Protocol for a prospective observational study to develop a frailty index for use in perioperative and critical care

IntroductionFrailty is of increasing importance to perioperative and critical care medicine, as the proportion of older patients increases globally. Evidence continues to emerge of the considerable impact frailty has on adverse outcomes from both surgery and critical care, which has led to a proliferation of different frailty measurement tools in recent years. Despite this, there remains a lack of easily implemented, comprehensive frailty assessment tools specific to these complex populations. Development of a frailty index using routinely collected hospital data, able to leverage the automated aspects of an electronic medical record, would aid risk stratification and benefit clinicians and patients alike.Methods and analysisThis is a prospective observational study. 150 intensive care unit (ICU) patients aged ≥50 years and 200 surgical patients aged ≥65 years will be enrolled. The primary objective is to develop a frailty index. Secondary objectives include assessing its ability to predict in-hospital mortality and/or discharge to a new non-home location; the performance of the frailty index in predicting postoperative and ICU complications, as well as health-related quality of life at 6 months; to compare the performance of the frailty index against existing frailty measurement and risk stratification tools; and to assess its modification by patients’ health assets.Ethics and disseminationThis study has been approved by the Melbourne Health Human Research Ethics Committee(20 January 2017, HREC/16/MH/321). Dissemination will be via international and national anaesthetic and critical care conferences, and publication in the peer-reviewed literature.

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Heart score as a risk stratification tool to assess patients with chest pain in emergency: A prospective observational study

Indian Heart Journal ◽

10.1016/j.ihj.2020.11.035 ◽

2020 ◽

Vol 72 ◽

pp. S9-S10

Author(s):

Laxmi Adhikari ◽

Nikhil Choudhary

Keyword(s):

Chest Pain ◽

Observational Study ◽

Risk Stratification ◽

Prospective Observational Study ◽

Heart Score ◽

Risk Stratification Tool

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The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

Journal of Nursing Education and Practice ◽

10.5430/jnep.v8n6p93 ◽

2018 ◽

Vol 8 (6) ◽

pp. 93

Author(s):

Ghada Shalaby Khalaf Mahran ◽

Sayed K. Abd-Elshafy ◽

Manal Mohammed Abd El Neem ◽

Jehan A. Sayed

Keyword(s):

Mechanical Ventilation ◽

Critical Care ◽

Observational Study ◽

Prospective Observational Study ◽

Body Position ◽

Critical Issue ◽

Lateral Position ◽

Abdominal Pressure ◽

University Hospitals ◽

Abdominal Hypertension

Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation.Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0º, 15º, and 30º). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p < .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p < .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p < .001) at 0º, 15º, and 30º respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0º, 3.8 ± 1.00 mmHg at 15º, and 5.5 ± 1.01 mmHg at 30 º (p < .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation

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