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https://www.readbyqxmd.com/read/28320569/a-new-method-to-predict-hospital-mortality-in-severe-community-acquired-pneumonia
#1
Xin Wang, Jianlong Jiao, Rongwei Wei, Yongli Feng, Xiuqin Ma, Yuan Li, Yue Du
BACKGROUND & AIMS: The aim of this study is to develop a new method that is able to accurately predict the 28day hospital mortality in patients with severe community acquired pneumonia (SCAP) at an early stage. METHODS: We selected 37,348 SCAP patients in ICU from 173 hospitals during 2011.1-2013.12. The predictive factors for 28day hospital mortality were evaluated retrospectively. All cases underwent intensive care, blood routine, blood biochemical tests and arterial blood gas analysis...
March 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#2
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28316308/where-we-fail-location-and-timing-of-failure-to-rescue-in-trauma
#3
Jennifer J Chung, Emily C Earl-Royal, M Kit Delgado, Jose L Pascual, Patrick M Reilly, Douglas J Wiebe, Daniel N Holena
Failure to rescue (FTR) is an outcome metric that reflects a center's ability to prevent mortality after a major complication. Identifying the timing and location of FTR events could help target efforts to reduce FTR rates. We sought to characterize the timing and location of FTR occurrences at our center, hypothesizing that FTR rates would be highest early after injury and in settings of lower intensity of care. We used data, prospectively collected from 2009 to 2013, on patients ≥16 years old with minimum Abbreviated Injury Score ≥2 from a single institution...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28291766/sepsis-3-on-the-block-what-does-it-mean-for-pre-clinical-sepsis-modeling
#4
Marcin F Osuchowski, Christoph Thiemermann, Daniel G Remick
To effectively improve outcomes of septic patients, we first need to elucidate the multifaceted pathogenesis of sepsis syndromes and related inflammatory conditions. In fulfillment of such needs, in February 2016, new definitions for sepsis and septic shock were published under the acronym Sepsis-3. Although aimed at the clinical area, Sepsis-3 will have an inevitable influence upon the field of translational research as well. Sepsis-3 brings a considerable shift regarding the experimental focal point: from inflammatory states (SIRS/CARS) to organ failure (single and multiple) as the decisive factor...
October 25, 2016: Shock
https://www.readbyqxmd.com/read/28288655/effect-of-an-automated-notification-system-for-deteriorating-ward-patients-on-clinical-outcomes
#5
Christian P Subbe, Bernd Duller, Rinaldo Bellomo
BACKGROUND: Delayed response to clinical deterioration of ward patients is common. METHODS: We performed a prospective before-and-after study in all patients admitted to two clinical ward areas in a district general hospital in the UK. We examined the effect on clinical outcomes of deploying an electronic automated advisory vital signs monitoring and notification system, which relayed abnormal vital signs to a rapid response team (RRT). RESULTS: We studied 2139 patients before (control) and 2263 after the intervention...
March 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28272241/trauma-injury-in-adult-underweight-patients-a-cross-sectional-study-based-on-the-trauma-registry-system-of-a-level-i-trauma-center
#6
Ching-Hua Hsieh, Wei-Hung Lai, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Hsiao-Yun Hsieh
The aim of this study was to investigate and compare the injury characteristics, severity, and outcome between underweight and normal-weight patients hospitalized for the treatment of all kinds of trauma injury.This study was based on a level I trauma center Taiwan.The detailed data of 640 underweight adult trauma patients with a body mass index (BMI) of <18.5 kg/m and 6497 normal-weight adult patients (25 > BMI ≥ 18.5 kg/m) were retrieved from the Trauma Registry System between January 1, 2009, and December 31, 2014...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28268836/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#7
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268442/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#8
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28263919/prognostic-index-for-critically-ill-allogeneic-transplant-patients
#9
Ulas D Bayraktar, Denái R Milton, Elizabeth J Shpall, Gabriela Rondon, Kristen J Price, Richard E Champlin, Joseph L Nates
Outcomes of intensive care for allogeneic hematopoietic stem cell transplantation (Allo-SCT) patients remain poor. Better selection of critically ill Allo-SCT patients for intensive care may alleviate costs to the patients, families, and the health system. We aimed to develop a prognostic index tailored for critically ill Allo-SCT patients as traditional instruments are of limited value in this setting. 656 Allo-SCT patients admitted to intensive care unit (ICU) at MD Anderson Cancer Center between 2001 and 2010 were divided into training and test sets...
March 3, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28227033/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#10
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Mohamed Rehman, Ali Jalali, Vinay Nadkanri, Dieter Bender, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226613/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#11
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Sridevi V Sarma, Sabato Santaniello, Kristin Gunnarsdottir, Matthew Kerr, Vijay Sadashivaiah
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#12
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28219187/-clinical-application-of-acutegastrointestinal-injury-grading-system-assocaited-with-clinical-severity-outcome-in-critically-ill-patients-a-multi-center-prospective-observational-study
#13
B C Hu, R H Sun, A P Wu, Y Ni, J Q Liu, L J Ying, Q P Xu, G P Ge, Y C Shi, C W Liu, L Xu, R H Lin, R L Jiang, J Lu, Y N Zhu, W D Wu, X J Ding, B Xie
Objective: To investigate the feasibility of utilizing the current acute gastrointestinal injury(AGI) grading system, and explore the association of severity of AGI grade with clinical outcome in critically ill patients. Methods: The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24 h were recruited, and all clinical, laboratory, and survival data were prospectively collected. The AGI grade was daily assessed based on GIsymptoms, feeding details and organ dysfunctionon the first week of admission to ICU...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28207167/bisap-ranson-lactate-and-others-biomarkers-in-prediction-of-severe-acute-pancreatitis-in-a-european-cohort
#14
Francisco Valverde-López, Ana M Matas-Cobos, Carlos Alegría-Motte, Rita Jiménez-Rosales, Margarita Úbeda-Muñoz, Eduardo Redondo-Cerezo
BACKGROUND AND AIM: Assessing and comparing the predicting ability of some scores and biomarkers in Acute Pancreatitis (AP). METHODS: We prospectively collected data from 269 patients diagnosed of AP, admitted to Virgen de las Nieves University Hospital between June 2010 and June 2012. Blood urea nitrogen (BUN), C-reactive protein (CRP) and creatinine (Cr) were measured on admission and after 48 hours, lactate and BISAP only on admission and RANSON within the first 48 hours...
February 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28188577/sofa-score-in-septic-patients-incremental-prognostic-value-over-age-comorbidities-and-parameters-of-sepsis-severity
#15
Francesca Innocenti, Camilla Tozzi, Chiara Donnini, Eleonora De Villa, Alberto Conti, Maurizio Zanobetti, Riccardo Pini
Several widely used scoring systems for septic patients have been validated in an ICU setting, and may not be appropriate for other settings like Emergency Departments (ED) or High-Dependency Units (HDU), where a relevant number of these patients are managed. The purpose of this study is to find reliable tools for prognostic assessment of septic patients managed in an ED-HDU. In 742 patients diagnosed with sepsis/severe sepsis/septic shock, not-intubated, admitted in ED between June 2008 and April 2016, SOFA, qSOFA, PIRO, MEWS, Charlson Comorbidity Index, MEDS, and APACHE II were calculated at ED admission (T0); SOFA and MEWS were also calculated after 24 h of ED-High-Dependency Unit stay (T1)...
February 10, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28164563/cell-free-dna-and-procalcitonin-as-early-markers-of-complications-in-icu-patients-with-multiple-trauma-and-major-surgery
#16
Asmaa I Ahmed, Randa A Soliman, Shereif Samir
BACKGROUND: Cell free DNA (cfDNA) was recently suggested as a new marker of sepsis and poor outcome in ICU patients. Procalcitonin has also been the focus of attention as an early marker for systemic inflammation and sepsis. METHODS: cfDNA, procalcitonin (PCT), C-reactive protein (CRP), and lactate levels were measured in 30 ICU patients with multiple trauma or after major surgery on the first day of admission and on 5th and 7th days for PCT, CRP, and lactate. cfDNA was measured by real-time PCR, PCT by ELISA, CRP immunoturbidimetrically, and lactate spectrophotometrically...
December 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28156462/patterns-of-palliative-care-utilization-and-end-of-life-care-in-adult-patients-with-cancer-who-died-as-inpatients-at-mayo-clinic
#17
Shivani S Shinde, Pashtoon Murtaza Kasi, Mark Robert Litzow, Jeanne M Huddleston
60 Background: A significant number of patients with advanced cancer die in the hospital. Examination of patterns of care and palliative care (PC) involvement may identify opportunities for process of care improvements for this vulnerable population. METHODS: Patients were identified using the institutional mortality review system registry (Mayo Clinic hospitals from July, 2013-June, 2014). Within this group, patients with a diagnosis of terminal malignancy were identified by chart review and ICD-9 codes...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149888/scoring-systems-for-the-characterization-of-sepsis-and-associated-outcomes
#18
COMMENT
Natalie McLymont, Guy W Glover
Sepsis is responsible for the utilisation of a significant proportion of healthcare resources and has high mortality rates. Early diagnosis and prompt interventions are associated with better outcomes but is impeded by a lack of diagnostic tools and the heterogeneous and enigmatic nature of sepsis. The recently updated definitions of sepsis have moved away from the centrality of inflammation and the systemic inflammatory response syndrome (SIRS) criteria which have been shown to be non-specific. Sepsis is now defined as a "life-threatening organ dysfunction caused by a dysregulated host response to infection"...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28149244/monitoring-and-treatment-of-coagulation-abnormalities-in-burn-patients-an-international-survey-on-current-practices
#19
A Lavrentieva, N Depetris, E Kaimakamis, M Berardino, M Stella
The magnitude of coagulation abnormalities, and the definition and treatment of coagulopathy in burn patients are inadequately understood and continue to be discussed in the literature. We aimed to analyse physicians' views on monitoring and treating coagulation abnormalities in burn patients. A total of 350 questionnaires were distributed electronically to burn ICU physicians. Participation was voluntary and anonymous. Responses were analysed electronically and comparisons were made according to the region of the ICU or the specialty of the physician...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28129261/identifying-augmented-renal-clearance-in-trauma-patients-validation-of-the-augmented-renal-clearance-in-trauma-intensive-care-scoring-system
#20
Jeffrey F Barletta, Alicia J Mangram, Marilyn Byrne, Joseph F Sucher, Alexzandra K Hollingworth, Francis R Ali-Osman, Gina R Shirah, Michael Haley, James K Dzandu
BACKGROUND: Augmented renal clearance (ARC) is common in trauma patients and associated with subtherapeutic antimicrobial concentrations. This study reported the incidence of ARC, identified ARC risk factors, and described a model to predict ARC (i.e., ARCTIC) that is specific to trauma patients. METHODS: Consecutive trauma patients who were admitted to the intensive care unit between March 2015 and January 2016 and had a measured creatinine clearance (CrCl) were considered for inclusion...
April 2017: Journal of Trauma and Acute Care Surgery
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