PTU-039 Mortality and utility of prognostic scoring models in cirrhotic patients admitted to a tertiary non-transplant intensive care unit (ICU) in the UK: Abstract PTU-039 Table 1

Abstract Background and Aims Liver cirrhosis is a systemic disease that substantially impacts the body’s physiology, especially in advanced stages. Accordingly, the outcome of patients with cirrhosis requiring intensive care treatment is poor. We aimed to analyze the impact of cirrhosis on mortality of intensive care unit (ICU) patients compared to other frequent chronic diseases and conditions. Methods In this retrospective study, patients admitted over three years to the ICU of the Department of Medicine of the University Hospital Frankfurt were included. Patients were matched for age, gender, pre-existing conditions, simplified acute physiology score (SAPS II), and therapeutic intervention scoring system (TISS). Results A total of 567 patients admitted to the ICU were included in the study; 99 (17.5 %) patients had liver cirrhosis. A total of 129 patients were included in the matched cohort for the sensitivity analysis. In-hospital mortality was higher in cirrhotic patients than non-cirrhotic patients (p < 0.0001) in the entire and matched cohort. Liver cirrhosis remained one of the strongest independent predictors of in-hospital mortality (entire cohort p = 0.001; matched cohort p = 0.03) along with dialysis and need for transfusion in the multivariate logistic regression analysis. Furthermore, in the cirrhotic group, the need for kidney replacement therapy (p < 0.001) and blood transfusion (p < 0.001) was significantly higher than in the non-cirrhotic group. Conclusions In the presented study, liver cirrhosis was one of the strongest predictors of in-hospital mortality in patients needing intensive care treatment along with dialysis and the need for ventilation. Therefore, concerted efforts are needed to improve cirrhotic patients’ outcomes, prevent disease progression, and avoid complications with the need for ICU treatment in the early stages of the disease.

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

Journal of the Intensive Care Society ◽

10.1177/1751143719860391 ◽

2019 ◽

Vol 20 (4) ◽

pp. 363-369 ◽

Cited By ~ 5

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.

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A Survey of Intensive Care Unit Discharge Communication Practices in the UK

Journal of the Intensive Care Society ◽

10.1177/175114371301400411 ◽

2013 ◽

Vol 14 (4) ◽

pp. 330-333 ◽

Cited By ~ 1

Author(s):

Danny JN Wong ◽

Alex J Wickham

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Unit Discharge ◽

Unit Discharge ◽

Communication Practices ◽

The Uk ◽

Discharge Communication

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25691 An audit of the management and outcomes of toxic epidermal necrolysis in a specialist intensive care unit in the UK

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2021.06.063 ◽

2021 ◽

Vol 85 (3) ◽

pp. AB9

Author(s):

Sally Aziz ◽

Helena Malhomme ◽

Cristina Psomadakis ◽

Andrew Slack

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Toxic Epidermal Necrolysis ◽

The Uk

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The provision of surgical tracheostomies by maxillofacial surgeons in the UK: time for a dedicated tracheostomy team?

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0173 ◽

2018 ◽

Vol 100 (2) ◽

pp. 116-119

Author(s):

P Chohan ◽

R Elledge ◽

MK Virdi ◽

GM Walton

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Telephone Survey ◽

Percutaneous Dilatational Tracheostomy ◽

Maxillofacial Surgery ◽

University Hospital ◽

Oral And Maxillofacial Surgery ◽

Surgical Tracheostomy ◽

Surgical Teams ◽

The Uk

Surgical tracheostomy is a commonly provided service by surgical teams for patients in intensive care where percutaneous dilatational tracheostomy is contraindicated. A number of factors may interfere with its provision on shared emergency operating lists, potentially prolonging the stay in intensive care. We undertook a two-part project to examine the factors that might delay provision of surgical tracheostomy in the intensive care unit. The first part was a prospective audit of practice within the University Hospital Coventry. This was followed by a telephone survey of oral and maxillofacial surgery units throughout the UK. In the intensive care unit at University Hospital Coventry, of 39 referrals, 21 (53.8%) were delayed beyond 24 hours. There was a mean (standard deviation) time to delay of 2.2 days (0.9 days) and the most common cause of delay was surgeon decision, accounting for 13 (61.9%) delays. From a telephone survey of 140 units nationwide, 40 (28.4%) were regularly involved in the provision of surgical tracheostomies for intensive care and 17 (42.5%) experienced delays beyond 24 hours, owing to a combination of theatre availability (76.5%) and surgeon availability (47.1%). There is case for having a dedicated tracheostomy team and provisional theatre slot to optimise patient outcomes and reduce delays. We aim to implement such a move within our unit and audit the outcomes prospectively following this change.

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Role of the intensive care unit

10.1093/med/9780199568741.003.0148 ◽

2018 ◽

Author(s):

Matt Wise ◽

Paul Frost

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Organ Failure ◽

Radiology Department ◽

Organ Support ◽

Specific Patient ◽

High Dependency ◽

Operating Theatres ◽

The Uk ◽

General Wards

The intensive care unit (ICU) can be defined as an area reserved for patients with potential or established organ failure and has the facilities for the diagnosis, prevention, and treatment of multi-organ failure. Usually, the ICU is located in close proximity to A & E, the radiology department, and the operating theatres, as it is between these areas that patient flows are greatest. In large urban hospitals, there may be more than one ICU, some of which serve specific patient populations, such as paediatrics, neurosurgery, cardiothoracic surgery, liver failure, and burns. Many hospitals also have high-dependency units (HDUs) that offer higher nurse-to-patient ratios and more advanced monitoring than a general wards does, as well as limited organ support. In the UK, the distinctions between ICU, HDU, and general ward have been abandoned in favour of a classification based on the patient’s needs rather than their location.

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Mortality prediction of cirrhotic patients admitted to the Intensive Care Unit

Annals of Hepatology ◽

10.1016/s1665-2681(19)31892-7 ◽

2008 ◽

Vol 7 (1) ◽

pp. 78-79 ◽

Cited By ~ 1

Author(s):

Genaro Vazquez-Elizondo ◽

Raúl Carrillo-Esper ◽

Daniel Zamora-Valdés ◽

Nahum Méndez-Sánchez

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mortality Prediction ◽

Cirrhotic Patients

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Nutrition Risk Assessment Using the Modified NUTRIC Score in Cirrhotic Patients with Acute Gastroesophageal Variceal Bleeding: Prevalence of High Nutrition Risk and its Independent Prognostic Value

Nutrients ◽

10.3390/nu11092152 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2152 ◽

Cited By ~ 6

Author(s):

Ming-Hung Tsai ◽

Hui-Chun Huang ◽

Yun-Shing Peng ◽

Yung-Chang Chen ◽

Ya-Chung Tian ◽

...

Keyword(s):

Risk Assessment ◽

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill ◽

Variceal Bleeding ◽

Assessment Tool ◽

Prognostic Significance ◽

Adverse Outcomes ◽

Nutrition Risk ◽

Cirrhotic Patients

Malnutrition is associated with adverse outcomes in patients with liver cirrhosis. Relevant data about nutrition risk in critically ill cirrhotic patients are lacking. The modified Nutrition Risk in Critically Ill (mNUTRIC) score is a novel nutrition risk assessment tool specific for intensive care unit (ICU) patients. This retrospective study was conducted to evaluate the prevalence and prognostic significance of nutrition risk in cirrhotic patients with acute gastroesophageal variceal bleeding (GEVB) using mNUTRIC scores computed on admission to the intensive care unit. The major outcome was 6-week mortality. One-hundred-and-thirty-one admissions in 120 patients were analyzed. Thirty-eight percent of cirrhotic patients with acute GEVB were categorized as being at high nutrition risk (a mNUTRIC score of ≥5). There was a significantly progressive increase in mortality associated with the mNUTRIC score (χ2 for trend, p < 0.001). By using the area under a receiver operating characteristic (ROC) curve, the mNUTRIC demonstrated good discriminative power to predict 6-week mortality (AUROC 0.859). In multivariate analysis, the mNUTRIC score was an independent factor associated with 6-week mortality. In conclusion, the mNUTRIC score can serve as a tool to assess nutrition risk in cirrhotic patients with acute GEVB.

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