Incidence, Risk Factors and Outcome Associations of Intra-Abdominal Hypertension in Critically Ill Patients

Abstract BackgroundAbdominal wall tension (AWT) plays an important role in the pathogenesis of abdominal compliance (AC). This study uses a polynomial regression model to analyze the correlation between intra-vesical pressure(IVP) and AWT in critically ill patients and provides new ideas for the diagnosis and treatment of critically ill patients with intra-abdominal hypertension（IAH）.MethodsA retrospective analysis was conducted in critically ill patients who met the inclusion criteria and were admitted to the Department of intensive care unit of Daping Hospital of Army Medical University from March 14, 2019, to May 23, 2020. According to the IVP on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.ResultsA total of 100 patients were enrolled, with an average age of 45.59±11.4 years. There were 55 males (55%), 30 patients from departments of internal medicine (30%), 43 patients from surgery departments (43%), and 27 trauma patients (27%). In the IAH group, there were 50 patients (29 males, 58%), with an average age of 45.28±12.27 years; there were 50 patients (26 males, 52%) in the non-IAH group, with an average age of 45.90±10.58 years. The IVP on the 1st day and the average IVP within 7 days of the IAH group was 18.99（17.52，20.77）mmHg and 19.43（16.87，22.25）mmHg, respectively, which was higher than that of the non-IAH group [ 6.14（3.48，8.70）mmHg, 6.66（2.74，9.08）mmHg], p＜0.001. The AWT on the 1st day and the average AWT within 7 days of the IAH group was 2.89±0.32 N/mm and 2.82±0.46 N/mm, respectively, which was higher than that of the non-IAH group [(2.45±0.29)N/mm,(2.43±0.39)N/mm],p＜0.001.The polynomial regression models showed that the average AWT and IVP on the 1st day and within 7 days were AWTday1 = -2.450×10-3IVP2+9.695×10-2 IVP+2.046，r=0.667（p＜0.0001），and AWTmean = -2.293×10-3IVP2+9.273×10-2 IVP+2.081, respectively. The logistic regression analysis showed that AWTday1 of 2.73-2.97 N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).ConclusionsThere is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.

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INCIDENCE, RISK FACTORS AND SURVIVAL OF CRITICALLY-ILL PATIENTS WITH ACUTE KIDNEY INJURY

Texto & Contexto - Enfermagem ◽

10.1590/s0104-07072021000100387 ◽

2021 ◽

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Critically Ill ◽

Critically Ill Patients ◽

Kidney Injury ◽

Incidence Risk

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The Frequency and Clinical Significance of Thrombocytopenia Complicating Critical Illness: A Systematic Review

Blood ◽

10.1182/blood.v116.21.4664.4664 ◽

2010 ◽

Vol 116 (21) ◽

pp. 4664-4664

Author(s):

Philip LY Hui ◽

Deborah J Cook ◽

Wendy Lim ◽

Graeme Fraser ◽

Donald M. Arnold

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Critical Illness ◽

Critically Ill ◽

Critically Ill Patients ◽

Conflicts Of Interest ◽

Risk Of Death ◽

Incidence Risk ◽

Computer Library ◽

Poor Outcomes

Abstract Abstract 4664 Background: The epidemiology of thrombocytopenia in critically ill patients has not been well characterized. The objective of this study was to systematically review the prevalence, incidence, risk factors for, and consequences of thrombocytopenia among critically ill patients. Methods: We searched MEDLINE, EMBASE, the Cochrane Registry for controlled trials (until May 2010), and the Online Computer Library as well as bibliographies of relevant studies to identify investigations designed to examine the frequency, risk factors and/or outcomes associated with thrombocytopenia among patients admitted to the intensive care unit (ICU). We selected studies, abstracted data and assessed methodological quality in duplicate, independently. Heterogeneity of design and analysis precluded statistical pooling of results. Results: We identified 23 studies (12 prospective) enrolling 6,568 patients from medical, surgical, mixed, cardiac or trauma ICUs. Prevalent thrombocytopenia (on ICU admission) occurred in 8.3 – 67.6% of patients; incident thrombocytopenia (developing during the course of the ICU stay) occurred in 13.0 – 44.1% patients. High illness severity, organ dysfunction, sepsis and renal failure were common risk factors. Only 1 study using multivariate analysis examined whether thrombocytopenia was associated with major bleeding but found no association. Six out of 8 studies using multivariate analysis found that thrombocytopenia increased the risk of death. Conclusion: The frequency of thrombocytopenia during critical illness varies widely based on case mix and definition. Thrombocytopenia appears to increase the risk of death after adjustment for confounding factors. The association between thrombocytopenia and bleeding in the ICU has not been adequately examined. Although thrombocytopenia was associated with poor outcomes in most studies, randomized trials of platelet transfusions or other interventions aimed at increasing the platelet count are needed to determine whether improvement of thrombocytopenia can modify these risks. Disclosures: No relevant conflicts of interest to declare.

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Incidence, risk factors, clinical and microbiological characteristics of clostridium difficile associated diarrhea in spanish critically ill patients (procrid study)

Intensive Care Medicine Experimental ◽

10.1186/2197-425x-3-s1-a116 ◽

2015 ◽

Vol 3 (S1) ◽

Author(s):

L Martin-Villen ◽

A Gutierrez-Pizarraya ◽

L Alcala-Hernandez ◽

M Marin-Arriaza ◽

B Balandin-Moreno ◽

...

Keyword(s):

Risk Factors ◽

Clostridium Difficile ◽

Critically Ill ◽

Critically Ill Patients ◽

Microbiological Characteristics ◽

Incidence Risk ◽

Clostridium Difficile Associated Diarrhea

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Candidaemia: incidence, risk factors, characteristics and outcomes in immunocompetent critically ill patients

Clinical Microbiology and Infection ◽

10.1111/j.1469-0691.2008.02653.x ◽

2009 ◽

Vol 15 (3) ◽

pp. 289-292 ◽

Cited By ~ 25

Author(s):

K.Z. Vardakas ◽

A. Michalopoulos ◽

K.G. Kiriakidou ◽

E.P. Siampli ◽

G. Samonis ◽

...

Keyword(s):

Risk Factors ◽

Critically Ill ◽

Critically Ill Patients ◽

Incidence Risk

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A Clinical Study of AWT Measurement and Polynomial Regression Model Analysis in Critically Ill Patients

10.21203/rs.3.rs-516211/v1 ◽

2021 ◽

Author(s):

Hao Tang ◽

Dongchu Zhao ◽

Chuan Zhang ◽

Xiaoying Huang ◽

Dong Liu ◽

...

Keyword(s):

Risk Factors ◽

Regression Model ◽

Critically Ill ◽

Critically Ill Patients ◽

Polynomial Regression ◽

Prognostic Indicators ◽

Survival Group ◽

Abdominal Hypertension ◽

Polynomial Regression Models ◽

Polynomial Regression Model

Abstract Objective: In this study, a new measurement device was used to measure the AWT in critically ill patients and a polynomial regression model was applied to analyze the correlation between intra-abdominal hypertension (IAH) and AWT in critically ill patients.Methods: A retrospective analysis was conducted in critically ill patients who were admitted to the Department of Critical Care Medicine of Daping Hospital of Army Medical University from August 30, 2018, to June 30, 2020. According to the intravesical pressure (IVP) on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.Results: The AWT on the 1st and mean 7th day of the IAH group was (2.89±0.32)N/mm and (2.82±0.46) N/mm, respectively, which was higher than that of the non-IAH group [ (2.45±0.29) N/mm, (2.43±0.39) N/mm], p＜0.001. The average IVP on the 1st and mean 7th day of all patients were 12.78 (6.14, 18.99) and 11.49 (6.66, 19.43) mmHg, and the AWT on the 1st and mean 7th days were (2.75±0.38) and (2.75±0.47) N/mm, respectively, with significant differences (p< 0.0001). The polynomial regression models showed that the average AWT and IVP on the 1st and mean 7th were AWTday1=-2.450×10-3, IVP2+9.695×10-2 IVP+2.046，r=0.667（p＜0.0001），and AWTmean=-2.293×10-3, IVP2+9.273×10-2 IVP+2.081, respectively. The logistic regression analysis showed that AWTday1 2.73-2.97N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).Conclusion: There is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.

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The incidence, risk factors and prognosis of acute kidney injury in severe and critically ill patients with COVID-19 in mainland China: a retrospective study

10.21203/rs.3.rs-50431/v1 ◽

2020 ◽

Author(s):

Ling Sang ◽

Sibei Chen ◽

Xia Zheng ◽

Weijie Guan ◽

Zhihui Zhang ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Retrospective Study ◽

Clinical Outcomes ◽

Critically Ill ◽

Critically Ill Patients ◽

Right Heart Failure ◽

Right Heart ◽

Icu Admission ◽

Incidence Risk

Abstract Background: Since the clinical correlates, prognosis and determinants of AKI in patients with Covid-19 remain largely unclear, we perform a retrospective study to evaluate the incidence, risk factors and prognosis of AKI in severe and critically ill patients with Covid-19.Methods: We reviewed medical records of all adult patients (>18 years) with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University. The clinical data, including patient demographics, clinical symptoms and signs, laboratory findings, treatment [including respiratory supports, use of medications and continuous renal replacement therapy (CRRT)] and clinical outcomes, were extracted from the electronic records, and we access the incidence of AKI and the use of CRRT, risk factors for AKI, the outcomes of renal diseases, and the impact of AKI on the clinical outcomes.Results: Among 210 subjects, 131 were males (62.4%). The median age was 64 years (IQR: 56-71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) patients were classified as stage 1, 2 and 3, respectively. 54 cases (58.7%) received CRRT. Age, sepsis, Nephrotoxic drug, IMV and elevated baseline Scr were associated with AKI occurrence. The renal recover during hospitalization among 16 AKI patients (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure and higher P/F ratio. Of 210 patients, 93 patients deceased within 28 days of ICU admission. AKI stage 3, critical disease, greater age and minimum P/F <150mmHg independently associated with it.Conclusions: Among patients with Covid-19, the incidence of AKI was high. age , sepsis, nephrotoxic drug, IMV and baseline Scr were strongly associated with the development of AKI. Time from admission to AKI diagnosis, right heart failure and P/F ratio were independently associated with the potential of renal recovery. Finally, AKI KIDGO stage 3 independently predicted the risk of death within 28 days of ICU admission.

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Incidence, Risk Factors, and Prognosis of Intra-Abdominal Hypertension in Critically Ill Children

Journal of Intensive Care Medicine ◽

10.1177/0885066615583645 ◽

2015 ◽

Vol 31 (6) ◽

pp. 403-408 ◽

Cited By ~ 16

Author(s):

Farah Chedly Thabet ◽

Iheb Mohamed Bougmiza ◽

May Said Chehab ◽

Hind Ali Bafaqih ◽

Sulaiman Abdulkareem AlMohaimeed ◽

...

Keyword(s):

Risk Factors ◽

Critically Ill ◽

Critically Ill Children ◽

Abdominal Hypertension ◽

Incidence Risk

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The Incidence, Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients Undergoing Emergency Surgery: A Prospective Observational Study

10.21203/rs.3.rs-78039/v1 ◽

2020 ◽

Author(s):

Linhui Hu ◽

Lu Gao ◽

Danqing Zhang ◽

Yating Hou ◽

Yujun Deng ◽

...

Keyword(s):

Risk Factors ◽

Critically Ill ◽

Critically Ill Patients ◽

Emergency Surgery ◽

Kidney Injury ◽

Apache Ii Score ◽

Incidence Risk ◽

Postoperative Serum ◽

Independent Risk Factors ◽

Postoperative Aki

Abstract BackgroundPostoperative acute kidney injury (AKI) is associated with higher morbidity, mortality, and economic burden. However, there is a lack of evaluation of postoperative AKI in highly heterogeneous critically ill patients undergoing emergency surgery. To explore the incidence, risk factors, and prognosis, to clarify the epidemiological status, and to improve the early identification and diagnosis of postoperative AKI, this study was taken.MethodsA prospective observational study was conducted in the general intensive care units of Guangdong Provincial People's Hospital from January 2014 to March 2018. Preoperative variables, intraoperative variables, postoperative variables, and postoperative prognosis data were collected. The diagnosis and staging of postoperative AKI were based on the Kidney Disease: Improving Global Outcomes criteria. They were divided into two groups according to whether postoperative AKI occurred: AKI group and non-AKI group. The baseline characteristics, postoperative AKI incidence, AKI stage, and in-hospital prognosis in all enrolled patients were analyzed prospectively. Multivariate logistic forward stepwise (odds ratio, OR) regression was used to determine the independent risk factors of postoperative AKI. Results were presented using the OR with 95% confidence intervals (CIs).ResultsA total of 383 critically ill patients undergoing emergency surgery, 151 (39.4%) patients among them developed postoperative AKI. Postoperative reoperation, postoperative Acute Physiology and Chronic Health Evaluation (APACHE II) score, postoperative serum lactic acid (LAC), postoperative serum creatinine (sCr) were independent risk factors for postoperative AKI in critically ill patients undergoing emergency surgery, with the adjusted OR (ORadj) of 1.854 ( 95% CI, 1.091 - 3.152), 1.059 ( 95% CI, 1.018 - 1.102), 1. 239 (95% CI, 1.047 - 1.467), and 3.934 (95% CI, 2.426 - 6.382), respectively. Duration of mechanical ventilation, renal replacement therapy, ICU and hospital mortality, ICU and hospital length of stay, total ICU and hospital costs were higher in the AKI group than in the non-AKI group.ConclusionsThe independent risk factors which included postoperative reoperation, postoperative APACHE II score, postoperative LAC, and postoperative sCr could improve the early diagnosis and prevention of postoperative AKI and identify the higher risk of adverse outcomes in critically ill patients undergoing emergency surgery.

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