent a heterogeneous group of diseases that share clinical features including respiratory distress, renal dysfunction, and neurologic disorders. These diseases may often cause life-threatening complications requiring admission to an intensive care unit (ICU). The aim of the study was to evaluate the validity and responsiveness of Birmingham Vasculitis Activity Score (BVAS) score to predict survival in patients with systemic vasculitides admitted to ICU.A retrospective study was carried out from 2004 to 2014 in 18 patients with systemic vasculitis admitted to 2 different Rheumatology divisions and transferred to ICU due to clinical worsening, with a length of stay beyond 24 hours...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27882011/better-prognostic-marker-in-icu-apache-ii-sofa-or-sap-ii
#19
Iftikhar Haider Naqvi, Khalid Mahmood, Syed Ziaullaha, Syed Mohammad Kashif, Asim Sharif
OBJECTIVES: This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients. METHODS: This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#20
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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