Pediatric Risk of Mortality and Hospital Infection

2004 ◽  
Vol 25 (9) ◽  
pp. 783-785 ◽  
Author(s):  
Aglai Arantes ◽  
Eduardo da Silva Carvalho ◽  
Eduardo A. S. Medeiros ◽  
Calil Kairalla Farhat ◽  
Orlando Cesar Mantese

AbstractWe studied the association of Pediatric Risk of Mortality scores with nosocomial infections among 341 critically ill patients admitted to a pediatric intensive care unit between June 1998 and December 2000. Through stepwise logistic regression analysis, the best predictors for nosocomial infections were device utilization ratio, antimicrobial therapy, and length of stay.

2007 ◽  
Vol 28 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Elizabeth E. Foglia ◽  
Victoria J. Fraser ◽  
Alexis M. Elward

Objective.To determine the prevalence, risk factors, and outcomes of nosocomial infection due to antimicrobial resistant bacteria in patients treated in the pediatric intensive care unit (PICU).Design.Nested case-cohort study. Patient data were collected prospectively, and antimicrobial susceptibility data were abstracted retrospectively.Setting.A large pediatric teaching hospital.Patients.All PICU patients admitted from September 1, 1999, to September 1, 2001, unless they died within 24 hours after PICU admission, were 18 years old or older, or were neonatal intensive care unit patients receiving extracorporeal membrane oxygenation.Results.A total of 135 patients with more than 1 nosocomial bacterial infection were analyzed; 52% were male, 75% were white, the mean Pediatric Risk of Mortality score was 10.5, and the mean age was 3.5 years. Of these patients, 37 (27%) had nosocomial infections due to antibiotic-resistant organisms. In univariate analysis, transplantation (odds ratio [OR], 2.83 [95% confidence interval (CI), 1.05-7.66]) and preexisting lung disease (OR, 2.63 [95% CI, 1.18-5.88]) were associated with nosocomial infections due to antibiotic-resistant organisms. Age, Pediatric Risk of Mortality score at admission, length of hospital stay before infection, and other underlying conditions were not associated with infections due to antibiotic-resistant organisms. Patients infected with antibiotic-resistant organisms had greater mean PICU lengths of stay after infection, compared with patients infected with antibiotic-susceptible organisms (22.9 vs 12.8 days;P= .004), and higher crude mortality rates (OR, 2.40 [95% CI, 1.03-5.61]).Conclusions.Identifiable risk factors exist for nosocomial infections due to antibiotic-resistant organisms. In univariate analysis, infections due to antibiotic-resistant bacteria are associated with increased length of stay in the PICU after onset of infection and increased mortality.


2020 ◽  
Author(s):  
Rui Yue ◽  
Minghui Yang ◽  
Xiaohui Deng ◽  
Ping Zhang

Abstract Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 343 patients were included in the study, of which 151 (44.0%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.


2018 ◽  
Vol 2 (4) ◽  
pp. 65 ◽  
Author(s):  
Kanokpan Ruangnapa ◽  
Sittikiat Sucheewakul ◽  
Tippawan Liabsuetrakul ◽  
Edward McNeil ◽  
Kantara Lim ◽  
...  

Author(s):  
Hongbai Wang ◽  
Liang Zhang ◽  
Qipeng Luo ◽  
Yinan Li ◽  
Fuxia Yan

ABSTRACT:Background:Post-cardiac surgery patients exhibit a higher incidence of postoperative delirium (PD) compared to non-cardiac surgery patients. Patients with various cardiac diseases suffer from preoperative sleep disorder (SPD) induced by anxiety, depression, breathing disorder, or other factors.Objective:To examine the effect of sleep disorder on delirium in post-cardiac surgery patients.Methods:We prospectively selected 186 patients undergoing selective cardiac valve surgery. Preoperative sleep quality and cognitive function of all eligible participants were assessed through the Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment, respectively. The Confusion Assessment Method for Intensive Care Unit was used to assess PD from the first to seventh day postoperatively. Patients were divided into two groups according to the PD diagnosis: (1) No PD group and (2) the PD group.Results:Of 186 eligible patients, 29 (15.6%) were diagnosed with PD. A univariate analysis showed that gender (p = 0.040), age (p = 0.009), SPD (p = 0.008), intraoperative infusion volume (p = 0.034), postoperative intubation time (p = 0.001), and intensive care unit stay time (p = 0.009) were associated with PD. A multivariate logistic regression analysis demonstrated that age (odds ratio (OR): 1.106; p = 0.001) and SPD (OR: 3.223; p = 0.047) were independently associated with PD. A receiver operating characteristic curve demonstrated that preoperative PSQI was predictive of PD (area under curve: 0.706; 95% confidence interval: 0.595–0.816). A binomial logistic regression analysis showed that there was a significant association between preoperative 6 and 21 PSQI scores and PD incidence (p = 0.009).Conclusions:Preoperative SPD was significantly associated with PD and a main predictor of PD.


2018 ◽  
Vol 7 (3.28) ◽  
pp. 68
Author(s):  
Siti Afiqah Muhamad Jamil ◽  
Mohd Asrul Affendi Abdullah ◽  
Kek Sie Long ◽  
Nur Fazilla Mohd Jupri ◽  
Mustafa Mamat

The aims of this study are to fit a logistic regression model towards the fly problem in a farm and to identify the variables that are associated with the fly problem in a poultry farm. By using SPSS software, this study used ‘FORWARD STEPWISE’ and ‘BACKWARD STEPWISE’ methods to perform the analysis. Compared to linear regression analysis, logistic regression does not require rigorous assumptions to be met. This study used Likelihood Ratio test, Omnibus test and Hosmer and Lemeshow test to validate and to test the fit of poultry farm data. Akaike Information Criterion (AIC) is calculated to observe the difference between the methods of stepwise used by SPSS software in this study. As a result, logistic regression is fit towards poultry farm data by a stepwise procedure. BACKWARD STEPWISE seems to be more suitable for conducting the stepwise method of analysis. Besides, variables that influence the problem of fly in a poultry are the wasps, distance and number of flies. 


1989 ◽  
Vol 10 (11) ◽  
pp. 515-520 ◽  
Author(s):  
E.L. Ford-Jones ◽  
C.M. Mindorff ◽  
E. Pollock ◽  
R. Milner ◽  
D. Bohn ◽  
...  

AbstractTo improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.


Sign in / Sign up

Export Citation Format

Share Document