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Icu admission criteria

Bianca Masturzo, Vera Franzè, Chiara Germano, Rossella Attini, Gianluca Gennarelli, Antonella Lezo, Alessandro Rolfo, Claudio Plazzotta, Elena Brunelli, Aly Youssef, Tullia Todros, Antonio Farina
PURPOSE: To estimate the impact of increasing pre-pregnancy Body Mass Index (BMI) on the risk of adverse maternal and perinatal outcomes, in patients who delivered in an Italian tertiary care Obstetric department. METHODS: Data, related to women who delivered at Sant'Anna Hospital, Turin, between 2011 and 2015, were collected retrospectively from the hospital database. According to BMI, women were considered as normal weight, overweight, and class 1, 2 and 3 obese (WHO criteria)...
February 15, 2019: Archives of Gynecology and Obstetrics
Emi Minejima, Vanessa Delayo, Mimi Lou, Pamela Ny, Paul Nieberg, Rosemary C She, Annie Wong-Beringer
BACKGROUND: The prognostic capability of the quick Sequential Organ Failure Assessment (qSOFA) bedside scoring tool is uncertain in non-ICU patients with sepsis due to bacteremia given the low number of patients previously evaluated. METHODS: We performed a retrospective cohort study of adult hospitalized patients with Staphylococcus aureus bacteremia (SAB). Medical charts were reviewed to determine qSOFA score, systemic inflammatory response syndrome (SIRS) criteria, and Pitt bacteremia score (PBS) at initial presentation; their predictive values were compared for ICU admission within 48 h, ICU stay duration > 72 h, and 30-day mortality...
February 13, 2019: BMC Infectious Diseases
Evgeni Brotfain, Yoram Klein, Ronen Toledano, Micha Yitzhak Shamir, Leonid Koyfman, Uri Barak, Tamar Guttmann, Alexander Zlotnik, Moti Klein
PURPOSE: Dynamic changes in urine output and neurological status are the recognized clinical signs of hemodynamically significant hemorrhage. In the present study, we analyzed the dynamic minute-to-minute changes in the UFR and also the changes in its minute-to-minute variability in a group of critically ill multiple trauma patients whose blood pressures were normal on admission to the ICU but who subsequently developed hypotension within the first few hours of their ICU admission. PATIENTS AND METHODS: The study was retrospective and observational...
February 13, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Takoua Merhabene, Farah Blel, Amira Jamoussi, Samia Ayed, Jalila Ben Khelil, Mohamed Besbes
BACKGROUND: Rationing in intensive care unit (ICU) beds is common and can leads to admission refusal. Understanding factors involved in triage practices is the first step towards an ethically optimal decision-making process. AIM: To identify determinants and patients' characteristics associated with decisions to deny ICU admission. METHODS: This prospective observational study was conducted in AbderrahmeneMami Hospital's medical ICU, in Ariana, between 1st January and 31th December 2016...
October 2018: La Tunisie Médicale
Elizabeth Y Killien, Reid W D Farris, R Scott Watson, Leslie A Dervan, Jerry J Zimmerman
OBJECTIVES: Mortality from pediatric sepsis has steadily declined over the past several decades; however, little is known about morbidity among survivors. We aimed to determine the prevalence of and risk factors for failure to recover to baseline health-related quality of life following community-acquired pediatric sepsis. DESIGN: Retrospective cohort study. SETTING: Seattle Children's Hospital. PATIENTS: Children aged 1 month to 21 years admitted to the inpatient wards or ICUs from 2012 to 2015 who met 2005 consensus sepsis criteria within 4 hours of hospitalization and were enrolled in the hospital's Outcomes Assessment Program with baseline, admission, and post-discharge health-related quality of life data available...
February 1, 2019: Pediatric Critical Care Medicine
Antoni Torres, James D Chalmers, Charles S Dela Cruz, Cristina Dominedò, Marin Kollef, Ignacio Martin-Loeches, Michael Niederman, Richard G Wunderink
PURPOSE: Severe community-acquired pneumonia (SCAP) is still associated with substantial morbidity and mortality. In this point-of-view review paper, a group of experts discuss the main controversies in SCAP: the role of severity scores to guide patient settings of care and empiric antibiotic therapy; the emergence of pathogens outside the core microorganisms of CAP; viral SCAP; the best empirical treatment; septic shock as the most lethal complication; and the need for new antibiotics...
January 31, 2019: Intensive Care Medicine
Nohra Chalouhi, Nikolaos Mouchtouris, Fadi Al Saiegh, Robert M Starke, Thana Theofanis, Somnath O Das, Jack Jallo
BACKGROUND: Traumatic brain injury (TBI) carries a devastatingly high rate of morbidity and mortality. OBJECTIVE: To assess whether patients undergoing craniotomy/craniectomy for severe TBI fare better at level I than level II trauma centers in a mature trauma system. METHODS: The data were extracted from the Pennsylvania Trauma Outcome Study database. Inclusion criteria were patients > 18 yr with severe TBI (Glasgow Coma Scale [GCS] score less than 9) undergoing craniotomy or craniectomy in the state of Pennsylvania from January 1, 2002 through September 30, 2017...
January 24, 2019: Neurosurgery
Alejandro Pita, Brian Nguyen, Daisy Rios, Nicolas Maalouf, Mary Lo, Yuri Genyk, Linda Sher, J Perren Cobb
PURPOSE: Recovery after liver transplant (LT) requires extensive resources, including prolonged intensive care unit stays. The objective of this study was to use an assessment tool to determine if LT recipients remain in ICU beyond designated indications. METHODS: Records from 100 consecutive LTs performed in a single institution were retrospectively reviewed. An admission, discharge, and triage screening (ADT) tool was utilized to assess the indications for each ICU day...
January 9, 2019: Journal of Critical Care
Jennifer M Singleton, Leslie A Bilello, Louisa S Canham, Robin B Levenson, Gregory J Lopez, Sarah P Tadiri, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Previous studies demonstrate an association between rib fractures and morbidity and mortality in trauma. This relationship in low-mechanism injuries such as ground-level fall is less clearly defined. Furthermore, computed tomography (CT) has increased sensitivity for rib fractures compared with chest x-ray (CXR); its utility in elderly fall patients is unknown. We sought to determine whether CT-diagnosed rib fractures in elderly fall patients with a normal CXR were associated with increased in-hospital resource utilization or mortality...
January 23, 2019: Journal of Trauma and Acute Care Surgery
Carolina Simões, Sara Santos, Madalena Vicente, Filipe Sousa Cardoso
Background and Aims: Acute liver failure (ALF) is a rare disease with potentially high mortality rates. We aimed to study the recent epidemiology of ALF in one of the Portuguese liver transplant (LT) regions. Methods: We assessed a retrospective cohort including 34 consecutive patients with ALF admitted to the intensive care unit (ICU) of Curry Cabral Hospital (Lisbon, Portugal) between October 2013 and December 2016. Results: The median age (IQR) was 49 (31-67) years, and 21 (62%) of the cohort were female...
December 2018: GE Portuguese Journal of Gastroenterology
Jesse Cohen, Javier Sotoca, Shikha Gandhi, Anusha K Yeshokumar, Eliza Gordon-Lipkin, Romergyko G Geocadin, Kevin D Frick, John C Probasco, Arun Venkatesan
OBJECTIVE: To assess the inpatient hospitalization burden and costs of patients with autoimmune encephalitis (AE) at a tertiary care institution. METHODS: Adult inpatients with AE were identified retrospectively from July 1, 2005, to June 30, 2015. Demographic and clinical data were collected and analyzed. Billing data were compared to those of patients with herpes simplex encephalitis (HSE). Charges were adjusted for inflation. RESULTS: Of 244 admissions for encephalitis reviewed, 63 patients met criteria for probable or definite AE...
January 23, 2019: Neurology
H Thabrew, A Nagahawatte, G B Wijayaratne
Introduction: The ability to predict candidaemia gives a significant advantage to the clinician by enabling pre-emptive treatment to reduce mortality. Objectives: To identify the prevalence, risk factors, and to validate candida colonization index (CI), candida score (CS) to reliably predict the development of candidaemia in the identified study sample. Methods: Cross sectional analytical study of consecutive admissions fulfilling inclusion criteria to intensive care units (ICUs) of Teaching Hospital Karapitiya from 1st December 2015 to 30th March 2016...
December 31, 2018: Ceylon Medical Journal
Ariana Lott, Kenneth A Egol, Thomas Lyon, Sanjit R Konda
OBJECTIVES: To investigate the ability of a validated geriatric trauma risk prediction tool to stratify hospital quality metrics and inpatient cost for middle-aged and geriatric patients admitted from the ED for operative treatment of an ankle fracture. DESIGN: Prospective cohort study SETTING:: Single Academic Medical Center PATIENTS:: Patients aged 55 and older who sustained a rotational ankle fracture and were treated operatively during their index hospitalization INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional status...
January 17, 2019: Journal of Orthopaedic Trauma
Timothy G Scully, Robert Grealy, Anthony S McLean, Sam R Orde
Background: Despite the evidence for calibrated cardiac monitored devices to determine fluid responsiveness, there is minimal evidence that the use of cardiac output monitor devices leads to an overall change in IV fluid use. We sought to investigate the feasibility of performing a randomised controlled study using calibrated cardiac output monitoring devices in shocked ICU patients and whether the use of these devices led to a difference in total volume of IV fluid administered. Methods: We performed a single-centre non-blinded randomised controlled study which included patients who met the clinical criteria for shock on admission to ICU...
2019: Journal of Intensive Care
Nicholas J Johnson, Ellen Caldwell, David J Carlbom, David F Gaieski, Matthew E Prekker, Thomas D Rea, Michael Sayre, Catherine L Hough
OBJECTIVE: To define the incidence of the acute respiratory distress syndrome (ARDS) following out-of-hospital cardiac arrest (OHCA) and characterize its impact on outcome. METHODS: This was a retrospective cohort study conducted at two urban, tertiary, academic hospitals from 2007 to 2014. We included adults with non-traumatic OHCA and survived for ≥48 h. Patients who received mechanical ventilation for ≥24 h, had 2 consecutive arterial blood gases with a ratio of the partial pressure of oxygen to the fraction of inspired oxygen ≤300, and bilateral radiographic opacities within 48 h of hospital admission were defined as having ARDS...
January 14, 2019: Resuscitation
TingTing Yao, Stephanie R DeJong, Michaela E McGree, Amy L Weaver, William A Cliby, Amanika Kumar
OBJECTIVES: We sought to examine the relationship between frailty and complicated postoperative courses, including intensive care unit (ICU) admission and non-home discharge, in patients with advanced ovarian cancer (OC) undergoing primary debulking surgery (PDS) for curative intent. METHODS: Patients were identified from a retrospectively collected database at a single institution between 1/1/2003-12/31/2011. A frailty index was derived from 30 items representing comorbidities and activities of daily living, each scored as 0, 0...
January 3, 2019: Gynecologic Oncology
Fabrizia Schmid, Alexandra Malinovska, Karin Weigel, Tito Bosia, Christian H Nickel, Roland Bingisser
OBJECTIVES: Validation of acute morbidity as a novel outcome in emergency medicine. METHODS: Construct validity of acute morbidity was established by comparison to other outcomes using linear and logistic regression models. RESULTS: Data of 4608 patients were analysed. 1869 patients (40.6%) fulfilled the criteria for acute morbidity. Using multivariate analyses, acute morbidity was associated with outcomes such as hospitalisation (OR: 11, 95%-CI 9-13), mortality (OR 15, 95%-CI 6-49), and ICU admission (OR: 46, 95%-CI 25-96)...
2019: PloS One
Sumit Kapoor, Christopher K Morgan, Muhammad Asim Siddique, Kalpalatha K Guntupalli
AIM: To study the management, complications and outcomes of adult patients admitted with hemophagocytic lymphohistiocytosis (HLH) in the intensive care unit (ICU). METHODS: We performed a retrospective observational study of adult patients with the diagnosis of "HLH" admitted to the two academic medical ICUs of Baylor College of Medicine between 01/01/2013 to 06/30/2017. HLH was diagnosed using the HLH-2004 criteria proposed by the Histiocyte Society. RESULTS: Sixteen adult cases of HLH were admitted to the medical ICUs over 4 years...
November 30, 2018: World Journal of Critical Care Medicine
James Broadley, Udaya Seneviratne, Paul Beech, Katherine Buzzard, Helmut Butzkueven, Terence O'Brien, Mastura Monif
OBJECTIVE: To perform a systematic review of the current scientific literature in order to identify variables associated with patient prognosis in autoimmune encephalitis. METHODS: We performed a systematic literature search using MEDLINE, Embase, PubMed and PsychInfo databases. We selected studies that explored the correlation between early clinical and paraclinical findings, and patient outcomes. Data was extracted, analyzed and recorded in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines...
January 2019: Journal of Autoimmunity
Britta K Sundquist, Jaison Jose, Daniel Pauze, Denis Pauze, Hongyue Wang, Kirsi M Järvinen
Background: Anaphylaxis is an acute, systemic allergic reaction that can be life threatening, and with an increasing incidence and costs associated with hospitalization and intensive care. Objective: To assess the risk factors for hospitalization by comparing pediatric and adult patients. Methods: We performed a retrospective chart review for patients with anaphylactic reactions who presented to the Albany Medical Center emergency department between 2005 and 2012. Results: We identified 267 anaphylactic reactions in 258 patients (143 adults)...
January 1, 2019: Allergy and Asthma Proceedings:
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