Risk factors associated with intensive care unit (ICU) admission and in-hospital death among adults hospitalized with COVID-19: a two-center retrospective observational study in tertiary care hospitals

Objective.To determine risk factors and outcomes associated with ciprofloxacin resistance in clinical bacterial isolates from intensive care unit (ICU) patients.Design.Prospective cohort study.Setting.Twenty-bed medical-surgical ICU in a Canadian tertiary care teaching hospital.Patients.All patients admitted to the ICU with a stay of at least 72 hours between January 1 and December 31, 2003.Methods.Prospective surveillance to determine patient comorbidities, use of medical devices, nosocomial infections, use of antimicrobials, and outcomes. Characteristics of patients with a ciprofloxacin-resistant gram-negative bacterial organism were compared with characteristics of patients without these pathogens.Results.Ciprofloxacin-resistant organisms were recovered from 20 (6%) of 338 ICU patients, representing 38 (21%) of 178 nonduplicate isolates of gram-negative bacilli. Forty-nine percent ofPseudomonas aeruginosaisolates and 29% ofEscherichia coliisolates were resistant to ciprofloxacin. In a multivariate analysis, independent risk factors associated with the recovery of a ciprofloxacin-resistant organism included duration of prior treatment with ciprofloxacin (relative risk [RR], 1.15 per day [95% confidence interval {CI}, 1.08-1.23];P< .001), duration of prior treatment with levofloxacin (RR, 1.39 per day [95% CI, 1.01-1.91];P= .04), and length of hospital stay prior to ICU admission (RR, 1.02 per day [95% CI, 1.01-1.03];P= .005). Neither ICU mortality (15% of patients with a ciprofloxacin-resistant isolate vs 23% of patients with a ciprofloxacin-susceptible isolate;P= .58 ) nor in-hospital mortality (30% vs 34%;P= .81 ) were statistically significantly associated with ciprofloxacin resistance.Conclusions.ICU patients are at risk of developing infections due to ciprofloxacin-resistant organisms. Variables associated with ciprofloxacin resistance include prior use of fluoroquinolones and duration of hospitalization prior to ICU admission. Recognition of these risk factors may influence antibiotic treatment decisions.

Download Full-text

ECG CHANGES IN PATIENTS WITH COVID-19 – A RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN CHENNAI

10.36106/paripex/9800205 ◽

2021 ◽

pp. 5-7

Author(s):

A .Shaik Sulaiman Meeran ◽

T. Balaji ◽

P. Raja ◽

Kiran Chandramohan

Keyword(s):

Risk Factors ◽

Observational Study ◽

Virus Disease ◽

Tertiary Care ◽

P Wave ◽

Retrospective Observational Study ◽

Care Hospital ◽

Icu Admission ◽

Corona Virus ◽

Increased Risk

Background:A global outbreak of corona virus disease, caused by severe respiratory corona virus 2, has emerged since December 2019. However electrocardiographic manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of ICU admission Methods:This retrospective observational study included the patients with COVID-19 at the Government Kilpauk Medical College, Chennai between June 1st and 31st, 2020. Demographic, clinical and ECG characteristics were collected and comparison were made between ICU and non ICU admission groups. Logistic regression was used to identify risk factors of ICU admission Results:Among the 159 patients included ST-T abnormalities were the most common ECG feature followed by arrhythmias. Compared with non ICU group, the ICU group showed higher heart rate and P wave duration and was more frequently associated with CVD, ST-T abnormalities, arrythmias, QTc prolongation and pathological Q waves. ST-T abnormalities and history of CVD were associated with increased risk of ICU admission Conclusion:COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission

Download Full-text

Microbial and Antibiotic Susceptibility Profile among Isolates of Clinical Samples of Cancer Patients admitted in the Intensive-care Unit at Regional Tertiary Care Cancer Center: A Retrospective Observational Study

Indian Journal of Critical Care Medicine ◽

10.5005/jp-journals-10071-23119 ◽

2019 ◽

Vol 23 (2) ◽

pp. 67-72 ◽

Cited By ~ 1

Author(s):

Vinod Kumar ◽

Sushma Bhatnagar ◽

Nishkarsh Gupta ◽

Vishnu Kumar Garg ◽

Seema Mishra ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Cancer Patients ◽

Antibiotic Susceptibility ◽

Tertiary Care ◽

Retrospective Observational Study ◽

Clinical Samples ◽

Cancer Center

Download Full-text

Clinical characteristics and risk factors for mortality in patients with coronavirus disease 2019 in intensive care unit: a single- center, retrospective, observational study in China

Annals of Palliative Medicine ◽

10.21037/apm-20-1575 ◽

2021 ◽

Vol 10 (2) ◽

pp. 11-11

Author(s):

Fangfang Sai ◽

Xiaolei Liu ◽

Lanyu Li ◽

Yan Ye ◽

Changqing Zhu ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Clinical Characteristics ◽

Retrospective Observational Study ◽

Single Center

Download Full-text

Reducing incidence of red cell transfusion among preterm babies in a tertiary care neonatal intensive care unit: A retrospective observational study

Journal of Clinical Neonatology ◽

10.4103/jcn.jcn_66_18 ◽

2019 ◽

Vol 8 (1) ◽

pp. 19

Author(s):

Ankit Agarwal ◽

Deepak Sikriwal ◽

Avadhesh Ahuja ◽

Raghuram Mallaiah

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Retrospective Observational Study ◽

Red Cell ◽

Preterm Babies ◽

Red Cell Transfusion

Download Full-text

Risk Factors Associated with Vancomycin-ResistantEnterococcusin Intensive Care Unit Settings in Saudi Arabia

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2013/369674 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Mahmoud Shorman ◽

Jaffar A. Al-Tawfiq

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Saudi Arabia ◽

Intensive Care ◽

Antimicrobial Agents ◽

Multiorgan Failure ◽

Tertiary Hospital ◽

Oral Contrast ◽

Factors Associated ◽

Icu Admission

Background. Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens worldwide. There is one report about the epidemiology of VRE in Saudi Arabia.Objective. To determine the risk factors associated with VRE infection or colonization in intensive care unit (ICU) settings.Design. This is a descriptive, epidemiologic hospital-based case-control study of patients with VRE from February 2006 to March 2010 in ICU in a tertiary hospital in Saudi Arabia.Methods. Data were collected from hospital records of patients with VRE. The main outcome measure was the adjusted odds ratio estimates of potential risk factors for VRE.Results. Factors associated with VRE included ICU admission for multiorgan failure, chronic renal failure, prior use of antimicrobial agents in the past three months and before ICU admission, gastrointestinal oral contrast procedure, and hemodialysis. Being located in a high risk room (roommate of patients colonized or infected with VRE) was found to be protective.Conclusions. Factors associated with VRE acquisition are often complex and may be confounded by local variables.

Download Full-text

Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET)

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1012 ◽

2020 ◽

Cited By ~ 31

Author(s):

Lindsay Kim ◽

Shikha Garg ◽

Alissa O’Halloran ◽

Michael Whitaker ◽

Huong Pham ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Hospital Mortality ◽

Invasive Mechanical Ventilation ◽

The United States ◽

Surveillance Network ◽

Factors Associated ◽

Icu Admission ◽

Male Sex

Abstract Background Currently, the United States has the largest number of reported coronavirus disease 2019 (COVID-19) cases and deaths globally. Using a geographically diverse surveillance network, we describe risk factors for severe outcomes among adults hospitalized with COVID-19. Methods We analyzed data from 2491 adults hospitalized with laboratory-confirmed COVID-19 between 1 March–2 May 2020, as identified through the Coronavirus Disease 2019–Associated Hospitalization Surveillance Network, which comprises 154 acute-care hospitals in 74 counties in 13 states. We used multivariable analyses to assess associations between age, sex, race and ethnicity, and underlying conditions with intensive care unit (ICU) admission and in-hospital mortality. Results The data show that 92% of patients had ≥1 underlying condition; 32% required ICU admission; 19% required invasive mechanical ventilation; and 17% died. Independent factors associated with ICU admission included ages 50–64, 65–74, 75–84, and ≥85 years versus 18–39 years (adjusted risk ratios [aRRs], 1.53, 1.65, 1.84, and 1.43, respectively); male sex (aRR, 1.34); obesity (aRR, 1.31); immunosuppression (aRR, 1.29); and diabetes (aRR, 1.13). Independent factors associated with in-hospital mortality included ages 50–64, 65–74, 75–84, and ≥ 85 years versus 18–39 years (aRRs, 3.11, 5.77, 7.67, and 10.98, respectively); male sex (aRR, 1.30); immunosuppression (aRR, 1.39); renal disease (aRR, 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR, 1.28); neurologic disorders (aRR, 1.25); and diabetes (aRR, 1.19). Conclusions In-hospital mortality increased markedly with increasing age. Aggressive implementation of prevention strategies, including social distancing and rigorous hand hygiene, may benefit the population as a whole, as well as those at highest risk for COVID-19–related complications.

Download Full-text