Safety in training for ultrasound guided internal jugular vein CVC placement: a propensity score analysis

Abstract Background Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. Methods This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Results Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Conclusions Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

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Propensity score analysis confirms the independent effect of parenteral nutrition on the risk of central venous catheter-related bloodstream infection in oncological patients

Clinical Nutrition ◽

10.1016/j.clnu.2012.12.006 ◽

2013 ◽

Vol 32 (6) ◽

pp. 1050-1054 ◽

Cited By ~ 16

Author(s):

Abdoulaye Touré ◽

Cécile Chambrier ◽

Philippe Vanhems ◽

Catherine Lombard-Bohas ◽

Jean-Christophe Souquet ◽

...

Keyword(s):

Propensity Score ◽

Central Venous Catheter ◽

Parenteral Nutrition ◽

Propensity Score Analysis ◽

Venous Catheter ◽

Independent Effect ◽

Central Venous ◽

Oncological Patients ◽

Score Analysis ◽

Catheter Related Bloodstream Infection

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Higher Mortality in Bacteremic Sepsis - A Propensity Score Matched Study

10.21203/rs.3.rs-113804/v3 ◽

2020 ◽

Author(s):

Lisa Mellhammar ◽

Fredrik Kahn ◽

Caroline Whitlow ◽

Thomas Kander ◽

Bertil Christensson ◽

...

Keyword(s):

Propensity Score ◽

Antibiotic Treatment ◽

Latent Class ◽

Propensity Score Analysis ◽

Significant Proportion ◽

Blood Cultures ◽

University Hospital ◽

Sepsis Diagnosis ◽

Score Analysis ◽

Prior Antibiotic Treatment

Abstract BackgroundSepsis is a highly heterogenous disease which needs to be thoroughly mapped. The aim of this study was to describe characteristics and outcome for critically ill patients with sepsis-3 with either culture-positive or -negative sepsis.Methods Patients with severe sepsis or septic shock were retrospectively identified in the local quality registry from a general mixed Intensive Care Unit (ICU) at a University Hospital in 2007-2014. Data were collected through manual review of medical charts. Patients were included if they fulfilled sepsis-3 criteria and at least one blood culture was sampled ±48h from ICU admission. In a propensity score analysis bacteremic and non-bacteremic patients were matched 1:1 with regard to age, comorbidities, site of infection and antimicrobial therapy prior to blood cultures. A Latent Class Analysis (LCA) was performed to identify unmeasured class membership.Results784 patients were identified as treated in the ICU with a sepsis diagnosis. Blood cultures were missing in 140 excluded patients and additionally 95 patients did not fulfill a sepsis diagnosis and were also excluded. In total 549 patients were included, 295 (54%) with bacteremia, 90 (16%) were non-bacteremic but had relevant pathogens detected from another body location and in 164 (30%) no relevant pathogen was detected in microbial samples. After the propensity score analysis (n=172 in each group) 90-day mortality was higher in bacteremic patients, 47%, than in non-bacteremic patients, 36%, p =0.04. Patients without antibiotic treatment before sample collection (n=352) were more often bacteremic, 63%. Non-bacteremic patients without prior antibiotic treatment had lower mortality, 31% (n=129), compared to non-bacteremic patients with prior antibiotic treatment, 51% (n=124), p <0.01.The LCA identified 8 classes, with different mortality rates, where pathogen detection in microbial sampleswere important factors for class distinction andoutcome.ConclusionsBacteremic patients had higher mortality than their non-bacteremic counter-parts. Bacteremia is more common in sepsis than previously reported, when studied in a clinical review. Clinical chart review should be considered gold standard since a significant proportion of the patients in the proposed sepsis cohort, did not have sepsis, but would have been included in ICD- or electronic health record (EHR) algorithm approaches.

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Sleep deprivation did not enhance the success rate of chloral hydrate sedation for non-invasive procedural sedation in pediatric patients

PLoS ONE ◽

10.1371/journal.pone.0245338 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245338

Author(s):

Yu Cui ◽

Langtao Guo ◽

Qixia Mu ◽

Qin Cheng ◽

Lu Kang ◽

...

Keyword(s):

Propensity Score ◽

Sleep Deprivation ◽

Failure Rate ◽

Chloral Hydrate ◽

Propensity Score Analysis ◽

Procedural Sedation ◽

Invasive Procedures ◽

Study Objective ◽

Non Invasive ◽

Score Analysis

Study objective In Asian countries, oral chloral hydrate is the most commonly used sedative for non-invasive procedures. Theoretically, mild sleep deprivation could be considered as one of assisted techniques. However, there is no consensus on sleep deprivation facilitating the sedation during non-painful procedures in children. The aim of our study is to analyze the clinical data of children undergoing non-invasive procedural sedation retrospectively and to evaluate the association between mild sleep deprivation and sedative effects in non-invasive procedures. Measurements Consecutive patients undergoing chloral hydrate sedation for non-invasive procedures between December 1, 2019 to June 30, 2020 were included in this study. The propensity score analysis with 1: 1 ratio was used to match the baseline variables between patients with sleep deprivation and non-sleep deprivation. The primary outcome was the failure rate of sedation with the initial dose. The secondary outcomes included the failure rate of sedation after supplementation of chloral hydrate, the incidence of major and minor adverse events, initial and supplemental dose of chloral hydrate, and the length of sedation time. Main results Of the 7789 patients undergoing chloral hydrate sedation, 6352 were treated with sleep deprivation and 1437 with non-sleep deprivation. After propensity score matching, 1437 pairs were produced. The failure rate of sedation with initial chlorate hydrate was not significantly different in two groups (8.6% [123/1437] vs. 10.6% [152/1437], p = 0.08), nor were the failure rates with supplemental chlorate hydrate (0.8% [12/1437] vs. 0.9% [13/1437], p = 1) and the length of sedation time (58 [45, 75] vs. 58 [45, 75] min; p = 0.93). Conclusions The current results do not support sleep deprivation have a beneficial effect in reducing the pediatric chloral hydrate sedation failure rate. The routine use of sleep deprivation for pediatric sedation is unnecessary.

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Higher Mortality in Bacteremic Sepsis - A Propensity Score Matched Study

10.21203/rs.3.rs-113804/v1 ◽

2020 ◽

Author(s):

Lisa Mellhammar ◽

Fredrik Kahn ◽

Caroline Whitlow ◽

Thomas Kander ◽

Bertil Christensson ◽

...

Keyword(s):

Propensity Score ◽

Antibiotic Treatment ◽

Latent Class ◽

Propensity Score Analysis ◽

Significant Proportion ◽

Blood Cultures ◽

University Hospital ◽

Sepsis Diagnosis ◽

Score Analysis ◽

Prior Antibiotic Treatment

Abstract BackgroundSepsis is a highly heterogenous disease which needs to be thoroughly mapped. The aim of this study was to describe characteristics and outcome for critically ill patients with sepsis-3 with either culture-positive or -negative sepsis.Methods Patients with severe sepsis or septic shock were retrospectively identified in the local quality registry from a general mixed Intensive Care Unit (ICU) at a University Hospital in 2007-2014. Data were collected through manual review of medical charts. Patients were included if they fulfilled sepsis-3 criteria and at least one blood culture was sampled ±48h from ICU admission. In a propensity score analysis bacteremic and non-bacteremic patients were matched 1:1 with regard to age, comorbidities, site of infection and antimicrobial therapy prior to blood cultures. A Latent Class Analysis (LCA) was performed to identify unmeasured class membership.Results784 patients were identified as treated in the ICU with a sepsis diagnosis. Blood cultures were missing in 140 excluded patients and additionally 95 patients did not fulfill a sepsis diagnosis and were also excluded. In total 549 patients were included, 295 (54%) with bacteremia, 90 (16%) were non-bacteremic but had relevant pathogens detected from another body location and in 164 (30%) no relevant pathogen was detected in microbial samples. After the propensity score analysis (n=172 in each group) 90-day mortality was higher in bacteremic patients, 47%, than in non-bacteremic patients, 36%, p =0.04. Patients without antibiotic treatment before sample collection (n=352) were more often bacteremic, 63%. Non-bacteremic patients without prior antibiotic treatment had lower mortality, 31% (n=129), compared to non-bacteremic patients with prior antibiotic treatment, 51% (n=124), p <0.01.The LCA identified 8 classes, with different mortality rates, where pathogen detection in microbial sampleswere important factors for class distinction andoutcome.ConclusionsBacteremic patients had higher mortality than their non-bacteremic counter-parts. Bacteremia is more common in sepsis than previously reported, when studied in a clinical review. Clinical chart review should be considered gold standard since a significant proportion of the patients in the proposed sepsis cohort, did not have sepsis, but would have been included in ICD- or electronic health record (EHR) algorithm approaches.

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