scholarly journals 1295. Mortality of Patients with HIV Infection Admitted to the Intensive Care Unit: A 16-Year Experience

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S466-S467
Author(s):  
Fernando Rosso ◽  
Diana Marcela Martínez-Ruiz ◽  
Andres Castro ◽  
Luis Gabriel Parra-Lara ◽  
Jorge Andrés Hoyos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Expectancy ◽  
Age Groups ◽  
Noncommunicable Diseases ◽  
Age Group ◽  
Icu Mortality ◽  
Hiv Patients ◽  
Hiv Mortality ◽  
Overall Mortality

Abstract Background The life expectancy of HIV patients has increased with antiretroviral therapy which has reduced the incidence of AIDS-associated illnesses. Longer life expectancy increases noncommunicable diseases cases and the demand for intensive care unit (ICU) care. ICU mortality is higher among HIV patients. Information about mortality and other relevant outcomes among HIV patients from developing countries is paramount for benchmarking purposes. This study aimed to evaluate the mortality of patients with HIV/AIDS admitted to the ICU during the years 1999 to 2015. Methods An observational retrospective study was conducted based on episodes of patients admitted to the ICU of the Fundación Valle del Lili from December 1998 to October 2015. The Cochran-Armitage test was used to evaluate the trend of HIV mortality by 4-year periods, considering sex and age groups ( <50 vs. >50 years). The Z test compared the mortality between HIV patients with non-HIV patients in the ICU; also it compared the mortality in HIV patients by sex and age group. Results A total of 53,798 episodes of ICU admissions were analyzed, 0.76% (414) were HIV patients, and of this 78.5% were men. Twenty-three percent were over 50 years old. Overall mortality in the ICU was 9.13%, and the mortality in HIV patients was 22.03%, which was higher when compared with a non-HIV group (9%, P < 0.001). Mortality due to HIV had a statistically significant decreasing trend (P < 0.001), going from 40% between 1999 and 2003 to 18.04% between 2012–2015, this trend was observed among men with HIV (P < 0.001) starting with 43. 5% and ending at 20%, but among women the decreasing trend was not statistically significant (P = 0.62). Mortality for HIV decreased, in the <50 years group: it went from 38. 3% to 18. 6% (P = 0.0003). Furthermore, in patients 50 years and older group mortality went from 50% to 17.9% (P = 0.025). During period 2008–2011, patients 50 years and older had more mortality compared with <50 years group (P = 0.019), but there were no differences by sex in any period. Conclusion This study found a statistically significant trend for mortality decrease over a 16-year period among HIV patients admitted to an ICU from a developing country. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Characteristics and Short-Term Outcomes of HIV Patients Admitted to an African Intensive Care Unit

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Arthur Kwizera ◽  
Mary Nabukenya ◽  
Agaba Peter ◽  
Lameck Semogerere ◽  
Emmanuel Ayebale ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Low Income ◽  
Clinical Characteristics ◽  
Income Country ◽  
Apache Ii ◽  
Icu Mortality ◽  
Hiv Patients ◽  
Low Income Country

Purpose. In high-income countries, improved survival has been documented among intensive care unit (ICU) patients infected with human immune deficiency virus (HIV). There are no data from low-income country ICUs. We sought to identify clinical characteristics and survival outcomes among HIV patients in a low-income country ICU.Materials and Methods. A retrospective cohort study of HIV infected patients admitted to a university teaching hospital ICU in Uganda. Medical records were reviewed. Primary outcome was survival to hospital discharge. Statistical significance was predetermined in reference toP<0.05.Results. There were 101 HIV patients. Average length of ICU stay was 4 days and ICU mortality was 57%. Mortality in non-HIV patients was 28%. Commonest admission diagnoses were Acute Respiratory Distress Syndrome (ARDS) (58.4%), multiorgan failure (20.8%), and sepsis (20.8%). The mean Acute Physiologic and Chronic Health Evaluation (APACHE II) score was 24. At multivariate analysis, APACHE II (OR 1.24 (95% CI: 1.1–1.4,P=0.01)), mechanical ventilation (OR 1.14 (95% CI: 0.09–0.76,P=0.01)), and ARDS (OR 4.5 (95% CI: 1.07–16.7,P=0.04)) had a statistically significant association with mortality.Conclusion. ICU mortality of HIV patients is higher than in higher income settings and the non-HIV population. ARDS, APACHE II, and need for mechanical ventilation are significantly associated with mortality.

scholarly journals Baseline and clinical characteristics of older adults admitted to the intensive care unit through the emergency room: Analysis based on age groups

2019 ◽  
pp. 102490791988044
Author(s):  
Ye Lim Lee ◽  
Sang Ook Ha ◽  
Young Sun Park ◽  
Jeong Hyeon Yi ◽  
Sun Beom Hur ◽  
...  
Keyword(s):  
Older Adults ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Discharge Disposition ◽  
Neurologic Outcomes ◽  
Diagnosis Of Cancer ◽  
Overall Mortality

Background and Objectives: There is currently no consensus on the criteria for admitting older adults to the intensive care unit. Methods: This single-center retrospective study evaluated the baseline and clinical characteristics of older adults admitted to the intensive care unit between January 2017 and June 2017; patients were analyzed according to their age group. Factors associated with in-hospital mortality were specifically determined using logistic regression analysis. Results: Among 582 patients included in the present study, 34.2%, 46.6%, and 19.2% were aged 65–74, 75–84, and over 84 years, respectively. In terms of clinical outcomes, although there were no significant differences in the length of intensive care unit and hospital stay and intensive care unit mortality, significant differences were observed in terms of in-hospital mortality, hospital discharge disposition, and neurologic outcomes at discharge ( p = 0.039, p = 0.005, and p = 0.032, respectively). Predictive factors for in-hospital mortality were age (⩾85 years), initial mental status (stupor to coma), a Korean Triage and Acuity Scale level of 1, underlying diagnosis of cancer, abdominal pain or discomfort, apnea, and a chief compliant of dyspnea. Conclusion: Compared to those aged 65–84 years, in-hospital mortality was 1.96-fold higher in those aged over 84 years. However, the overall mortality in our cohort was not considerably different from that of the younger population. Intensive care unit admission should be considered in selected older adults after evaluating the risk factors for mortality.

scholarly journals One Year of the COVID-19 Pandemic in Galicia: A Global View of Age-Group Statistics during Three Waves

2021 ◽  
Vol 18 (10) ◽  
pp. 5104
Author(s):  
Iván Area ◽  
Henrique Lorenzo ◽  
Pedro J. Marcos ◽  
Juan J. Nieto
Keyword(s):  
Intensive Care Unit ◽  
Hospital Admissions ◽  
Age Groups ◽  
Age Group ◽  
Nw Spain ◽  
The Past ◽  
Global View ◽  
Time Period ◽  
Key Variables ◽  
One Year

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories.

scholarly journals The use of score for neonatal acute physiology perinatal extention II (SNAPPE II) in predicting neonatal outcome in neonatal intensive care unit

2016 ◽  
Vol 45 (6) ◽  
pp. 241
Author(s):  
Mia R A ◽  
Risa Etika ◽  
Agus Harianto ◽  
Fatimah Indarso ◽  
Sylviati M Damanik
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Characteristic Curve ◽  
Newborn Care ◽  
Scoring Systems ◽  
Laboratory Observation ◽  
The Mean ◽  
Overall Mortality

Background Scoring systems which quantify initial risks have animportant role in aiding execution of optimum health services by pre-dicting morbidity and mortality. One of these is the score for neonatalacute physiology perinatal extention (SNAPPE), developed byRichardson in 1993 and simplified in 2001. It is derived of 6 variablesfrom the physical and laboratory observation within the first 12 hoursof admission, and 3 variables of perinatal risks of mortality.Objectives To assess the validity of SNAPPE II in predicting mor-tality at neonatal intensive care unit (NICU), Soetomo Hospital,Surabaya. The study was also undertaken to evolve the best cut-offscore for predicting mortality.Methods Eighty newborns were admitted during a four-month periodand were evaluated with the investigations as required for the specifi-cations of SNAPPE II. Neonates admitted >48 hours of age or afterhaving been discharged, who were moved to lower newborn care <24hours and those who were discharged on request were excluded. Re-ceiver operating characteristic curve (ROC) were constructed to derivethe best cut-off score with Kappa and McNemar Test.Results Twenty eight (35%) neonates died during the study, 22(82%) of them died within the first six days. The mean SNAPPE IIscore was 26.3+19.84 (range 0-81). SNAPPE II score of thenonsurvivors was significantly higher than the survivors(42.75+18.59 vs 17.4+14.05; P=0.0001). SNAPPE II had a goodperformance in predicting overall mortality and the first-6-daysmortality, with area under the ROC 0.863 and 0.889. The best cut-off score for predicting mortality was 30 with sensitivity 81.8%,specificity 76.9%, positive predictive value 60.0% and negativepredictive value 90.0%.Conclusions SNAPPE II is a measurement of illness severity whichcorrelates well with neonatal mortality at NICU, Soetomo Hospital.The score of more than 30 is associated with higher mortality

scholarly journals Intensive Care Unit Capacity Strain and Outcomes of Critical Illness in a Resource-Limited Setting: A 2-Hospital Study in South Africa

2018 ◽  
Vol 35 (10) ◽  
pp. 1104-1111 ◽  
Author(s):  
George L. Anesi ◽  
Nicole B. Gabler ◽  
Nikki L. Allorto ◽  
Carel Cairns ◽  
Gary E. Weissman ◽  
...  
Keyword(s):  
South Africa ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Primary Outcome ◽  
Resource Limited Setting ◽  
Icu Mortality ◽  
Icu Admission ◽  
Resource Limited ◽  
Limited Setting

Objective: To measure the association of intensive care unit (ICU) capacity strain with processes of care and outcomes of critical illness in a resource-limited setting. Methods: We performed a retrospective cohort study of 5332 patients referred to the ICUs at 2 public hospitals in South Africa using the country’s first published multicenter electronic critical care database. We assessed the association between multiple ICU capacity strain metrics (ICU occupancy, turnover, census acuity, and referral burden) at different exposure time points (ICU referral, admission, and/or discharge) with clinical and process of care outcomes. The association of ICU capacity strain at the time of ICU admission with ICU length of stay (LOS), the primary outcome, was analyzed with a multivariable Cox proportional hazard model. Secondary outcomes of ICU triage decision (with strain at ICU referral), ICU mortality (with strain at ICU admission), and ICU LOS (with strain at ICU discharge), were analyzed with linear and logistic multivariable regression. Results: No measure of ICU capacity strain at the time of ICU admission was associated with ICU LOS, the primary outcome. The ICU occupancy at the time of ICU admission was associated with increased odds of ICU mortality (odds ratio = 1.07, 95% confidence interval: 1.02-1.11; P = .004), a secondary outcome, such that a 10% increase in ICU occupancy would be associated with a 7% increase in the odds of ICU mortality. Conclusions: In a resource-limited setting in South Africa, ICU capacity strain at the time of ICU admission was not associated with ICU LOS. In secondary analyses, higher ICU occupancy at the time of ICU admission, but not other measures of capacity strain, was associated with increased odds of ICU mortality.

scholarly journals Burnout Syndrome in UK Intensive Care Unit staff: Data from all three Burnout Syndrome domains and across professional groups, genders and ages

2019 ◽  
Vol 20 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Laura Vincent ◽  
Peter G Brindley ◽  
Julie Highfield ◽  
Richard Innes ◽  
Paul Greig ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Emotional Exhaustion ◽  
Comprehensive Evaluation ◽  
Maslach Burnout Inventory ◽  
Medical Personnel ◽  
Personal Accomplishment ◽  
Burnout Syndrome ◽  
Age Group ◽  
The Uk

IntroductionThis is the first comprehensive evaluation of Burnout Syndrome across the UK Intensive Care Unit workforce and in all three Burnout Syndrome domains: Emotional Exhaustion, Depersonalisation and lack of Personal Accomplishment.MethodsA questionnaire was emailed to UK Intensive Care Society members, incorporating the 22-item Maslach Burnout Inventory Human Services Survey for medical personnel. Burnout Syndrome domain scores were stratified by ‘risk’. Associations with gender, profession and age-group were explored.ResultsIn total, 996 multi-disciplinary responses were analysed. For Emotional Exhaustion, females scored higher and nurses scored higher than doctors. For Depersonalisation, males and younger respondents scored higher.ConclusionApproximately one-third of Intensive Care Unit team-members are at ‘high-risk’ for Burnout Syndrome, though there are important differences according to domain, gender, age-group and profession. This data may encourage a more nuanced understanding of Burnout Syndrome and more personalised strategies for our heterogeneous workforce.

scholarly journals Advances in the Management of Sepsis and the Understanding of Key Immunologic Defects

2011 ◽  
Vol 115 (6) ◽  
pp. 1349-1362 ◽  
Author(s):  
Lee P. Skrupky ◽  
Paul W. Kerby ◽  
Richard S. Hotchkiss
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Operating Room ◽  
The United States ◽  
Difficult Problem ◽  
Treatment Algorithms ◽  
New Treatment ◽  
Overall Mortality

Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these new therapeutic regimens. The goal of this review is to include practical points on important advances in the treatment of sepsis and provide a vision of future immunotherapeutic approaches.

scholarly journals Morbidity pattern and outcome of children admitted to a paediatric intensive care unit of Eastern India

2017 ◽  
Vol 4 (2) ◽  
pp. 486
Author(s):  
Bandya Sahoo ◽  
Sibabratta Patnaik ◽  
Reshmi Mishra ◽  
Mukesh Kumar Jain
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gastrointestinal Diseases ◽  
Medical Advice ◽  
Eastern India ◽  
Medical Sciences ◽  
Against Medical Advice ◽  
Co Morbidity ◽  
Paediatric Critical Care ◽  
Overall Mortality

Background: In developing countries, there is scarce data on paediatric critical care. This makes modification of practices to improve outcome, difficult. The above study was done to highlight the lack of facilities and concept of pediatric critical in the eastern part of India so that modification of management can lead to better outcome of critically ill children.Methods: A retrospective study of the demography, clinical profile, diagnosis, treatment and outcome of children admitted to the PICU of Kalinga Institute of Medical Sciences from January 2014 to December 2015 was done. Results: A total of 848 children were admitted to the PICU with male and female children being 61.3% and 38.7% respectively. Diagnoses included infectious diseases (20.7%), respiratory disease (19.1%), central nervous system diseases (14.3%), cardiovascular diseases (10.8%), gastrointestinal diseases (7%), surgical problems (4.7%) haematological (4%), renal (3.3%), poisonings (1.4%), and others (14.3%). Out of 848 admitted children, 4.1% died and (1.4%) left against medical advice (8.5%) children received mechanical ventilation, among which (62.5%) improved, 34.7% died and 2.8% children left against medical advice. Multiorgan dysfunction syndrome (MODS) and co-morbidity were present in 25% and 22% respectively. The proportion of death among patients admitted to PICU was 4.1%.Conclusions: The leading cause of admission was infectious and respiratory diseases. Children with MODS and co-morbidity had higher mortality. The overall mortality rate in our PICU was low. We conclude, a well-equipped intensive care unit with modern and innovative facilities leads to a good outcome. 

scholarly journals PREVALENCE OF SMOKING IN ADULT POPULATION OF IRKUTSK

2016 ◽  
Vol 1 (6) ◽  
pp. 153-156
Author(s):  
Максикова ◽  
Tatyana Maksikova ◽  
Бабанская ◽  
Evgeniya Babanskaya ◽  
Меньшикова ◽  
...  
Keyword(s):  
Risk Factor ◽  
Adult Population ◽  
Age Groups ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Noncommunicable Diseases ◽  
Age Difference ◽  
Age Group ◽  
Considerable Problem ◽  
The One

Smoking is a significant risk factor of chronic noncommunicable diseases. Smoking prevalence is variable in different populations. A study of the prevalence of this risk factor allows to estimate its contribution to the development of cardiovascular pathology, to plan the necessary amount of medical care for people using tobacco, and to determine the effectiveness of prevention activities in the region. As a result of the study, smoking frequency in population of the Irkutsk region older 18years of age or over was established as 29.5%. The number of smokers increased with age, reaching maximum value of 38.6% in the group 30–39 years. Male smokers made maximum in the age group 30–39 years, women – in the age group of 18–19 years. The average age of smokers was 34 years, the one of nonsmokers – 43 years. The age difference was 9 years, and it was lower in the group of men than in the group of women (5 and 11 years, respectively). The number of the smoking men were 3 times larger, than women: 50.2% and 13.5%, respectively. Among persons with arterial hypertension, 22.1% were smoking with the maximum frequency of smoking in age groups from 20 to 49 years. These figures point to a considerable problem of smoking in the region.

scholarly journals Primary brain tumor patients admitted to a US intensive care unit: a descriptive analysis

CNS Oncology ◽  
2021 ◽  
pp. CNS77
Author(s):  
Jennifer H Kang ◽  
Christa B Swisher ◽  
Evan D Buckley ◽  
James E Herndon ◽  
Eric S Lipp ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Tumor ◽  
Hematological Malignancies ◽  
Descriptive Analysis ◽  
Primary Brain Tumor ◽  
Icu Mortality ◽  
Tumor Patients ◽  
Common Indication ◽  
Better Than

Purpose: To describe our population of primary brain tumor (PBT) patients, a subgroup of cancer patients whose intensive care unit (ICU) outcomes are understudied. Methods: Retrospective analysis of PBT patients admitted to an ICU between 2013 to 2018 for an unplanned need. Using descriptive analyses, we characterized our population and their outcomes. Results: Fifty-nine PBT patients were analyzed. ICU mortality was 19% (11/59). The most common indication for admission was seizures (n = 16, 27%). Conclusion: Our ICU mortality of PBT patients was comparable to other solid tumor patients and the general ICU population and better than patients with hematological malignancies. Further study of a larger population would inform guidelines for triaging PBT patients who would most benefit from ICU-level care.

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