Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Records ◽  
Injury Severity ◽  
University Hospital ◽  
Factors Associated ◽  
Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

scholarly journals Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

2018 ◽  
Vol 7 (4) ◽  
pp. 197-203 ◽  
Author(s):  
Roghieh Nazari ◽  
Saeed Pahlevan Sharif ◽  
Kelly A Allen ◽  
Hamid Sharif Nia ◽  
Bit-Lian Yee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Injury Severity ◽  
Repeated Measure ◽  
Neck Stiffness ◽  
Significant Difference ◽  
Eye Opening ◽  
Different Levels

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients’ inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.

Microbiology and Risk Factors for Catheter Exit-Site and -Hub Colonization in Neonatal Intensive Care Unit Patients

2001 ◽  
Vol 22 (6) ◽  
pp. 357-362 ◽  
Author(s):  
Ludo M. Mahieu ◽  
Jozef J. De Dooy ◽  
Aimé O. De Muynck ◽  
Guillaume Van Melckebeke ◽  
Margareta M. Ieven ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Strong Association ◽  
University Hospital ◽  
Exit Site ◽  
Coagulase Negative Staphylococci ◽  
Factors Associated

AbstractObjective:To identify risk factors and describe the microbiology of catheter exit-site and hub colonization in neonates.Design:During a period of 2 years, we prospectively investigated 14 risk factors for catheter exit-site and hub colonization in 862 central venous catheters in a cohort of 441 neonates. Cultures of the catheter exit-site and hub were obtained using semiquantitative techniques at time of catheter removal.Setting:A neonatal intensive care unit at a university hospital.Results:Catheter exit-site colonization was found in 7.2% and hub colonization in 5.3%. Coagulase-negative staphylococci were predominant at both sites. Pathogenic flora were found more frequently at the catheter hub (36% vs 14%;P<.05). Through logistic regression, factors associated with exit-site colonization were identified as umbilical insertion (odds ratio [OR], 8.1; 95% confidence interval [CI95], 2.35-27.6;P<.001), subclavian insertion (OR, 54.6; CI95, 12.2-244;P<.001), and colonization of the catheter hub (OR, 8.9; CI95,3.5-22.8;P<.001). Catheter-hub colonization was associated with total parenteral nutrition ([TPN] OR for each day of TPN, 1.056; CI95,1.029-1.083;P<.001) and catheter exit-site colonization (OR, 6.11; CI95, 2.603-14.34;P<.001). No association was found between colonization at these sites and duration of catheterzation and venue of insertion, physician's experience, postnatal age and patient's weight, ventilation, steroids or antibiotics, and catheter repositioning.Conclusion:These data support that colonization of the catheter exit-site is associated with the site of insertion and colonization of the catheter hub with the use of TPN. There is a very strong association between colonization at both catheter sites.

scholarly journals Hemotransfusion and mechanical ventilation time are associated with intra-hospital mortality in patients with traumatic brain injury admitted to intensive care unit

2016 ◽  
Vol 74 (8) ◽  
pp. 644-649 ◽  
Author(s):  
Kelson James Almeida ◽  
Ânderson Batista Rodrigues ◽  
Luiz Euripedes Almondes Santana Lemos ◽  
Marconi Cosme Soares de Oliveira Filho ◽  
Brisa Fideles Gandara ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Hospital Death ◽  
Factors Associated ◽  
Ventilation Time ◽  
Mechanical Ventilation Time

ABSTRACT Objective To identify the factors associated with the intra-hospital mortality in patients with traumatic brain injury (TBI) admitted to intensive care unit (ICU). Methods The sample included patients with TBI admitted to the ICU consecutively in a period of one year. It was defined as variables the epidemiological characteristics, factors associated with trauma and variables arising from clinical management in the ICU. Results The sample included 87 TBI patients with a mean age of 28.93 ± 12.72 years, predominantly male (88.5%). The intra-hospital mortality rate was of 33.33%. The initial univariate analysis showed a significant correlation of intra-hospital death and the following variables: the reported use of alcohol (p = 0.016), hemotransfusion during hospitalization (p = 0.036), and mechanical ventilation time (p = 0.002). Conclusion After multivariate analysis, the factors associated with intra-hospital mortality in TBI patients admitted to the intensive care unit were the administration of hemocomponents and mechanical ventilation time.

scholarly journals Factors associated with readmissions to an adult intensive care unit at a university hospital

Rev Rene ◽  
2020 ◽  
Vol 21 ◽  
pp. e43724
Author(s):  
Daniele Lopes ◽  
Luciana Magnani Fernandes ◽  
Débora Cristina Ignácio Alves ◽  
Nelsi Salete Tonini ◽  
João Lucas Campos de Oliveira
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Medical Records ◽  
University Hospital ◽  
Chi Square ◽  
Adult Intensive Care Unit ◽  
Factors Associated ◽  
Extubation Time ◽  
Chi Square Test

Objective: to verify the rate and factors associated with readmissions in the Intensive Care Unit. Methods: a documentary study, carried out with a sample (n=441) of medical records of adult patients admitted to the Intensive Care Unit of a university hospital. The descriptive and inferential statistical analysis was applied, using Pearson’s correlation, the chi-square test, and the t-student test, at a 5% confidence level. Results: most were men (66.2%), with 52.8±18.5 years of age and hospital stay of 10.2±10.8 days. Of these, 29 (6.5%) were readmitted. Death was similar (p=0.893) between readmitted (31.0%) and not readmitted (29.8%). There was no significant correlation between the readmission outcome and age, Nursing Activities Score and time on mechanical ventilation. By comparison, the hospital stay, and extubation were significantly longer (p<0.05) among those readmitted. Conclusion: the rate of readmission was slightly low. Only extubation time was negatively and significantly correlated with the readmission outcome.

scholarly journals Risk factors for death of trauma patients admitted to an Intensive Care Unit

2020 ◽  
Vol 28 ◽  
Author(s):  
Maicon Henrique Lentsck ◽  
Rosana Rosseto de Oliveira ◽  
Ligiana Pires Corona ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Prehospital Care ◽  
Multiple Logistic Regression Analysis ◽  
Trauma Patients ◽  
Multiple Logistic Regression ◽  
Factors Associated

Objective: To analyze the risk factors for death of trauma patients admitted to the intensive care unit (ICU). Method: Retrospective cohort study with data from medical records of adults hospitalized for trauma in a general intensive care unit. We included patients 18 years of age and older and admitted for injuries. The variables were grouped into levels in a hierarchical manner. The distal level included sociodemographic variables, hospitalization, cause of trauma and comorbidities; the intermediate, the characteristics of trauma and prehospital care; the proximal, the variables of prognostic indices, intensive admission, procedures and complications. Multiple logistic regression analysis was performed. Results: The risk factors associated with death at the distal level were age 60 years or older and comorbidities; at intermediate level, severity of trauma and proximal level, severe circulatory complications, vasoactive drug use, mechanical ventilation, renal dysfunction, failure to perform blood culture on admission and Acute Physiology and Chronic Health Evaluation II. Conclusion: The identified factors are useful to compose a clinical profile and to plan intensive care to avoid complications and deaths of traumatized patients.

Persistent Hyperglycemia in Severe Traumatic Brain Injury: An Independent Predictor of Outcome

2009 ◽  
Vol 75 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Ali Salim ◽  
Pantelis Hadjizacharia ◽  
Joseph Dubose ◽  
Carlos Brown ◽  
Kenji Inaba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Blood Glucose ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Significant Risk ◽  
Severe Tbi ◽  
Persistent Hyperglycemia

In patients with severe traumatic brain injury (TBI), admission hyperglycemia is associated with poor outcome. The effect of persistent hyperglycemia (PH) on outcome in severe TBI, however, remains unknown. We performed a retrospective review of all blunt trauma patients with severe TBI (head Abbreviated Injury Score ≥ 3) admitted to the intensive care unit at a Level I trauma center from January 1998 through December 2005. Admission and daily intensive care unit blood glucose levels up to the end of the first week were measured. PH was defined as an average daily blood glucose ≥ 150 mg/dL on all days for the first week of the hospital stay. TBI patients with and without PH were compared with respect to baseline demographics, injury characteristics, and outcomes. Independent risk factors for mortality were identified using logistic regression analysis. One hundred and five (12.6%) out of 834 severe TBI patients had PH. Patients with PH were older, more severely injured, and had worse head injury compared with patients without PH. After adjusting for significant risk factors, PH was identified as an independent risk factor for mortality (odds ratio (OR): 4.91 [95% confidence interval (CI), 2.88–8.56, P < 0.0001]). PH is associated with significantly higher mortality rates in severe TBI patients.

scholarly journals The incidence and risk factors of ventilator-associated pneumonia in patients with severe traumatic brain injury

2011 ◽  
Vol 64 (7-8) ◽  
pp. 403-407 ◽  
Author(s):  
Vesna Marjanovic ◽  
Vesna Novak ◽  
Ljubinka Velickovic ◽  
Goran Marjanovic
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Prolonged Mechanical Ventilation ◽  
Chest Injury ◽  
Ventilator Associated Pneumonia

Introduction. Patients with severe traumatic brain injury are at a risk of developing ventilator-associated pneumonia. The aim of this study was to describe the incidence, etiology, risk factors for development of ventilator- associated pneumonia and outcome in patients with severe traumatic brain injury. Material and Methods. A retrospective study was done in 72 patients with severe traumatic brain injury, who required mechanical ventilation for more than 48 hours. Results. Ventilator-associated pneumonia was found in 31 of 72 (43.06%) patients with severe traumatic brain injury. The risk factors for ventilator-associated pneumonia were: prolonged mechanical ventilation (12.42 vs 4.34 days, p<0.001), longer stay at intensive care unit (17 vs 5 days, p<0.001) and chest injury (51.61 vs 19.51%, p< 0.009) compared to patients without ventilator-associated pneumonia.. The mortality rate in the patients with ventilator-associated pneumonia was higher (38.71 vs 21.95%, p= 0.12). Conclusion. The development of ventilator-associated pneumonia in patients with severe traumatic brain injury led to the increased morbidity due to the prolonged mechanical ventilation, longer stay at intensive care unit and chest injury, but had no effect on mortality.

One-year costs of intensive care in pediatric patients with traumatic brain injury

2021 ◽  
Vol 27 (1) ◽  
pp. 79-86
Author(s):  
Era D. Mikkonen ◽  
Markus B. Skrifvars ◽  
Matti Reinikainen ◽  
Stepani Bendel ◽  
Ruut Laitio ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Social Security ◽  
Functional Outcome ◽  
Injury Severity ◽  
Pediatric Population ◽  
Favorable Outcome ◽  
Index Hospitalization ◽  
Pediatric Tbi

OBJECTIVETraumatic brain injury (TBI) is a major cause of death and disability in the pediatric population. The authors assessed 1-year costs of intensive care in pediatric TBI patients.METHODSIn this retrospective multicenter cohort study of four academic ICUs in Finland, the authors used the Finnish Intensive Care Consortium database to identify children aged 0–17 years treated for TBI in ICUs between 2003 and 2013. The authors reviewed all patient health records and head CT scans for admission, treatment, and follow-up data. Patient outcomes included functional outcome (favorable outcome defined as a Glasgow Outcome Scale score of 4–5) and death within 6 months. Costs included those for the index hospitalization, rehabilitation, and social security up to 1 year after injury. To assess costs, the authors calculated the effective cost per favorable outcome (ECPFO).RESULTSIn total, 293 patients were included, of whom 61% had moderate to severe TBI (Glasgow Coma Scale [GCS] score 3–12) and 40% were ≥ 13 years of age. Of all patients, 82% had a favorable outcome and 9% died within 6 months of injury. The mean cost per patient was €48,719 ($54,557) (95% CI €41,326–€56,112). The index hospitalization accounted for 66%, rehabilitation costs for 27%, and social security costs for 7% of total healthcare costs. The ECPFO was €59,727 ($66,884) (95% CI €52,335–€67,120). A higher ECPFO was observed among patients with clinical and treatment-related variables indicative of parenchymal swelling and high intracranial pressure. Lower ECPFO was observed among patients with higher admission GCS scores and those who had epidural hematomas.CONCLUSIONSGreater injury severity increases ECPFO and is associated with higher postdischarge costs in pediatric TBI patients. In this pediatric cohort, over two-thirds of all resources were spent on patients with favorable functional outcome, indicating appropriate resource allocation.

Sign in / Sign up

Export Citation Format

Share Document