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https://www.readbyqxmd.com/read/27911103/tools-for-outcome-prediction-in-patients-with-community-acquired-pneumonia
#1
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 2, 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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27873292/icu-management-based-on-picco-parameters-reduces-duration-of-mechanical-ventilation-and-icu-length-of-stay-in-patients-with-severe-thoracic-trauma-and-acute-respiratory-distress-syndrome
#7
Zhong Yuanbo, Wang Jin, Shi Fei, Long Liangong, Liu Xunfa, Xu Shihai, Shan Aijun
BACKGROUND: This study aimed to assess whether a management algorithm using data obtained with a PiCCO system can improve clinical outcomes in critically ill patients with acute respiratory distress syndrome (ARDS). RESULTS: The PaO2/FiO2 ratio increased over time in both groups, with a sharper increase in the PiCCO group. There was no difference in 28-day mortality (3.2 vs. 3.6%, P = 0.841). Days on mechanical ventilation (3 vs. 5 days, P = 0.002) and ICU length of stay (6 vs...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27873233/four-score-predicts-early-outcome-in-patients-after-traumatic-brain-injury
#8
Tee-Tau Eric Nyam, Kam-Hou Ao, Shu-Yu Hung, Mei-Li Shen, Tzu-Chieh Yu, Jinn-Rung Kuo
BACKGROUND: The aim of the study was to determine whether the Full Outline of UnResponsiveness (FOUR) score, which includes eyes opening (E), motor function (M), brainstem reflex (B), and respiratory pattern (R), can be used as an alternate method to the Glasgow Coma Scale (GCS) in predicting intensive care unit (ICU) mortality in traumatic brain injury (TBI) patients. METHODS: From January 2015 to June 2015, patients with isolated TBI admitted to the ICU were enrolled...
November 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27865895/intensive-care-unit-acquired-pneumonia-due-to-pseudomonas-aeruginosa-with-and-without-multidrug-resistance
#9
Laia Fernández-Barat, Miquel Ferrer, Francesca De Rosa, Albert Gabarrús, Mariano Esperatti, Silvia Terraneo, Mariano Rinaudo, Gianluigi Li Bassi, Antoni Torres
OBJECTIVE: Pseudomonas aeruginosa often presents multi-drug resistance (MDR) in intensive care unit (ICU)-acquired pneumonia (ICUAP), possibly resulting in inappropriate empiric treatment and worse outcomes. We aimed to identify patients with ICUAP at risk for these pathogens in order to improve treatment selection and outcomes. METHODS: We prospectively assessed 222 consecutive immunocompetent ICUAP patients confirmed microbiologically. We determined the characteristics, risk factors, systemic inflammatory response and outcomes of P...
November 16, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27865003/capturing-early-signs-of-deterioration-the-dutch-early-nurse-worry-indicator-score-denwis-and-its-value-in-the-rapid-response-system
#10
Gooske Douw, Getty Huisman-de Waal, Arthur R H van Zanten, Johannes G van der Hoeven, Lisette Schoonhoven
OBJECTIVES: To determine the predictive value of individual and combined DENWIS-indicators at various Early-Warning-Score (EWS)-levels, differentiating between EWSs reaching the trigger-threshold to call an RRT and EWS-levels not reaching this point. INTRODUCTION: DENWIS comprises nine indicators underlying nurses' 'worry' about a patients' condition. All indicators independently show significant association with unplanned Intensive-Care/High-Dependency-Unit (ICU/HDU)-admission or unexpected mortality...
November 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27856268/validation-of-the-new-sepsis-3-definitions-proposal-for-improvement-in-early-risk-identification
#11
Evangelos J Giamarellos-Bourboulis, Thomas Tsaganos, Iraklis Tsangaris, Malvina Lada, Christina Routsi, Dimitrios Sinapidis, Marina Koupetori, Magdalini Bristianou, George Adamis, Konstantinos Mandragos, George N Dalekos, Ioannis Kritselis, George Giannikopoulos, Ioannis Koutelidakis, Maria Pavlaki, Eleni Antoniadou, Glykeria Vlachogiannis, Vasilios Koulouras, Athanassios Prekates, George Dimopoulos, Antonia Koutsoukou, Ioannis Pnevmatikos, Aikaterini Ioakeimidou, Anastasia Kotanidou, Stylianos E Orfanos, Apostolos Armaganidis, Charalambos Gogos
OBJECTIVES: Sepsis-3 definitions generated controversies regarding their general applicability. The Sepsis-3 Task Force outscored the need of validation with emphasis on quick SOFA (qSOFA) score. This was done in a prospective cohort coming from a different health-care setting. METHODS: Patients with infections and at least two signs of the systemic inflammatory response syndrome (SIRS) were analyzed. Sepsis was defined as total SOFA ≥2 outside the ICU or as increase of ICU admission SOFA ≥2...
November 14, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27851704/developing-a-patient-classification-system-for-a-neonatal-icu
#12
Nancy M Daraiseh, William P Vidonish, Pam Kiessling, Li Lin
OBJECTIVE: The purpose of this study was to develop a valid and reliable patient classification system (PCS) for a neonatal ICU (NICU). BACKGROUND: PCSs have been widely used to determine required care hours, budgeting, and staffing. There is a lack of and a vital need for a valid and reliable pediatric PCS because of differences in needs and treatment from adults. METHODS: Data were collected in a NICU using work sampling, chart reviews, and expert opinion...
December 2016: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27850757/1120-existing-disease-severity-scoring-systems-and-their-utility-in-an-ed-icu
#13
Joshua Glazer, Richard Medlin, Benjamin Bassin, Kyle Gunnerson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27832691/clinical-course-teaching-in-transport-of-critically-ill-patients-small-group-methods
#14
Mohammad Taghi Beigmohammadi, Mojgan Rahimi, Omid Nabavian, Seyed Hossein Davarani, Kassra Karvandian, Fatemeh Kamalitabar
Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160) and other group the lecture base learning (n=160)...
September 2016: Acta Medica Iranica
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
#15
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/27822309/trends-in-intubation-rates-and-durations-in-ventilated-severely-injured-trauma-patients-an-analysis-from-the-traumaregister-dgu%C3%A2
#16
Khalid Almahmoud, Michel Teuben, Hagen Andruszkow, Klemens Horst, Rolf Lefering, Frank Hildebrand, Hans Christoph Pape, Roman Pfeifer
BACKGROUND: Endotracheal intubation in severely injured patients is known to be a risk factor for systemic complications. We aimed to examine the changes in intubation rates and durations in severely injured trauma patients, and rates of the systemic complications associated with ventilation changes by using a large trauma registry over the period of 13 years. METHODS: Patient demographics, Injury Severity Score (ISS), ventilation days, ventilation free days (VFD), and prevalence of systemic complications (sepsis and multiple organ failure (MOF)) were obtained from the TraumaRegister DGU® and were compared over the study period...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27822095/the-danish-intensive-care-database
#17
REVIEW
Christian Fynbo Christiansen, Morten Hylander Møller, Henrik Nielsen, Steffen Christensen
AIM OF DATABASE: The aim of this database is to improve the quality of care in Danish intensive care units (ICUs) by monitoring key domains of intensive care and to compare these with predefined standards. STUDY POPULATION: The Danish Intensive Care Database (DID) was established in 2007 and includes virtually all ICU admissions in Denmark since 2005. The DID obtains data from the Danish National Registry of Patients, with complete follow-up through the Danish Civil Registration System...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27818706/random-survival-forests-for-predicting-the-bed-occupancy-in-the-intensive-care-unit
#18
Joeri Ruyssinck, Joachim van der Herten, Rein Houthooft, Femke Ongenae, Ivo Couckuyt, Bram Gadeyne, Kirsten Colpaert, Johan Decruyenaere, Filip De Turck, Tom Dhaene
Predicting the bed occupancy of an intensive care unit (ICU) is a daunting task. The uncertainty associated with the prognosis of critically ill patients and the random arrival of new patients can lead to capacity problems and the need for reactive measures. In this paper, we work towards a predictive model based on Random Survival Forests which can assist physicians in estimating the bed occupancy. As input data, we make use of the Sequential Organ Failure Assessment (SOFA) score collected and calculated from 4098 patients at two ICU units of Ghent University Hospital over a time period of four years...
2016: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/27811534/performance-in-trauma-resuscitation-at-an-urban-tertiary-level-i-pediatric-trauma-center
#19
Payal Kadia Gala, Kevin Osterhoudt, Sage R Myers, Mariel Colella, Aaron Donoghue
BACKGROUND: The role of the surveyor in trauma resuscitations is to identify life-threatening injuries and is meant to be conducted by a set protocol for every patient. Optimal performance of the trauma survey is known to be a challenge in pediatric trauma resuscitation. A postulated reason for this observation is that many trainees, such as pediatric residents, who perform the trauma survey have minimal experience and do not have formal advanced trauma life support training. The assessment of factors that may be obstacles in performing the trauma survey has not been studied robustly...
November 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27809885/which-score-should-be-used-for-posttraumatic-multiple-organ-failure-comparison-of-the-mods-denver-and-sofa-scores
#20
Matthias Fröhlich, Arasch Wafaisade, Anastasios Mansuri, Paola Koenen, Christian Probst, Marc Maegele, Bertil Bouillon, Samir G Sakka
BACKGROUND: Multiple organ dysfunction and multiple organ failure (MOF) is still a major complication and challenge in the treatment of severely injured patients. The incidence varies decisively in current studies, which complicates the comparability regarding risk factors, treatment recommendations and patients' outcome. Therefore, we analysed how the currently used scoring systems, the MODS, Denver- and SOFA Score, influence the definition and compared the scores' predictive ability...
November 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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