Risk Factors for Gastrointestinal Bleeding in Critically Ill Patients

2018 ◽  
pp. 187-191
Author(s):  
Miguel Cobas ◽  
Melissa Grillo
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multicenter Cohort Study ◽  
Hemodynamic Compromise ◽  
Potential Risk Factors ◽  
Independent Risk Factors ◽  
Clinically Significant ◽  
Ulcer Prophylaxis

The efficacy of stress ulcer prophylaxis for the prevention of gastrointestinal bleeding in the critically ill has led to its widespread use. Side effects and cost of prophylaxis necessitate targeting the therapy to those patients most likely to benefit. A prospective multicenter cohort study was conducted to evaluate potential risk factors for stress ulceration in patients admitted to intensive care units. Two strong independent risk factors for bleeding were identified: respiratory failure and coagulopathy. Since few critically ill patients have clinically significant gastrointestinal bleeding (defined as overt bleeding in association with hemodynamic compromise or the need for blood transfusion), prophylaxis can safely be withheld unless they require mechanical ventilation or have a coagulopathy.

Clinically significant gastrointestinal bleeding in critically ill patients with and without stress-ulcer prophylaxis

2003 ◽  
Vol 29 (8) ◽  
pp. 1306-1313 ◽  
Author(s):  
Christophe Faisy ◽  
Emmanuel Guerot ◽  
Jean-Luc Diehl ◽  
Eléonore Iftimovici ◽  
Jean-Yves Fagon
Keyword(s):  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Clinically Significant ◽  
Ulcer Prophylaxis

scholarly journals Risk Factors For Kidney Damage In COVID-19 Patients Admitted To The Intensive Care Unit

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Diana K. Sarkisian ◽  
Natalia V. Chebotareva ◽  
Valerie McDonnell ◽  
Armen V. Oganesyan ◽  
Tatyana N. Krasnova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Kidney Damage ◽  
Elderly Age ◽  
Total Blood ◽  
Independent Risk Factors

Background — Acute kidney injury (AKI) reaches 29% in the intensive care unit (ICU). Our study aimed to determine the prevalence, features, and the main AKI factors in critically ill patients with coronavirus disease 2019 (COVID-19). Material and Methods — The study included 37 patients with COVID-19. We analyzed the total blood count test results, biochemical profile panel, coagulation tests, and urine samples. We finally estimated the markers of kidney damage and mortality. Result — All patients in ICU had proteinuria, and 80.5% of patients had hematuria. AKI was observed in 45.9% of patients. Independent risk factors were age more than 60 years, increased C-reactive protein (CRP) level, and decreased platelet count. Conclusion — Kidney damage was observed in most critically ill patients with COVID-19. The independent risk factors for AKI in critically ill patients were elderly age, a cytokine response with a high CRP level.

scholarly journals Risk factors for mortality in elderly and very elderly critically ill patients with sepsis: a prospective, observational, multicenter cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ignacio Martin-Loeches ◽  
Maria Consuelo Guia ◽  
Maria Sole Vallecoccia ◽  
David Suarez ◽  
Mercedes Ibarz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Very Elderly ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort

scholarly journals Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Eirini Tsakiridou ◽  
Demosthenes Makris ◽  
Vasiliki Chatzipantazi ◽  
Odysseas Vlachos ◽  
Grigorios Xidopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Hemoglobin A1c ◽  
District Hospital ◽  
Bloodstream Infections ◽  
Inclusion Criteria ◽  
Icu Mortality ◽  
Independent Risk Factors

Objective. To evaluate whether diabetes mellitus (DM) and hemoglobin A1c (HbA1c) are risk factors for ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) in critically ill patients.Methods. Prospective observational study; patients were recruited from the intensive care unit (ICU) of a general district hospital between 2010 and 2012. Inclusion criteria: ICU hospitalization >72 hours and mechanical ventilation >48 hours. HbA1c was calculated for all participants. DM, HbA1c, and other clinical and laboratory parameters were assessed as risk factors for VAP or BSI in ICU.Results. The overall ICU incidence of VAP and BSI was 26% and 30%, respectively. Enteral feeding OR (95%CI) 6.20 (1.91–20.17;P=0.002) and blood transfusion 3.33 (1.23–9.02;P=0.018) were independent risk factors for VAP. BSI in ICU (P=0.044) and ICU mortality (P=0.038) were significantly increased in diabetics. Independent risk factors for BSI in ICU included BSI on admission 2.45 (1.14–5.29;P=0.022) and stroke on admission2.77 (1.12–6.88;P=0.029). Sepsis 3.34 (1.47–7.58;P=0.004) and parenteral feeding 6.29 (1.59–24.83;P=0.009) were independently associated with ICU mortality. HbA1c ≥ 8.1% presented a significant diagnostic performance in diagnosing repeated BSI in ICU.Conclusion. DM and HbA1c were not associated with increased VAP or BSI frequency. HbA1c was associated with repeated BSI episodes in the ICU.

Risk factors for gastrointestinal bleeding in critically ill patients

1994 ◽  
Vol 17 (2) ◽  
pp. 89
Author(s):  
D. J. Cook ◽  
H. D. Fuller ◽  
G. H. Guyatt ◽  
J. C. Marshall ◽  
D. Leasa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals Erratum to: Risk Factors for Nosocomial Gastrointestinal Bleeding and Use of Acid-Suppressive Medication in Non-Critically Ill Patients

2013 ◽  
Vol 28 (7) ◽  
pp. 978-978 ◽  
Author(s):  
Shoshana J. Herzig ◽  
Michael B. Rothberg ◽  
David B. Feinbloom ◽  
Michael D. Howell ◽  
Kalon K. L. Ho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals Accuracy of a Bedside Swallow Test After Extubation in ICU: A Prospective Validation of a Clinical Test Compared to a Fiberoptic Endoscopy.

2020 ◽  
Author(s):  
Adel Maamar ◽  
Valentine Parent ◽  
Emmanuel Guérot ◽  
Pauline Berneau ◽  
Aurélien Frérou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Validation Cohort ◽  
Clinical Test ◽  
Exclusion Criteria ◽  
Predictive Values ◽  
Swallowing Evaluation ◽  
Independent Risk Factors ◽  
Preliminary Study

Abstract Background: Swallowing disorders (SDs) are frequent after extubation in intensive care unit (ICU) exposing patients to aspiration pneumonia. There is no validated bedside swallowing evaluation (BSE) after extubation. We aimed to evaluate the accuracy of our BSE in comparison with fiberoptic endoscopic evaluation of swallowing (FEES) in critically ill patients after extubation, and to identify the incidence and risk factors of SD.Methods: After a preliminary study in a first center, we conducted a 1-year prospective study as a validation cohort in a second center. Patients intubated for longer than 48 hours were included. Exclusion criteria were a known laryngeal pathology, a preexisting SD and an admission for stroke. FEES of the larynx and BSE were assessed within 24 hours after extubation to compare the accuracy of the BSE to the FEES procedure.Results: One hundred and twenty eight patients were included, respectively 69 and 79 in the preliminary study and the validation cohort. Thirteen of 69 (19%) and 33/79 (42%) had SD assessed by FEES. The area under curve (AUC) reached respectively 0.86 (95% CI 0.73-0.98) and 0.83 (95% CI 0.74-0.92). Sensitivities were 77% (95% CI 0.54-0.99) and 85% (95% CI 0.73-0.94), specificities 94% (95% CI 0.87-0.98) and 80% (95% CI 0.7-0.91), and negative predictive values (NPV) were 95% and 90% in respectively preliminary study and validation cohort. Independent risk factors for SD were duration of intubation (OR=1.08; 95% CI 1.02-1.17, p=0.03) and hemodynamic failure (OR=4.46; 95% CI 1.27-21, p=0.03).Conclusion: Our BSE is accurate to detect SDs after extubation in critically ill patients and can easily be implemented in an ICU setting.

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