Potential risk factors for infection with Candida spp. in critically ill patients

Objective. The aim of this study was to estimate the incidence of delirium and its risk factors among critically ill cancer patients in an intensive care unit (ICU). Materials and Methods. This is a prospective cohort study. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was measured daily at morning to diagnose delirium by a physician. Delirium was diagnosed when the daily was positive during a patient’s ICU stay. All patients were followed until they were discharged from the ICU. Using logistic regression, we estimated potential risk factors for developing delirium. The primary outcome was the development of ICU delirium. Results. There were 109 patients included in the study. Patients had a mean age of 48.6 ± 18.07 years, and the main reason for admission to the ICU was septic shock (40.4%). The incidence of delirium was 22.9%. The mortality among all subjects was 15.6%; the mortality rate in patients who developed delirium was 12%. The only variable that had an association with the development of delirium in the ICU was the days of use of mechanical ventilation (OR: 1.06; CI 95%: 0.99–1.13;p=0.07). Conclusion. Delirium is a frequent condition in critically ill cancer patients admitted to the ICU. The duration in days of mechanical ventilation is potential risk factors for developing delirium during an ICU stay. Delirium was not associated with a higher rate of mortality in this group of patients.

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Critical Care: Incidence and Risk Factors of Thrombocytopenia in Critically Ill Trauma Patients

Annals of Pharmacotherapy ◽

10.1177/106002809703100302 ◽

1997 ◽

Vol 31 (3) ◽

pp. 285-289 ◽

Cited By ~ 56

Author(s):

Scott D Hanes ◽

Deborah A Quarles ◽

Bradley A Boucher

Keyword(s):

Risk Factors ◽

Critically Ill ◽

Potential Risk ◽

University Hospital ◽

Minor Role ◽

Trauma Patients ◽

Icu Stay ◽

Potential Risk Factors ◽

Trauma Score ◽

Type Of Injury

Objective To determine the incidence of thrombocytopenia (<100 platelets × 103/mm3) and potential risk factors, including medications, associated with the development of thrombocytopenia in critically ill trauma patients. Design Prospective, observational study. Setting A 20-bed trauma intensive care unit (ICU) at a university hospital. Patients Sixty-three critically ill trauma patients without baseline thrombocytopenia admitted to the trauma ICU for at least 48 hours. Interventions Patients were followed for up to 14 days. Platelet counts were determined daily. The following data were collected and analyzed as potential risk factors for the development of thrombocytopenia: medications, age, sex, race, trauma score, mode and type of injury, alcohol history, units of packed red blood cells (PRBC) and platelets transfused, surgical procedures, duration of ICU stay, and the development of systemic inflammatory response syndrome or disseminated intravascular coagulation. Results Thrombocytopenia occurred in 26 (41%) of the patients. Among risk factors studied, nonhead injury, age, trauma score, duration of ICU stay, and the number of PRBC transfusions were significanüy associated with the development of thrombocytopenia (P < 0.05). However, nonhead injury, age, and trauma score were useful variables in predicting the development of thrombocytopenia by using multivariate analysis. Medications were not associated with the development of thrombocytopenia. Conclusions The type of injury sustained, the quantity of platelet-deficient transfusions, and age are the greatest risk factors associated with the development of thrombocytopenia in critically ill trauma patients. Drug-induced thrombocytopenia appears to play a minor role in the development of thrombocytopenia; therefore, medications should not be automatically discontinued or substituted when thrombocytopenia occurs.

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Candidemia in nonneutropenic critically ill patients: Risk factors for non-albicans Candida spp.

Critical Care Medicine ◽

10.1097/ccm.0b013e3181760f42 ◽

2008 ◽

Vol 36 (7) ◽

pp. 2034-2039 ◽

Cited By ~ 104

Author(s):

E Geoffrey Playford ◽

Deborah Marriott ◽

Quoc Nguyen ◽

Sharon Chen ◽

David Ellis ◽

...

Keyword(s):

Risk Factors ◽

Critically Ill ◽

Critically Ill Patients ◽

Candida Spp

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Clinical characteristics and risk factors for severe-critically ill COVID-19 adult patients in Jiangsu, China: a multiple-centered, retrospective study

10.21203/rs.3.rs-28628/v1 ◽

2020 ◽

Author(s):

Jiangnan Zhao ◽

Meiying Zhu ◽

Xin Su ◽

Mao Huang ◽

Yi Yang ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Clinical Characteristics ◽

Final Analysis ◽

Adult Patients ◽

Potential Risk Factors ◽

Critically Illness ◽

D Dimer

Abstract Background A number of reports have documented the clinical characteristics of patients with severe coronavirus disease 2019 (COVID-19) in Wuhan. Clinical features of severe-critically ill COVID-19 patients in Jiangsu, outside Wuhan, remains unknown. Methods This multi-centered retrospective study collected the information of 631 laboratory-confirmed COVID-19 patients hospitalized at 28 authorized hospitals in Jiangsu province between January 23, 2019 and March 13, 2020. Epidemiological and demographic information, clinical and radiological characteristics, laboratory results and treatment of these patients were analyzed. Results A total of 583 adult patients with laboratory-confirmed COVID-19 were enrolled for final analysis, including 84 severe-critically ill patients and 499 mild-moderate patients. Median age of the severe-critically ill patients was 57.0 years [interquartile range (IQR), 49.0-65.8], and 50 (59.5%) were males. Multisystemic laboratory abnormalities were observed on admission in severe-critically ill patients. The severe-critically ill patients showed more noticeable radiologic abnormalities and more coexisting health issues as compared to mild-moderate patients. Most of the severe-critically ill COVID-19 patients become deteriorated in two weeks after diagnosis. Age [odds ratio (OR) 1.08, 95% confidence interval (CI) (1.03-1.14)], D-dimer (OR 3.21, 95% CI 1.39-7.40), and lymphocytes (OR 0.28, 95% CI 0.04-0.88) were independently associated with the progression of severe-critically illness. Conclusions Older age, higher D-dimer levels and less lymphocyte counts on admission are potential risk factors for COVID-19 patients to develop into severe and critically illness. The results would help clinicians to identify high-risk patients in advance.

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Risk Factors for Gastrointestinal Bleeding in Critically Ill Patients

50 Studies Every Intensivist Should Know ◽

10.1093/med/9780190467654.003.0031 ◽

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.

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A Survey of Electronic Health Record (EHR) Variables Associated with Postoperative Delirium: A Systematic Review

10.1101/2020.05.28.20116251 ◽

2020 ◽

Author(s):

Matthew M Ruppert ◽

Haleh Hashemighouchani ◽

Emel Bihorac ◽

Seth Williams ◽

Laura Velez ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Critically Ill ◽

Critically Ill Patients ◽

Postoperative Delirium ◽

Significant Risk ◽

Individual Risk ◽

Abnormal Laboratory ◽

Laboratory Values ◽

Potential Risk Factors

Introduction: Delirium is a common post-operative complication in critically ill patients, displaying transient changes in consciousness, inattention, awareness, and organized thought. Not a lot is known about the specific causes of this condition, as it is a complex physiologic state that is currently being unraveled to determine any correlation with imbalances in homeostasis. Objective: The aim of this systematic review is to report on and summarize risk factors associated with the development of postoperative delirium in critically ill adult patients. Methods: This systematic review assessed studies reporting on risk factors for postoperative delirium in critically ill patients. PubMed, PsycINFO, and CINAHL databases were searched for studies. Observational or interventional studies reviewing predictors for postoperative delirium in delirious versus non-delirious patients were included. Results: Fifty-one potential risk factors were identified and divided into eight subgroups. The significance of a specific risk factor for postoperative delirium was found to depend on the patient population in question, but consistently cited significant risk factors across cohorts included high mortality risk, abnormal laboratory values, and use of vasopressors, analgesics, thiopentones, propofol, and benzodiazepines. There was not enough evidence found to definitively state the significance of type of surgery being performed or cognitive impairment on development of this condition. Conclusion: Several risk factors were found to be significantly associated with the development of postoperative delirium, including high risk of mortality, specific medication use, and abnormal laboratory values. Further research needs to be performed to fully define the importance of these individual risk factors across broad critical care population.

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NOD2 gene variants as novel risk factors for secondary sclerosing cholangitis in critically ill patients

10.1055/s-0037-1604988 ◽

2017 ◽

Author(s):

C Jüngst ◽

V Stadlbauer ◽

M Reichert ◽

V Zimmer ◽

S Weber ◽

...

Keyword(s):

Risk Factors ◽

Critically Ill ◽

Critically Ill Patients ◽

Sclerosing Cholangitis ◽

Gene Variants ◽

Secondary Sclerosing Cholangitis ◽

Novel Risk Factors

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Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645677 ◽

1990 ◽

Vol 63 (01) ◽

pp. 013-015 ◽

Cited By ~ 15

Author(s):

E J Johnson ◽

C R M Prentice ◽

L A Parapia

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Potential Risk ◽

Antithrombin Iii ◽

Arterial Disease ◽

Coagulation System ◽

Early Age ◽

Arterial Thromboembolism ◽

Potential Risk Factors ◽

Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

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