scholarly journals Sex differences in crude mortality rates and predictive value of intensive care unit-based scores when applied to the cardiac intensive care unit

2019 ◽  
Vol 9 (8) ◽  
pp. 966-974 ◽  
Author(s):  
Romana Herscovici ◽  
James Mirocha ◽  
Jed Salomon ◽  
Noel B Merz ◽  
Bojan Cercek ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Sex Differences ◽  
Intensive Care ◽  
Predictive Value ◽  
Scoring Systems ◽  
Mortality Rates ◽  
P Value ◽  
Cardiac Intensive Care Unit ◽  
C Statistic ◽  
Cardiac Intensive Care

Background: Limited data exists regarding sex differences in outcome and predictive accuracy of intensive care unit-based scoring systems when applied to cardiac intensive care unit patients. Methods: We reviewed medical records of patients admitted to cardiac intensive care unit from 1 January 2011–31 December 2016. Sex differences in mortality rates and the performance of intensive care unit-based scoring systems in predicting in-hospital mortality were analyzed. Calibration was assessed by the Hosmer-Lemeshow test and locally weighted scatterplot smoothing curves. Discrimination was assessed using the c statistic and receiver-operating characteristic curve. Results: Among 6963 patients, 2713 (39%) were women. Overall in-hospital and cardiac intensive care unit mortality rates were similar in women and men (9.1% vs 9.4%, p=0.67 and 5.9% vs 6%, p=0.88, respectively) and in age and major diagnosis subgroups. Of the scoring systems, Acute Physiology and Chronic Health Evaluation III and Sequential Organ Failure Assessment had poor calibration (Hosmer-Lemeshow p value <0.001), while Simplified Acute Physiology Score II performed better (Hosmer-Lemeshow p value 0.09), in both women and men. All scores had good discrimination (C statistics >0.8). In the subgroups of acute myocardial infarction and heart failure patients, all scores had good calibration (Hosmer-Lemeshow p>0.001) and discrimination (C statistic >0.8) while in diagnosis subgroups with highest mortality, the calibration varied among scores and by sex, and discrimination was poor. Conclusions: No sex differences in mortality were seen in cardiac intensive care unit patients. The mortality predictive value of intensive care unit-based scores is limited in both sexes and variable among different subgroups of diagnoses.

scholarly journals Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216177 ◽  
Author(s):  
Jacob C. Jentzer ◽  
Courtney Bennett ◽  
Brandon M. Wiley ◽  
Dennis H. Murphree ◽  
Mark T. Keegan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Predictive Value ◽  
Cardiac Intensive Care Unit ◽  
Failure Assessment ◽  
Cardiac Intensive Care

scholarly journals Medication time out as a strategy for patient safety: reducing medication errors

2021 ◽  
Vol 74 (1) ◽  
Author(s):  
Laís Lima Santos ◽  
Flávia Giron Camerini ◽  
Cíntia Silva Fassarella ◽  
Luana Ferreira de Almeida ◽  
Daniel Xavier de Brito Setta ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medication Errors ◽  
University Hospital ◽  
P Value ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Material Resources ◽  
Time Out ◽  
Cardiac Intensive Care

ABSTRACT Objectives: to analyze the implementation of the medication time out strategy to reduce medication errors. Methods: this is a quantitative, cross-sectional, inferential study, with direct observation of the implementation of the medication time out strategy, carried out in a cardiac intensive care unit of a university hospital in Rio de Janeiro. Results: 234 prescriptions with 2,799 medications were observed. Of the prescriptions analyzed, 143 (61%) had at least one change with the use of the strategy. In the prescriptions altered, 290 medications had some type of change, and 104 (35.9%) changes were related to potentially harmful medication. During the application of the strategy, prescriptions with polypharmacy had 1.8 times greater chance of presenting an error (p-value = 0.031), which reinforces the importance of the strategy for prescriptions with multiple medications. Conclusions: the implementation of the medication time out strategy contributed to the interception of a high number of medication errors, using few human and material resources.

Abstract 17002: Performance of the Mortality Probability Model (MPM0) in a Contemporary Cardiac Intensive Care Unit

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Maria E Rodrigo ◽  
Federico M Asch ◽  
Tania A Singh ◽  
Tishangi Kumar ◽  
David A Morrow ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Risk Score ◽  
Surgical Intensive Care ◽  
Cardiac Intensive Care Unit ◽  
Coronary Syndrome ◽  
C Statistic ◽  
Prediction Of Mortality ◽  
Cardiac Intensive Care

Introduction: The Mortality Prediction Model (MPM0) was developed to estimate the probability of hospital mortality among patients in general and surgical intensive care units (ICUs). Although this score is widely accepted, its applicability in patients with primary cardiac conditions has not been thoroughly evaluated. The aim of this study is to assess the performance of the MPM0 score in a cardiac intensive care unit (CICU). Methods: From 2007 to 2012, data related to variables from the MPM0 (Table 1) were prospectively collected on all consecutive patients admitted due to a primary cardiac condition to the CICU of a tertiary referral center. MPM0 was applied to all patients. Two variables of the original risk score were not included in the analysis: intracranial mass effect and cirrhosis. The incidence of each variable within the score was determined. Test performance was assessed using the area under the receiver operating characteristic curve (c-statistic). Results: A total of 6,433 patients were admitted to the CICU, of whom 5,710 (89%) had a primary cardiac diagnosis. Complete data were available for 4,641 patients, who comprise the study population. Primary cardiac diagnoses were: acute coronary syndrome (54%), arrhythmia (13%), valvular (12%), cardiomyopathy (8%), cardiac arrest (4%) and other (9%). Overall hospital mortality was 10.4%. The c-statistic for application of MPM0 to this population was 0.82 (95% CI 0.81-0.84), indicating excellent discriminatory capacity. Conclusions: The MPM0 risk score, described originally to aid in prediction of mortality for patients admitted to medical and surgical ICUs, performed extremely well when applied to cardiac patients admitted to a large contemporary CICU.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

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