scholarly journals Incidence of Delirium in Critically Ill Cancer Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Luis A. Sánchez-Hurtado ◽  
Nancy Hernández-Sánchez ◽  
Mario Del Moral-Armengol ◽  
Humberto Guevara-García ◽  
Francisco J. García-Guillén ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Cancer Patients ◽  
Critically Ill ◽  
Potential Risk ◽  
Assessment Method ◽  
Icu Stay ◽  
Potential Risk Factors

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.

Skin Integrity in Critically Ill and Injured Children

2007 ◽  
Vol 16 (6) ◽  
pp. 568-574 ◽  
Author(s):  
Christine A. Schindler ◽  
Theresa A. Mikhailov ◽  
Kay Fischer ◽  
Gloria Lukasiewicz ◽  
Evelyn M. Kuhn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Ventilatory Support ◽  
Pediatric Intensive Care ◽  
Cost Of Care ◽  
Respiratory Illnesses ◽  
Skin Breakdown ◽  
Potential Risk Factors

Background Skin breakdown increases the cost of care, may lead to increased morbidity, and has negative psychosocial implications because of secondary scarring or alopecia. The scope of this problem has not been widely studied in critically ill and injured children. Objectives To determine the incidence of skin breakdown in critically ill and injured children and to compare the characteristics of patients who experience skin breakdown with those of patients who do not. Methods Admission and follow-up data for a 15-week period were collected retrospectively on children admitted to a large pediatric intensive care unit. The incidence of skin breakdown was calculated. The risk for skin breakdown associated with potential risk factors (relative risk) and 95% confidence intervals were determined. Results The sample consisted of 401 distinct stays in the intensive care unit for 373 patients. During the 401 stays, skin breakdown occurred in 34 (8.5%), redness in 25 (6.2%), and breakdown and redness in 13 (3.2%); the overall incidence was 18%. Patients who had skin breakdown or redness were younger, had longer stays, and were more likely to have respiratory illnesses and require mechanical ventilatory support than those who did not. Patients who had skin breakdown or redness had a higher risk of mortality than those who did not. Conclusions Risk factors for skin breakdown were similar to those previously reported. Compared with children of other ages, children 2 years or younger are at higher risk for skin breakdown.

scholarly journals Pressure Ulcers Prevalence and Potential Risk Factors Among Intensive Care Unit Patients in Governmental Hospitals in Palestine: A Cross-sectional Study

2019 ◽  
Vol 12 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Jamal A.S. Qaddumi ◽  
Omar Almahmoud
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Potential Risk ◽  
Pressure Ulcers ◽  
Advisory Panel ◽  
Cross Sectional ◽  
Data Set ◽  
Potential Risk Factors ◽  
The Government

Aim: To determine the prevalence rate and the potential risk factors of pressure ulcers (PUs) among patients in the intensive care unit (ICU) departments of the government hospitals in Palestine. Methods: A quantitative, cross-sectional, descriptive analytical study was carried out in five government hospital intensive care units in four different Palestinian cities between September 27, 2017, and October 27, 2017. The data of 109 out of 115 (94.78%) inpatients were analyzed. The Minimum Data Set (MDS) recommended by the European Pressure Ulcer Advisory Panel (EPUAP) was used to collect inpatients’ information. Results: The result of the analysis showed that the prevalence of pressure ulcers in the ICU departments was 33%, and the prevalence of PUs when excluding stage one was 7.3%. The common stage for pressure ulcers was stage one. It was also determined that the most common risk factors for the development of pressure ulcers were the number of days in the hospital, moisture, and friction. Conclusion: According to the recent studies in the Asian States, the prevalence of pressure ulcers in Palestine is considerably higher than in China and Jordan. However, it is still lower than the prevalence reported in comparable published studies in Western Europe. Increasing the staff’s knowledge about PUs screening and preventive measures is highly recommended in order to decrease the burden of PUs.

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

1997 ◽  
Vol 31 (3) ◽  
pp. 285-289 ◽  
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.

scholarly journals Risk Factors for Development of Intestinal Colonization with Imipenem-Resistant Pseudomonas aeruginosa in the Intensive Care Unit Setting

2011 ◽  
Vol 32 (7) ◽  
pp. 719-722 ◽  
Author(s):  
Anthony D. Harris ◽  
J. Kristie Johnson ◽  
Kerri A. Thom ◽  
Daniel J. Morgan ◽  
Jessina C. McGregor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Potential Risk ◽  
Selective Pressure ◽  
Intensive Care Unit Setting ◽  
Intestinal Colonization ◽  
Potential Risk Factors

Risk factors for development of intestinal colonization by imipenem-resistant Pseudomonas aeruginosa (IRPA) may differ between those who acquire the organism via patient-to-patient transmission versus by antibiotic selective pressure. The aim of this study was to quantify potential risk factors for the development of IRPA not due to patient-to-patient transmission.

Risk factors to predict outcome in critically ill cancer patients receiving chemotherapy in the intensive care unit

2010 ◽  
Vol 19 (4) ◽  
pp. 491-495 ◽  
Author(s):  
Jae-Uk Song ◽  
Gee Young Suh ◽  
Man Pyo Chung ◽  
Hojoong Kim ◽  
O Jung Kwon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Cancer Patients ◽  
Critically Ill

Potential Risk Factors for Autism in Children Requiring Neonatal Intensive Care Unit

2021 ◽  
Author(s):  
Marília Barbosa de Matos ◽  
Tiago S. Bara ◽  
Érico P. G. Felden ◽  
Mara L. Cordeiro
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Potential Risk ◽  
Neonatal Intensive Care ◽  
Feeding Tube ◽  
Autism Spectrum ◽  
Perinatal Complications ◽  
Potential Risk Factors

Abstract Background The etiology of autism spectrum disorder (ASD) is complex and involves the interplay of genetic and environmental factors. Aim We sought to identify potential prenatal, perinatal, and neonatal risk factors for ASD in a unique population of children who had perinatal complications and required care in a neonatal intensive care unit (NICU). Methods This prospective cohort study included 73 patients discharged from a NICU who received long-term follow-up at the largest children's hospital in Brazil. Potential risk factors were compared between 44 children with a diagnosis of ASD and 29 children without using the Mann–Whitney U test. Proportions were analyzed using the chi-square test. Simple and multiple logistic regression tests were performed. Results Of 38 factors analyzed, the following 7 were associated with ASD: family history of neuropsychiatric disorders (p = 0.049); maternal psychological distress during pregnancy (p = 0.007); ≥ 26 days in the NICU (p = 0.001); feeding tube for ≥ 15 days (p = 0.014); retinopathy of prematurity (p = 0.022); use of three or more antibiotics (p = 0.008); and co-sleeping until up to 2 years of age (p = 0.004). Conclusion This study found associations between specific risk factors during critical neurodevelopmental periods and a subsequent diagnosis of ASD. Knowledge of the etiologic factors that may influence the development for ASD is paramount for the development of intervention strategies and improvement of prognoses.

scholarly journals The CAM-ICU-7 and ICDSC as measures of delirium severity in critically ill adult patients

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242378
Author(s):  
Karla D. Krewulak ◽  
Brianna K. Rosgen ◽  
E. W. Ely ◽  
Henry T. Stelfox ◽  
Kirsten M. Fiest
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critically Ill ◽  
Assessment Method ◽  
Adult Patients ◽  
Screening Tools ◽  
Cross Sectional ◽  
Prolonged Length ◽  
Icu Stay ◽  
Length Of Icu Stay

Background In clinical practice, a dichotomous approach to delirium identification may no longer be relevant when existing delirium screening tools measure a range of scores. The objective of this study was to compare the Confusion Assessment Method for the Intensive Care Unit 7-item (CAM-ICU-7) and the Intensive Care Delirium Screening Checklist (ICDSC) as measures of the spectrum of delirium severity in critically ill adult patients. Methods In this cross-sectional study, 218 patients underwent 641 paired assessments by bedside nurses (ICDSC, as per usual care) and trained research assistants (CAM-ICU-7). Correlation between the CAM-ICU-7 and ICDSC scores was evaluated. Logistic regression was used to explore associations between CAM-ICU-7 or ICDSC score and length of ICU stay and mechanical ventilation (receipt, ≥96 hours). Results Delirium prevalence evaluated by the CAM-ICU-7 and ICDSC were 46.3% (95% CI:39.7–53.0) and 34.4% (95% CI:28.3–41.0). Prevalence of less than clinical threshold symptoms of delirium evaluated by the CAM-ICU-7 (score: 1–2) and ICDSC (score: 1–3) were 30.3% (95%CI:24.5–36.7) and 50.9% (95%CI:44.3–57.6). The CAM-ICU-7 and ICDSC had significant positive correlation (0.58, p<0.001). Agreement between the tools as measures of delirium was moderate (kappa = 0.51) and as measures of less than clinical threshold symptoms of delirium was fair (kappa = 0.21). Less than clinical threshold symptoms of delirium identified by the ICDSC, not CAM-ICU-7, were associated with prolonged length of ICU stay (≥7 days) in patients <65 years of age [Odds Ratio (OR) 9.2, 95% CI:2.5–34.0] and mechanical ventilation (receipt: OR 2.8, 95% CI:1.3–6.4; ≥96 hours: OR 6.6, 95% CI:1.9–22.9), when compared to patients with no delirium. Conclusions The CAM-ICU-7 and ICDSC are measures of the spectrum of delirium severity that are closely correlated. Less than clinical threshold symptoms of delirium measure by the ICDSC is a better predictor of outcomes, when compared with the CAM-ICU-7.

Analysis of diagnostic criteria for ventilator-associated pneumonia: a cohort study

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Caroline Gonçalves Pustiglione Campos ◽  
Aline Pacheco ◽  
Maria Dagmar da Rocha Gaspar ◽  
Guilherme Arcaro ◽  
Péricles Martim Reche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Diagnostic Criteria ◽  
Statistical Tests ◽  
Significant Risk ◽  
Diagnostic Methods ◽  
Ventilator Associated Pneumonia

ABSTRACT Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.

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