Causes and Outcomes of Finger Ischemia in Hospitalized Patients in the Intensive Care Unit

Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death rates depend mainly on the patients' comorbidities and age. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia, (b) mechanical ventilation (c) intensive care unit, and (d) death; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male. Hospital mortality among patients aged<15 was 9.11%, 51.99% of those aged >65 died. Male gender and increasing age predicted every severity outcome. Diabetes and hypertension predicted every severity outcome significantly. Obesity did not predict mortality, but CKD, respiratory diseases, cardiopathies were significant predictors. Conclusion: Obesity increased the risk for pneumonia, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death. Patients with respiratory diseases were less prone to develop pneumonia, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death.

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Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit

Cureus ◽

10.7759/cureus.2100 ◽

2018 ◽

Cited By ~ 2

Author(s):

Daniel Garrido ◽

Justin J Assioun ◽

Anahit Keshishyan ◽

Marcos A Sanchez-Gonzalez ◽

Bishoy Goubran

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Prognostic Factor ◽

Respiratory Rate ◽

Hospitalized Patients ◽

Respiratory Rate Variability

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MO392ACUTE KIDNEY INJURY IN HOSPITALIZED PATIENTS WITH COVID-19: A SINGLE-CENTER EXPERIENCE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab082.0046 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Tulin Akagun ◽

Arzu Ayraler ◽

Murat Usta ◽

Süleyman Baylan ◽

Ahmet Cumhur Dulger

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Laboratory Tests ◽

Laboratory Data ◽

Kidney Injury ◽

Prognostic Nutritional Index ◽

Hospitalized Patients ◽

Albumin Concentration ◽

Single Center Experience ◽

Before And After

Abstract Background and Aims Preliminary reports indicate that AKI (acute kidney injury) seem to be associated with coronavirus disease 2019 (COVID-19) severity and outcomes. Although the reported incidence of AKI among hospitalized patients with COVID-19 varies widely, AKI among hospitalized patients is associated with poor prognosis. The aim of this study was to evaluate the clinical characteristics and outcomes in our COVID-19 patients who developed AKI during intensive care unit hospitalization. Method In our retrospective, observational study COVID-19 PCR positive 49 patients who were hospitalized with COVID-19 pnumoniae in intensive care unit and developed AKI were evaluated with demographics, laboratory data, treatment and outcome. The prognostic nutritional index (PNI), which is calculated using the serum albumin concentration and total lymphocytic count were also evaluated. All patients were treated with favipiravir+low molecular weight heparin; laboratory tests were recorded before and after favipiravir treatment. Results Of 49 patients; 28 were male. A total of 9/49 (18.4%) patients survived. All patients were treated with favipiravir; laboratory tests were recorded before and after favipiravir treatment. The clinical parameters of patients are shown in Table-1 and Table-2. Mean PNI of the patients who survived was higher than patients who were exitus. Conclusion AKI in hospitalized patients with COVID-19 was associated with high mortality. Of all patients with AKI, only 18.4% survived.

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Analyze the risk factors for developing pressure ulcer among hospitalized patients in the Intensive Care Unit / Avaliação de risco para desenvolvimento de Úlceras por Pressão em pacientes críticos

Revista de Enfermagem da UFPI ◽

10.26694/reufpi.v2i1.818 ◽

2013 ◽

Vol 2 (1) ◽

pp. 9 ◽

Cited By ~ 2

Author(s):

Pietro Rodrigo Almeida e Sousa ◽

Mayara Feliciano Da Silva e Sousa ◽

Idna Carvalho Barros ◽

Sandra Marina Gonçalves Bezerra ◽

Jairo Edielson Rodrigues Barbosa de Sousa ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Pressure Ulcer ◽

Hospitalized Patients ◽

Terapia Intensiva

Objetivo: analisar os fatores de risco para desenvolvimento de Úlcera por Pressão em pacientes internados em UTI. Metodologia: estudo descritivo, de abordagem quantitativa, realizado em duas Unidades de Terapia Intensiva (UTI) de um hospital geral de Teresina-PI, com 40 pacientes, em abril de 2012. Resultados: os resultados mostraram que os fatores de risco associados ao desenvolvimento de UPP foram: idade elevada; doenças do sistema nervoso; respiratório e circulatório; além de comorbidades, tempo de internação entre 11 a 20 dias, condições de alimentação ruim e o uso de noradrenalina. Pela avaliação na Escala de Braden, observou-se uma maior ocorrência de UPP nos pacientes com risco alto e elevado, com p=0,03 para as duas variáveis. Conclusão: conclui-se que a aplicação da Escala de Braden e o conhecimento sobre os fatores de riscos adicionais, mostraram-se fundamentais para a assistência de enfermagem em predizer o risco individual para desenvolvimento de UPP. Descritores: Úlcera por Pressão, UTI, Assistência de enfermagem.

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COVID-19 as cause of viral sepsis: A Systematic Review and Meta-Analysis

10.1101/2020.12.02.20242354 ◽

2020 ◽

Author(s):

Eleni Karakike ◽

Evangelos J. Giamarellos-Bourboulis ◽

Miltiades Kyprianou ◽

Carolin Fleischmann-Struzek ◽

Mathias W. Pletz ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care Unit ◽

Intensive Care ◽

Organ Dysfunction ◽

Full Text ◽

Meta Analysis ◽

Hospitalized Patients ◽

Adult Patients ◽

Sensitivity Analyses ◽

Organ Dysfunctions

ABSTRACTImportanceCOVID-19 is a heterogenous disease most frequently causing respiratory tract infection but in its severe forms, respiratory failure and multiple organ dysfunction syndrome may occur, resembling sepsis. The prevalence of viral sepsis among COVID-19 patients is still unclear.ObjectiveWe aimed to describe this in a systematic review.Data sourcesMEDLINE(PubMed), Cochrane and Google Scholar databases were searched for studies reporting on patients hospitalized with confirmed COVID-19, diagnosed with sepsis or infection-related organ dysfunctions or receiving organ replacement therapy.Study selectionEligible were full-text English articles of randomized and non-randomized clinical trials and observational studies reporting on patients with confirmed COVID-19, who are diagnosed with sepsis or have infection-related organ dysfunctions. Systematic reviews, editorials, conference abstracts, animal studies, case reports, articles neither in English nor full-text, and studies with fewer than 30 participants were excluded.Data extraction and synthesisAll eligible studies were included in a narrative synthesis of results and after reviewing all included studies a meta-analysis was conducted. Separate sensitivity analyses were conducted per adult vs pediatric populations and per Intensive Care Unit (ICU) vs non-ICU populations.Main outcomes and measuresPrimary endpoint was the prevalence of sepsis using Sepsis-3 criteria among patients with COVID-19 and among secondary, new onset of infection-related organ dysfunction. Outcomes were expressed as proportions with respective 95% confidence interval (CI).ResultsOf 1,903 articles, 104 were analyzed. The prevalence of sepsis in COVID-19 was 39.9% (95% CI, 35.9-44.1; I2, 99%). In sensitivity analysis, sepsis was present in 25.1% (95% CI, 21.8-28.9; I2 99%) of adult patients hospitalized in non-Intensive-Care-Unit (ICU) wards (40 studies) and in 83.8 (95% CI, 78.1-88.2; I2,91%) of adult patients hospitalized in the ICU (31 studies). Sepsis in children hospitalized with COVID-19 was as high as 7.8% (95% CI, 0.4-64.9; I2, 97%). Acute Respiratory Distress Syndrome was the most common organ dysfunction in adult patients in non-ICU (27.6; 95% CI, 21.6-34.5; I2, 99%) and ICU (88.3%; 95% CI, 79.7-93.5; I2, 97%)Conclusions and relevanceDespite the high heterogeneity in reported results, sepsis frequently complicates COVID-19 among hospitalized patients and is significantly higher among those in the ICU. PROSPERO registration number: CRD42020202018. No funding.KEY POINTSQuestionWhat is the prevalence of viral sepsis by Sepsis-3 definition among hospitalized patients with COVID-19?FindingsIn this systematic review and meta-analysis, we systematically reviewed published literature for evidence of organ failure in COVID-19, to estimate the prevalence of viral sepsis in this setting, by means of SOFA score calculation. The prevalence of sepsis in COVID-19 was 39.9% (95% CI, 35.9-44.1; I2, 99%).MeaningThis is the first study to address the burden of viral sepsis in hospitalized patients with COVID-19, a highly heterogenous infection ranging from asymptomatic cases to severe disease leading to death, as reflected in the high heterogeneity of this study.

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