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https://www.readbyqxmd.com/read/29143551/independent-validation-of-the-icu-requirement-score-in-a-cohort-of-acutely-poisoned-adults
#1
Regina Böll, Katrin Romanek, Sabrina Schmoll, Raphael Stich, Armin Ott, Jochen Stenzel, Stefanie Geith, Florian Eyer, Christian Rabe
OBJECTIVE: To independently validate the predictive value of the intensive care requirement score (IRS) in unselected poisoned patients. DESIGN: Retrospective chart review. PATIENTS AND METHODS: Five hundred and seventeen out of 585 admissions for acute intoxications could be analyzed. Eleven were excluded for a condition already requiring intensive care unit (ICU) support at admission (e.g., preclinical intubation). A further 57 admissions were excluded due to missing data...
November 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29142372/mapping-the-characteristics-of-critical-care-facilities-assessment-distribution-and-level-of-critical-care-facilities-from-central-india
#2
Saurabh Saigal, Jai Prakash Sharma, Abhijit Pakhare, Santosh Bhaskar, Sanjay Dhanuka, Sanjay Kumar, Yogesh Sabde, Pradip Bhattacharya, Rajnish Joshi
Background: In low- and middle-income countries such as India, where health systems are weak, the number of available Critical Care Unit (Intensive Care Unit [ICU]) beds is expected to be low. There is no study from the Indian subcontinent that has reported the characteristics and distribution of existing ICUs. We performed this study to understand the characteristics and distribution of ICUs in Madhya Pradesh (MP) state of Central India. We also aimed to develop a consensus scoring system and internally validate it to define levels of care and to improve health system planning and to strengthen referral networks in the state...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29140952/-don-t-lose-hope-early-hemorrhagic-diffuse-axonal-injury-on-head-ct-is-not-associated-with-poor-outcome-in-moderate-severe-tbi-patients
#3
Nils Henninger, Rebecca A Compton, Muhammad W Khan, Raphael Carandang, Wiley Hall, Susanne Muehlschlegel
BACKGROUND: Diffuse axonal injury (DAI) on MRI has been associated with poor functional outcome after moderate-severe traumatic brain injury (msTBI). Yet, DAI assessment with highly-sensitive MRI-techniques is unfeasible in the acute trauma setting, and CT remains the key diagnostic modality despite its lower sensitivity. We sought to determine whether CT-defined-hemorrhagic-DAI (hDAI) is associated with discharge and favorable 3-and 12-month functional outcome (Glasgow Outcome Score ≥4) after msTBI...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29138849/elevated-serum-levels-of-lipoprotein%C3%A2-associated-phospholipase%C3%A2-a2-predict-mortality-rates-in-patients-with-sepsis
#4
Zhongwei Huang, Haiyan Jiang, Xiaohui Cui, Guiwen Liang, Yu Chen, Ting Wang, Zhichao Sun, Lei Qi
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis...
November 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29132626/early-hospital-mortality-prediction-of-intensive-care-unit-patients-using-an-ensemble-learning-approach
#5
Aya Awad, Mohamed Bader-El-Den, James McNicholas, Jim Briggs
BACKGROUND: Mortality prediction of hospitalized patients is an important problem. Over the past few decades, several severity scoring systems and machine learning mortality prediction models have been developed for predicting hospital mortality. By contrast, early mortality prediction for intensive care unit patients remains an open challenge. Most research has focused on severity of illness scoring systems or data mining (DM) models designed for risk estimation at least 24 or 48h after ICU admission...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#6
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
Background The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. Methods In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29130231/-effect-of-postoperative-hyperglycemia-on-clinical-outcome-of-gastrointestinal-fistula-patients-undergoing-gastrointestinal-reconstruction
#7
Qiongyuan Hu, Jian'an Ren, Wenhao Tang, Jieshou Li
OBJECTIVE: To investigate the effect of hyperglycemia within postoperative 48 hours on gastrointestinal (GI) fistula patients without preoperative diagnosis of diabetes undergoing selective GI reconstruction. METHODS: Clinical data of GI fistula patients with age of 18 to 70 years and without diffuse peritonitis and systemic infection undergoing definitive GI reconstruction at Intestinal Fistula Center of Jinling Hospital from September 2012 to December 2015 were retrospectively analyzed...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29127841/comparison-of-the-performance-of-sofa-qsofa-and-sirs-for-predicting-mortality-and-organ-failure-among-sepsis-patients-admitted-to-the-intensive-care-unit-in-a-middle-income-country
#8
Bodin Khwannimit, Rungsun Bhurayanontachai, Veerapong Vattanavanit
INTRODUCTION: The Sepsis-3 definition provides a change of two or more scores from zero or a known baseline of the Sequential Organ Failure Assessment (SOFA) as criteria of sepsis. The aim of this study was to compare the SOFA score and the quick SOFA (qSOFA) to Systemic Inflammatory Response Syndrome (SIRS) criteria in predictive ability of mortality and organ failure. METHODS: A-10year retrospective cohort study was conducted in a teaching hospital in Thailand...
October 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29123370/assessing-hand-hygiene-compliance-among-healthcare-workers-in-six-intensive-care-units
#9
REVIEW
M Musu, A Lai, N M Mereu, M Galletta, M Campagna, M Tidore, M F Piazza, L Spada, M V Massidda, S Colombo, P Mura, R C Coppola
Introduction: Healthcare associated infections (HAIs) are a cause of high morbidity, disability and reduced quality of life, as well as mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health. Methods: The study aimed to evaluate the presence of procedures and protocols for infection control, to assess the adhesion to the different aspects of hand hygiene (HH) and hand washing technique by healthcare workers in six ICUs...
September 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/29121653/comparison-of-the-new-exponential-injury-severity-score-with-the-injury-severity-score-and-the-new-injury-severity-score-in-trauma-patients-a-cross-sectional-study
#10
Spencer C H Kuo, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
OBJECTIVE: To compare Exponential Injury Severity Score (EISS) with Injury Severity Score (ISS) and New Injury Severity Score (NISS) in terms of their predictive capability of the outcomes and medical expenses of hospitalized adult trauma patients. SETTING: This study was based at a level I trauma center in Taiwan. METHODS: Data for 17,855 adult patients hospitalized from January 1, 2009 to December 31, 2015 were retrieved from the Trauma Registry System...
2017: PloS One
https://www.readbyqxmd.com/read/29121480/palliative-care-planner-pcplanner-a-pilot-study-to-evaluate-acceptability-and-usability-of-an-electronic-health-records-system-integrated-needs-targeted-app-platform
#11
Christopher E Cox, Derek M Jones, Wen Reagan, Mary D Key, Vinca Chow, Jessica McFarlin, David Casarett, Claire J Creutzfeldt, Sharron L Docherty
RATIONALE: The quality and patient-centeredness of intensive care unit (ICU)-based palliative care delivery is highly variable. OBJECTIVE: To develop and pilot an app platform for clinicians, ICU patients, and their family members that enhances the delivery of needs-targeted palliative care. METHODS: In the Development Phase of the study, we developed an electronic health record (EHR) system-integrated mobile web app system prototype, PCplanner (Palliative Care Planner)...
November 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29118410/the-microbiological-characteristics-and-risk-factors-for-picc-related-bloodstream-infections-in-intensive-care-unit
#12
Shumin Zhang, Xiaofeng Sun, Yan Lei
The study was aimed to investigate the pathogens distribution and risk factors for PICC-related bloodstream infection in intensive care unit (ICU) patients. 402 patients placed with PICC in ICU were recruited in the study. The microbiological characteristics of PICC-related infection were investigated by Vitek 2 Compact automated microbial system. Antibiotics sensitivity was performed with disk diffusion and minimum inhibitory concentration (MIC) methods. Multivariate logistic and cox analyses were performed to identify the risk factors for PICC-related infection in ICU patients...
November 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29115091/efficacy-of-uncross-matched-type-o-packed-red-blood-cell-transfusion-to-traumatic-shock-patients-a-propensity-score-match-study
#13
Byung Hee Kang, Donghwan Choi, Jayun Cho, Junsik Kwon, Yo Huh, Jonghwan Moon, Younghwan Kim, Kyoungwon Jung, John Cook Jong Lee
A new blood bank system was established in our trauma bay, which allowed immediate utilization of uncross-matched type O packed red blood cells (UORBCs). We investigated the efficacy of UORBC compared to that of the ABO type-specific packed red blood cells (ABO RBCs) from before the bank was installed. From March 2016 to February 2017, data from trauma patients who received UORBCs in the trauma bay were compared with those of trauma patients who received ABO RBCs from January 2013 to December 2015. Propensity matching was used to overcome retrospective bias...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29105539/treatment-profile-and-1-year-mortality-among-nontraumatic-intensive-care-unit-patients-with-alcohol-related-health-problems
#14
Siiri Hietanen, Tero Ala-Kokko, Pasi Ohtonen, Riikka Käkelä, Solja Niemelä, Janne H Liisanantti
BACKGROUND: Long-term excessive use of alcohol leads to severe complications, which often require treatment in an intensive care unit (ICU). The aim of this study was to report on the associations between alcohol-related health problems and treatment profile, as well as 1-year mortality among patients with nontrauma-related ICU admissions. METHODS: Information on the history of alcohol-related health problems or excessive alcohol use and ICU treatment was collected retrospectively from electronic medical records and ICU patient data management systems at Oulu University Hospital, Finland...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29096231/the-feasibility-study-of-computer-cognitive-senior-assessment-system-screen-cosas-s-in-critically-ill-patients-with-sepsis
#15
Eun-Young Kang, Sung Ju Jee, Cuk-Seong Kim, Kwang-Sun Suh, Alex W K Wong, Jae Young Moon
PURPOSE: Early cognitive assessment in the intensive care unit (ICU) is essential to monitor cognitive dysfunction after critical illness. We have implemented a Computer Cognitive Senior Assessment System-Screen (CoSAS-S) which is a brief, objective, and tablet-based cognitive screening test as a mobile platform to detect any cognitive problems in ICUs. This study aimed to evaluate the feasibility and initial validation of a tablet-based CoSAS-S in critically ill patients with sepsis...
October 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29095276/outcome-and-risk-factors-associated-with-extent-of-central-nervous-system-injury-due-to-exertional-heat-stroke
#16
Mengmeng Yang, Zhi Li, Yan Zhao, Feihu Zhou, Yu Zhang, Jingli Gao, Ting Yin, Xin Hu, Zhi Mao, Jianguo Xiao, Li Wang, Chao Liu, Liqiong Ma, Zhihao Yuan, Jianfei Lv, Haoliang Shen, Peter C Hou, Hongjun Kang
To explore the relationship between the extent of central nervous system (CNS) injury and patient outcomes meanwhile research the potential risk factors associated with neurologic sequelae. In this retrospective cohort study, we analyzed data from 117 consecutive patients (86 survivors, 31 nonsurvivors) with exertional heat stroke (EHS) who had been admitted to intensive care unit (ICU) at 48 Chinese hospitals between April 2003 and July 2015. Extent of CNS injury was dichotomized according to Glasgow coma scale (GCS) score (severe 3-8, not severe 9-15)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095203/acute-respiratory-distress-syndrome-cases-volume-and-icu-mortality-in-medical-patients
#17
Martin Dres, Peter C Austin, Tài Pham, Philippe Aegerter, Bertrand Guidet, Alexandre Demoule, Antoine Vieillard-Baron, Laurent Brochard, Guillaume Géri
OBJECTIVES: To determine whether ICUs caring for higher volumes of acute respiratory distress syndrome patients would be associated with lower ICU mortality. DESIGN: A 9-year multicenter retrospective cohort study of prospectively collected data. SETTING: French medical ICUs. PATIENTS: From 2004 to 2012, acute respiratory distress syndrome cases were identified from a coding system through a regional database (Collège des Utilisateurs de Données en Réanimation)...
October 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29089687/follow-up-chest-radiographic-findings-in-patients-with-mers-cov-after-recovery
#18
Karuna M Das, Edward Y Lee, Rajvir Singh, Mushira A Enani, Khalid Al Dossari, Klaus Van Gorkom, Sven G Larsson, Ruth D Langer
PURPOSE: To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms. MATERIALS AND METHODS: Thirty-six consecutive patients (9 men, 27 women; age range 21-73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29073262/development-and-validation-of-immune-dysfunction-score-to-predict-28-day-mortality-of-sepsis-patients
#19
Wen-Feng Fang, Ivor S Douglas, Yu-Mu Chen, Chiung-Yu Lin, Hsu-Ching Kao, Ying-Tang Fang, Chi-Han Huang, Ya-Ting Chang, Kuo-Tung Huang, Yi-His Wang, Chin-Chou Wang, Meng-Chih Lin
BACKGROUND: Sepsis-induced immune dysfunction ranging from cytokines storm to immunoparalysis impacts outcomes. Monitoring immune dysfunction enables better risk stratification and mortality prediction and is mandatory before widely application of immunoadjuvant therapies. We aimed to develop and validate a scoring system according to patients' immune dysfunction status for 28-day mortality prediction. METHODS: A prospective observational study from a cohort of adult sepsis patients admitted to ICU between August 2013 and June 2016 at Kaohsiung Chang Gung Memorial Hospital in Taiwan...
2017: PloS One
https://www.readbyqxmd.com/read/29072311/modifications-of-the-national-early-warning-score-for-patients-with-chronic-respiratory-disease
#20
N E Pedersen, L S Rasmussen, J A Petersen, T A Gerds, D Østergaard, A Lippert
BACKGROUND: The National Early Warning Score (NEWS) uses physiological variables to detect deterioration in hospitalized patients. However, patients with chronic respiratory disease may have abnormal variables not requiring interventions. We studied how the Capital Region of Denmark NEWS Override System (CROS), the Chronic Respiratory Early Warning Score (CREWS) and the Salford NEWS (S-NEWS) affected NEWS total scores and NEWS performance. METHODS: In an observational study, we included patients with chronic respiratory disease...
October 26, 2017: Acta Anaesthesiologica Scandinavica
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