scholarly journals Adverse outcomes after planned surgery with anticipated intensive care admission in out-of-office-hours time periods: a multicentre cohort study

2018 ◽  
Vol 120 (6) ◽  
pp. 1420-1428 ◽  
Author(s):  
D.J. Morgan ◽  
K.M. Ho ◽  
M.L. Kolybaba ◽  
Y.J. Ong
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Adverse Outcomes ◽  
Intensive Care Admission ◽  
Multicentre Cohort Study ◽  
Time Periods ◽  
Multicentre Cohort

scholarly journals Age differences in clinical features and outcomes in patients with COVID-19, Jiangsu, China: a retrospective, multicentre cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039887 ◽  
Author(s):  
Huanyuan Luo ◽  
Songqiao Liu ◽  
Yuancheng Wang ◽  
Penelope A Phillips-Howard ◽  
Shenghong Ju ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Older Patients ◽  
Adverse Outcomes ◽  
Trend Test ◽  
Chronic Obstructive ◽  
Multicentre Cohort Study ◽  
Multicentre Cohort

ObjectivesTo determine the age-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China.Design and settingRetrospective, multicentre cohort study performed at 24 hospitals in Jiangsu, China.Participants625 patients with COVID-19 enrolled between 10 January and 15 March 2020.ResultsOf the 625 patients (median age, 46 years; 329 (52.6%) men), 37 (5.9%) were children (18 years or younger), 261 (41.8%) young adults (19–44 years), 248 (39.7%) middle-aged adults (45–64 years) and 79 (12.6%) elderly adults (65 years or older). The incidence of hypertension, coronary heart disease, chronic obstructive pulmonary disease and diabetes comorbidities increased with age (trend test, p<0.0001, p=0.0003, p<0.0001 and p<0.0001, respectively). Fever, cough and shortness of breath occurred more commonly among older patients, especially the elderly, compared with children (χ2 test, p=0.0008, 0.0146 and 0.0282, respectively). The quadrant score and pulmonary opacity score increased with age (trend test, both p<0.0001). Older patients had many significantly different laboratory parameters from younger patients. Elderly patients had the highest proportion of severe or critically-ill cases (33.0%, χ2 test p<0.0001), intensive care unit use (35.4%, χ2 test p<0.0001), respiratory failure (31.6%, χ2 test p<0.0001) and the longest hospital stay (median 21 days, Kruskal–Wallis test p<0.0001).ConclusionsElderly (≥65 years) patients with COVID-19 had the highest risk of severe or critical illness, intensive care use, respiratory failure and the longest hospital stay, which may be due partly to their having a higher incidence of comorbidities and poor immune responses to COVID-19.

Association between Frailty and 90-Day Outcomes amongst the Chinese Population: A Hospital-Based Multicentre Cohort Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Jing Jiao ◽  
Na Guo ◽  
Lingli Xie ◽  
Qiaoyan Ying ◽  
Chen Zhu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Outcomes ◽  
Hospital Ward ◽  
Adverse Health Outcomes ◽  
Multicentre Cohort Study ◽  
Older Inpatients ◽  
Ward Clustering ◽  
Clustering Effect ◽  
The Relationship ◽  
Multicentre Cohort

<b><i>Introduction:</i></b> Frailty has gained increasing attention as it is by far the most prevalent geriatric condition amongst older patients which heavily impacts chronic health status. However, the relationship between frailty and adverse health outcomes in China is far from clear. This study explored the relation between frailty and a panel of adverse health outcomes. <b><i>Methods:</i></b> We performed a multicentre cohort study of older inpatients at 6 large hospitals in China, with two-stage cluster sampling, from October 2018 to April 2019. Frailty was measured according to the FRAIL scale and categorized into robust, pre-frail, and frail. A multivariable logistic regression model and multilevel multivariable negative binomial regression model were used to analyse the relationship between frailty and adverse outcomes. Outcomes were length of hospitalization, as well as falls, readmission, and mortality at 30 and 90 days after enrolment. All regression models were adjusted for age, sex, BMI, surgery, and hospital ward. <b><i>Results:</i></b> We included 9,996 inpatients (median age 72 years and 57.8% male). The overall mortality at 30 and 90 days was 1.23 and 1.88%, respectively. At 30 days, frailty was an independent predictor of falls (odds ratio [OR] 3.19; 95% CI 1.59–6.38), readmission (OR 1.45; 95% CI 1.25–1.67), and mortality (OR 3.54; 95% confidence interval [CI] 2.10–5.96), adjusted for age, sex, BMI, surgery, and hospital ward clustering effect. At 90 days, frailty had a strong predictive effect on falls (OR 2.10; 95% CI 1.09–4.01), readmission (OR 1.38; 95% CI 1.21–1.57), and mortality (OR 6.50; 95% CI 4.00–7.97), adjusted for age, sex, BMI, surgery, and hospital ward clustering effect. There seemed to be a dose-response association between frailty categories and fall or mortality, except for readmission. <b><i>Conclusions:</i></b> Frailty is closely related to falls, readmission, and mortality at 30 or 90 days. Early identification and intervention for frailty amongst older inpatients should be conducted to prevent adverse outcomes.

scholarly journals Utility of electronic AKI alerts in intensive care: A national multicentre cohort study

2018 ◽  
Vol 44 ◽  
pp. 185-190 ◽  
Author(s):  
Jennifer Holmes ◽  
Gethin Roberts ◽  
John Geen ◽  
Alan Dodd ◽  
Nicholas M. Selby ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Multicentre Cohort Study ◽  
Multicentre Cohort

scholarly journals The influence of volume and intensive care unit organization on hospital mortality in patients admitted with severe sepsis: a retrospective multicentre cohort study

Critical Care ◽  
2007 ◽  
Vol 11 (2) ◽  
pp. R40 ◽  
Author(s):  
Linda Peelen ◽  
Nicolette F de Keizer ◽  
Niels Peek ◽  
Gert Scheffer ◽  
Peter HJ van der Voort ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Severe Sepsis ◽  
Cohort Study ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Multicentre Cohort Study ◽  
Unit Organization ◽  
Multicentre Cohort

scholarly journals Incidence, duration and cost of futile treatment in end-of-life hospital admissions to three Australian public-sector tertiary hospitals: a retrospective multicentre cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017661 ◽  
Author(s):  
Hannah E Carter ◽  
Sarah Winch ◽  
Adrian G Barnett ◽  
Malcolm Parker ◽  
Cindy Gallois ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Health System ◽  
End Of Life ◽  
Hospital Admissions ◽  
Multicentre Cohort Study ◽  
Futile Treatment ◽  
Tertiary Hospitals ◽  
Bed Days ◽  
Multicentre Cohort

ObjectivesTo estimate the incidence, duration and cost of futile treatment for end-of-life hospital admissions.DesignRetrospective multicentre cohort study involving a clinical audit of hospital admissions.SettingThree Australian public-sector tertiary hospitals.ParticipantsAdult patients who died while admitted to one of the study hospitals over a 6-month period in 2012.Main outcome measuresIncidences of futile treatment among end-of-life admissions; length of stay in both ward and intensive care settings for the duration that patients received futile treatments; health system costs associated with futile treatments; monetary valuation of bed days associated with futile treatment.ResultsThe incidence rate of futile treatment in end-of-life admissions was 12.1% across the three study hospitals (range 6.0%–19.6%). For admissions involving futile treatment, the mean length of stay following the onset of futile treatment was 15 days, with 5.25 of these days in the intensive care unit. The cost associated with futile bed days was estimated to be $AA12.4 million for the three study hospitals using health system costs, and $A988 000 when using a decision maker’s willingness to pay for bed days. This was extrapolated to an annual national health system cost of $A153.1 million and a decision maker’s willingness to pay of $A12.3 million.ConclusionsThe incidence rate and cost of futile treatment in end-of-life admissions varied between hospitals. The overall impact was substantial in terms of both the bed days and cost incurred. An increased awareness of these economic costs may generate support for interventions designed to reduce futile treatments. We did not include emotional hardship or pain and suffering, which represent additional costs.

Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study

2011 ◽  
Vol 11 (3) ◽  
pp. 181-189 ◽  
Author(s):  
Daniel H Kett ◽  
Ennie Cano ◽  
Andrew A Quartin ◽  
Julie E Mangino ◽  
Marcus J Zervos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
Multicentre Cohort Study ◽  
Multicentre Cohort

scholarly journals Causes of death in critically ill paediatric patients in Japan: a retrospective multicentre cohort study

2019 ◽  
Vol 3 (1) ◽  
pp. e000499 ◽  
Author(s):  
Tadashi Ishihara ◽  
Hiroshi Tanaka
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Chronic Illness ◽  
Intensive Care Units ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Causes Of Death ◽  
Paediatric Patients ◽  
Multicentre Cohort Study ◽  
Multicentre Cohort

ObjectivesThe primary objective is to clarify the clinical profiles of paediatric patients who died in intensive care units (ICUs) or paediatric intensive care units (PICUs), and the secondary objective is to ascertain the demographic differences between patients who died with and without chronic conditions.MethodsIn this retrospective multicentre cohort study, we collected data on paediatric death from the Japanese Registry of Pediatric Acute Care (JaRPAC) database. We included patients who were ≤16 years of age and had died in either a PICU or an ICU of a participating hospital between April 2014 and March 2017. The causes of death were compared between patients with and without chronic conditions.ResultsTwenty-three hospitals participated, and 6199 paediatric patients who were registered in the JaRPAC database were included. During the study period, 126 (2.1%) patients died (children without chronic illness, n=33; children with chronic illness, n=93). Twenty-five paediatric patients died due to an extrinsic disease, and there was a significant difference in extrinsic diseases between the two groups (children without chronic illness, 15 (45%); children with chronic illness, 10 (11%); p<0.01). Cardiovascular disease was the most common chronic condition (27/83, 29%). Eighty-three patients (85%) in the chronic group died due to an intrinsic disease, primarily congenital heart disease (14/93, 15%), followed by sepsis (13/93, 14%).ConclusionsThe majority of deaths were in children with a chronic condition. The major causes of death in children without a chronic illness were due to intrinsic factors such as cardiovascular and neuromuscular diseases, and the proportion of deaths due to extrinsic causes was higher in children without chronic illness.

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