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Older ICU survivors

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https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#1
Morgane Commereuc, Emmanuel Guérot, Anais Charles-Nelson, Adrien Constan, Sandrine Katsahian, Frédérique Schortgen
OBJECTIVES: To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. DESIGN: Retrospective pooled analysis of prospectively collected data. SETTING: ICUs of two teaching hospitals in Paris area, France. SUBJECTS: One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. INTERVENTIONS: None...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28398076/refining-low-physical-activity-measurement-improves-frailty-assessment-in-advanced-lung-disease-and-survivors-of-critical-illness
#2
Matthew R Baldwin, Jonathan P Singer, Debbie Huang, Jessica Sell, Wendy C Gonzalez, Lauren Pollack, Mathew S Maurer, Frank F D'Ovidio, Matthew Bacchetta, Joshua R Sonett, Selim M Arcasoy, Lori Shah, Hilary Robbins, Steven R Hays, Jasleen Kukreja, John R Greenland, Rupal J Shah, Lorriana Leard, Matthew Morrell, Cynthia Gries, Patricia P Katz, Jason D Christie, Joshua M Diamond, David J Lederer
RATIONALE: The frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and critical illness survivors. Since respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure-time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients. OBJECTIVES: To test and validate replacing the Duke Activities Scale Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Activities (MLTA), a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype instrument (FFP)...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28358584/assessing-the-utility-and-validity-of-frailty-markers-in-critically-ill-adults
#3
Aluko A Hope, S J Hsieh, Alex Petti, Mariana Hurtado-Sbordoni, Joe Verghese, Michelle Ng Gong
RATIONALE: Identifying frailty by the presence of a critical number of frailty markers has been difficult to operationalize in the Intensive Care Unit (ICU) where patients often cannot complete performance measures or answer complex questions. OBJECTIVES: To assess the construct and predictive validity of a questionnaire-based approach to identifying frailty in adult ICU patients. METHODS: We conducted an observational cohort study of adults admitted to a medical or surgical ICU at one of two hospitals in New York...
March 30, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28347296/the-effect-of-postal-questionnaire-burden-on-response-rate-and-answer-patterns-following-admission-to-intensive-care-a-randomised-controlled-trial
#4
Robert Hatch, Duncan Young, Vicki Barber, David A Harrison, Peter Watkinson
BACKGROUND: The effects of postal questionnaire burden on return rates and answers given are unclear following treatment on an intensive care unit (ICU). We aimed to establish the effects of different postal questionnaire burdens on return rates and answers given. METHODS: Design: A parallel group randomised controlled trial. We assigned patients by computer-based randomisation to one of two questionnaire packs (Group A and Group B). SETTING: Patients from 26 ICUs in the United Kingdom...
March 27, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28333761/race-ethnicity-health-insurance-and-mortality-in-older-survivors-of-critical-illness
#5
Matthew R Baldwin, Jessica L Sell, Nina Heyden, Azka Javaid, David A Berlin, Wendy C Gonzalez, Peter B Bach, Mathew S Maurer, Gina S Lovasi, David J Lederer
OBJECTIVES: To determine whether minority race or ethnicity is associated with mortality and mediated by health insurance coverage among older (≥ 65 yr old) survivors of critical illness. DESIGN: A retrospective cohort study. SETTING: Two New York City academic medical centers. PATIENTS: A total of 1,947 consecutive white (1,107), black (361), and Hispanic (479) older adults who had their first medical-ICU admission from 2006 through 2009 and survived to hospital discharge...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28263377/the-frailty-phenotype-and-palliative-care-needs-of-older-survivors-of-critical-illness
#6
Lauren R Pollack, Nathan E Goldstein, Wendy C Gonzalez, Craig D Blinderman, Mathew S Maurer, David J Lederer, Matthew R Baldwin
OBJECTIVES: To assess symptoms in older intensive care unit (ICU) survivors and determine whether post-ICU frailty identifies those with the greatest palliative care needs. DESIGN: A prospective cohort study. SETTING: Urban tertiary care hospital and community hospital. PARTICIPANTS: Medical ICU survivors of mechanical ventilation aged 65 and older (N = 125). MEASUREMENTS: Baseline measurements of the Edmonton Symptom Assessment Scale (ESAS), categorized as mild (0-3), moderate (4-6), and severe (7-10), and the frailty phenotype were made during the week before hospital discharge...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28215127/characteristics-and-outcomes-of-critically-ill-patients-with-drug-overdose-in-australia-and-new-zealand
#7
Luca Cioccari, Nora Luethi, Michael Bailey, David Pilcher, Rinaldo Bellomo
OBJECTIVE: The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand. DESIGN, SETTING AND PATIENTS: Retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database, including all patients admitted to an ICU with OD from 2005 to 2013...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#8
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
March 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/27912904/changes-of-geriatric-syndromes-in-older-adults-survived-from-intensive-care-unit
#9
Hsin-Ju Tang, Hsin-Yi Jean Tang, Fang-Wen Hu, Ching-Huey Chen
Nearly 90% of the older adult patients discharged from hospital with a cluster of geriatric syndromes. The patterns of geriatric syndromes in older adult ICU survivors are to be further explored. The aim of this study was to examine the risk factors and patterns of geriatric syndromes among older adult patients before admitting to ICU and throughout their hospitalization. A total of 137 older adult patients (age 76.9 ± 6.6; 52.6% male) participated in the study. The results showed significant increase in the occurrence of geriatric syndromes from T0 (upon ICU admission) to T1 (transition to inpatient care unit), with improvement at T2 (hospital discharge), but did not return to the baseline...
November 29, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27901330/critically-ill-octogenarians-and-nonagenarians-evaluation-of-long-term-outcomes-post-hospital-trajectories-and-quality-of-life-one-year-and-seven-years-after-icu-discharge
#10
Sandra Oeyen, Joris Vermassen, Ruth Piers, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
BACKGROUND: To investigate long-term outcomes, post-hospital trajectories, and quality of life (QOL) in patients ≥ 80 years admitted to the intensive care unit (ICU) of a tertiary care hospital. METHODS: A 1-year prospective observational cohort analysis was performed. All consecutive patients ≥ 80 years admitted to the ICU were screened for inclusion. Demographics, comorbidity, organ failures, and outcomes were analyzed. QOL before admission, 3 months, 1 year, and 7 years after ICU discharge was assessed using EuroQoL-5D (EQ-5D) and Medical Outcomes Study 36-item Short Form Health Survey (SF-36) questionnaires...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27686235/prognostic-factors-for-severe-pneumocystis-jiroveci-pneumonia-of-non-hiv-patients-in-intensive-care-unit-a-bicentric-retrospective-study
#11
Li Weng, Xu Huang, Lie Chen, Li-Qin Feng, Wei Jiang, Xiao-Yun Hu, Jin-Min Peng, Chun-Yao Wang, Qing-Yuan Zhan, Bin Du
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS: Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS: Eighty-two patients were enrolled in the study...
September 29, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27637716/physical-declines-occurring-after-hospital-discharge-in-ards-survivors-a-5-year-longitudinal-study
#12
Elizabeth R Pfoh, Amy W Wozniak, Elizabeth Colantuoni, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
PURPOSE: Survivors of acute respiratory distress syndrome (ARDS) are at high risk for new or ongoing physical declines after hospital discharge. The objective of our study was to evaluate the epidemiology of physical declines over 5-year follow-up and identify patients at risk for decline. METHODS: This multi-site prospective cohort study evaluated ARDS survivors who completed a physical status assessment at 3 or 6 months post-discharge. Three measures were evaluated: muscle strength (Medical Resource Council sumscore); exercise capacity [6-min walk test (6MWT)]; physical functioning [36-Item Short Form Health Survey (SF-36 survey)]...
October 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27518322/determinants-of-time-to-death-in-hospital-in-critically-ill-patients-around-the-world
#13
Ignacio Martin-Loeches, Richard G Wunderink, Rahul Nanchal, Jean Yves Lefrant, Farhad Kapadia, Yasser Sakr, Jean-Louis Vincent
PURPOSE: To investigate which factors influence time to death in hospital in critically ill patients worldwide, including the possible impact of gross national income (GNI). METHODS: This was a pre-defined post hoc analysis of the Intensive Care Over Nations (ICON) database, which included 10,069 patients. For this sub-analysis, we included only the 2062 60-day in-hospital non-survivors (22.3 %) among the 9258 patients with available hospital mortality and length-of-stay data...
September 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27441901/the-use-of-ferritin-to-identify-critically-ill-patients-with-secondary-hemophagocytic-lymphohistiocytosis
#14
Steven Grangé, Gérard Buchonnet, Emmanuel Besnier, Elise Artaud-Macari, Gaetan Beduneau, Dorothée Carpentier, Julien Dehay, Christophe Girault, Antoine Marchalot, Dominique Guerrot, Fabienne Tamion
OBJECTIVES: Thrombocytopenia is a common, multifactorial, finding in ICU. Hemophagocytosis is one of the main explanatory mechanisms, possibly integrated into hemophagocytic lymphohistiocytosis syndrome, of infectious origin in the majority of cases in ICU. The hemophagocytic lymphohistiocytosis is probably underdiagnosed in the ICU, although it is associated with dramatic outcomes. The main objectives of this work were to identify the frequency of secondary hemophagocytic lymphohistiocytosis, and the main prognostic factors for mortality...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27367877/effect-of-a-primary-care-management-intervention-on-mental-health-related-quality-of-life-among-survivors-of-sepsis-a-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Konrad Schmidt, Susanne Worrack, Michael Von Korff, Dimitry Davydow, Frank Brunkhorst, Ulrike Ehlert, Christine Pausch, Juliane Mehlhorn, Nico Schneider, André Scherag, Antje Freytag, Konrad Reinhart, Michel Wensing, Jochen Gensichen
IMPORTANCE: Survivors of sepsis face long-term sequelae that diminish health-related quality of life and result in increased care needs in the primary care setting, such as medication, physiotherapy, or mental health care. OBJECTIVE: To examine if a primary care-based intervention improves mental health-related quality of life. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial conducted between February 2011 and December 2014, enrolling 291 patients 18 years or older who survived sepsis (including septic shock), recruited from 9 intensive care units (ICUs) across Germany...
June 28, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27333269/natural-language-processing-to-assess-documentation-of-features-of-critical-illness-in-discharge-documents-of-acute-respiratory-distress-syndrome-survivors
#16
Gary E Weissman, Michael O Harhay, Ricardo M Lugo, Barry D Fuchs, Scott D Halpern, Mark E Mikkelsen
RATIONALE: Transitions to outpatient care are crucial after critical illness, but the documentation practices in discharge documents after critical illness are unknown. OBJECTIVES: To characterize the rates of documentation of various features of critical illness in discharge documents of patients diagnosed with acute respiratory distress syndrome (ARDS) during their hospital stay. METHODS: We used natural language processing tools to build a keyword-based classifier that categorizes discharge documents by presence of terms from four groups of keywords related to critical illness...
September 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27290634/mortality-rates-increase-dramatically-below-a-systolic-blood-pressure-of-105-mm-hg-in-septic-surgical-patients
#17
Damian L Clarke, Jennifer A Chipps, Benn Sartorius, John Bruce, Grant L Laing, Petra Brysiewicz
BACKGROUND: This study used a prospective surgical database, to investigate the level of systolic blood pressure (SBP) at which the mortality rates begin to increase in septic surgical patients. METHODS: All acute, septic general surgical patients older than 15 years of age admitted between January 2012 and January 2015 were included in these analyses. RESULTS: Of a total of 6,020 adult surgical patients on the database, 3,053 elective patients, 1,664 nonseptic, 52 duplicates, and 11 patients with missing SBP were excluded to leave a cohort of 1,232 acute, septic surgical patients...
November 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27000326/functional-status-and-quality-of-life-in-elderly-intensive-care-unit-survivors
#18
Patricia Villa, María-Consuelo Pintado, Jimena Luján, Natalia González-García, María Trascasa, Rocío Molina, José-Andrés Cambronero, Raúl de Pablo
OBJECTIVES: To evaluate functional status and quality of life in elderly intensive care unit (ICU) survivors at 1-year follow-up. DESIGN: Prospective 18-month observational study. SETTING: University medical-surgical ICU. PARTICIPANTS: ICU survivors aged 75 and older. MEASUREMENTS: Functional status at baseline (Barthel Index (BI)) was compared with that at hospital discharge and 1-year follow-up...
March 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/26840348/factors-associated-with-functional-recovery-among-older-intensive-care-unit-survivors
#19
Lauren E Ferrante, Margaret A Pisani, Terrence E Murphy, Evelyne A Gahbauer, Linda S Leo-Summers, Thomas M Gill
RATIONALE: Most of the 1.4 million older adults who survive the intensive care unit (ICU) annually in the United States face increased disability, but little is known about those who achieve functional recovery. OBJECTIVES: Our objectives were twofold: to evaluate the incidence and time to recovery of premorbid function within 6 months of a critical illness and to identify independent predictors of functional recovery among older ICU survivors. METHODS: Potential participants included 754 persons aged 70 years or older who were evaluated monthly in 13 functional activities (1998-2012)...
August 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26815475/health-related-quality-of-life-of-trauma-patients-after-intensive-care-a-2-year-follow-up-study
#20
X-Y Fu, M Chen, T Yu, X-K Liu
PURPOSE: This study aimed to assess the health-related quality of life (HRQOL) in trauma patients 2 years after discharge from an intensive care unit (ICU) in Zunyi, China, and to investigate the possible determinants of HRQOL. METHODS: A total of 436 trauma patients treated in the ICU were followed up for 2 years. The Medical Outcomes Study Short Form 36 (SF-36) was used to measure the quality of life 1 and 2 years after their discharge. RESULTS: After a 2-year follow-up, there were, in total, 347 (79...
December 2011: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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