scholarly journals Factors associated with admission to intensive care units in COVID-19 patients in Lyon-France

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0243709
Author(s):  
Philippe Vanhems ◽  
Marie-Paule Gustin ◽  
Christelle Elias ◽  
Laetitia Henaff ◽  
Cédric Dananché ◽  
...  

Introduction A new respiratory virus, SARS-CoV-2, has emerged and spread worldwide since late 2019. This study aims at analysing clinical presentation on admission and the determinants associated with admission in intensive care units (ICUs) in hospitalized COVID-19 patients. Patients and methods In this prospective hospital-based study, socio-demographic, clinical and biological characteristics, on admission, of adult COVID-19 hospitalized patients presenting from the community for their first admission were prospectively collected and analysed. Characteristics of patients hospitalized in medical ward to those admitted in ICU were compared using Mann-Whitney and Chi-square or Fisher exact test when appropriate. Univariate logistic regression was first used to identify variables on admission that were associated with the outcome i.e. admission to an ICU versus total hospital stay in a medical ward. Forward selection was then applied beginning with sex, age and temperature in the multivariable logistic regression model. Results Of the 412 patients included, 325 were discharged and 87 died in hospital. Multivariable regression showed increasing odds of ICU hospitalization with temperature (OR, 1.56 [95% CI, 1.06–2.28] per degree Celsius increase), oxygen saturation <90% (OR, 12.45 [95% CI, 5.27–29.4]), abnormal lung auscultation on admission (OR, 3.58 [95% CI, 1.58–8.11]), elevated level of CRP (OR, 2.7 [95% CI, 1.29–5.66for CRP>100mg/L vs CRP<10mg/L). and monocytopenia (OR, 3.28 [95% CI, 1.4–7.68]) were also associated with increasing odds of ICU hospitalization. Older patients were less likely to be hospitalized in ICU (OR, 0.17 [95%CI, 0.05–0.51]. Conclusions Age and delay between onset of symptoms and hospital admission were associated with the risk of hospitalisation in ICU. Age being a fixed variable, interventions that shorten this delay would improve the prognosis of Covid-19 patients.

2021 ◽  
Vol 30 (2) ◽  
pp. 140-144
Author(s):  
Jill M. Delawder ◽  
Samantha L. Leontie ◽  
Ralitsa S. Maduro ◽  
Merri K. Morgan ◽  
Kathie S. Zimbro

Background Patients in intensive care units are 5 times more likely to have skin integrity issues develop than patients in other units. Identifying the most appropriate assessment tool may be critical to preventing pressure injuries in intensive care patients. Objectives To validate the Cubbin-Jackson skin risk assessment in the critical care setting and to compare the predictive accuracy of the Cubbin-Jackson and Braden scales for the same patients. Methods In 5 intensive care units, the Cubbin-Jackson and Braden assessments were completed by different clinicians within 61 minutes of each other for 4137 patients between October 2017 and March 2018. Bivariate correlations and the Fisher exact test were used to check for associations between the scores. Results The Cubbin-Jackson and Braden scores were significantly and positively correlated (r = 0.80, P &lt; .001). Both tools were significant predictors of skin changes and identified as “at risk” 100% of the patients who had a change in skin integrity occur. The specificity was 18.4% for the Cubbin-Jackson scale and 27.9% for the Braden scale, and the area under the curve was 0.75 (P &lt; .001) for the Cubbin-Jackson scale and 0.76 (P &lt; .001) for the Braden scale. These findings show acceptable construct validity for both scales. Conclusions The predictive validities of the Cubbin-Jackson and Braden scales are similar, but both are sub-optimal because of poor specificity and positive predictive value. Change in practice may not be warranted, because there are no differences between the 2 scales of practical benefit to bedside nurses.


2018 ◽  
Vol 10 (02) ◽  
pp. 181
Author(s):  
Luluk Nur Fakhidah ◽  
Fitria Hayu Palupi

Luluk Nur Fakhidah 1), Fitria Hayu Palupi 2)1), 2) Program Studi D3 Kebidanan STIKes Mitra Husada KaranganyarEmail :[email protected],[email protected] ASI eksklusif sangat diperlukan sampai bayi karena sebagai makanan alamiah ASI saja sudah cukup untuk memenuhi kebutuhan gizi bayi dan energi hingga berumur 6 bulan. Tujuan penelitian ini adalah untuk mengetahui faktor individu yang  menentukan pemberian ASI eksklusif pada ibu menyusui di Kabupaten Karanganyar. Faktor yang di identifikasiantara lain usia ibu, tingkat pendidikan ibu, status pekerjaan, urutan kelahiran bayi, tempat bersalin, proses persalinan dan IMD. Penelitian ini adalah penelitian kuantitatif analitik observasionaldengan pendekatan cross sectional dan metode survey analitik.Pengumpulan data dilakukan dengan kuesioner. Jumlah responden sebanyak 38 ibu yang memenuhi kriteria inkiusi dengan teknik pengambilan sampel purposive sampling. Data yang diperoleh diolah secara statistik dengan menggunakan uji Chi Square dan fisher exact test untuk menentukan faktor-faktor yang berpengaruh terhadap pemberian ASI eksklusif dan regresi logistik digunakan untuk menentukan faktor yang paling berpengaruh terhadap pemberian ASI eksklusif. Uji statistik menunjukkanvariabel yang berpengaruh secara signifikan terhadap pemberian ASI eksklusif adalah paritas dan IMD. Uji regresi logistik menunjukkan bahwa faktor paling dominan yang mempengaruhi pemberian ASI eksklusif adalah tindakan IMD dengan p=0,025 dan OR=0.19 Faktor individu  yang berpengaruh terhadap pemberian ASIeksklusif paritas dan Imdd sedangkan usia ibu,pendidikan, status bekerja,paritas dan jenis proses persalinan tidak menunjukan pengaruh signifikan terhadap pemberian ASI eksklusifKata kunci: faktor individu, ASI eksklusifANALYSIS  FACTORS AFFECTING  EXCLUSIVE  BREASTFEEDINGABSTRACTThe provision of exclusive breastfeeding is very necessary until the baby because only natural food ASI is enough to meet the nutritional needs of the baby and energy up to 6 months of age. The purpose of this study was to determine the individual factors that determine exclusive breastfeeding in nursing mothers in Karanganyar Regency. Factors identified included maternal age, maternal education level, employment status, baby birth order, place of birth, labor and IMD. This study was an observational quantitative analytic study with a cross sectional approach and analytical survey method. Data collection was done by questionnaire. The number of respondents was 38 mothers who fulfilled initial criteria with purposive sampling sampling technique. The data obtained were processed statistically using Chi Square test and fisher exact test to determine the factors that influence exclusive breastfeeding and logistic regression was used to determine the most influential factors for exclusive breastfeeding. Statistical tests show variables that significantly influence exclusive breastfeeding are parity and IMD. Logistic regression test showed that the most dominant factor affecting exclusive breastfeeding was IMD with p = 0.025 and OR = 0.19 Individual factors that influence exclusive breastfeeding parity and Imdd while maternal age, education, work status, parity and type of labor were not show significant influence on exclusive breastfeedingKeyword : Individual factors, Exclusive breastfeeding


2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Anggraini Dwi Kurnia ◽  
Nurlailatul Masruroh ◽  
Nur Melizza

Tuberculosis and malnutrition are serious problems. Tuberculosis causes malnutrition that potentially lessen patients’ immunity and increase the risk for activating tuberculosis. The purpose of this study was to identify the factors related to the low nutritional status among tuberculosis patients in Malang City. This research applied a corelational study. The subjects involved were tuberculosis patients with BMI<18.5. Chi-square and Fisher Exact Test were used to analyse the identified factors. Moreover, binary logistic regression to identify factors related to the low nutritional status among tuberculosis patients in Malang City. This study found almost half of participants (46.8%) had poor family knowledge about dietary TB patients. More than half of the participant’s culture (62.5%) was abstinence. A more than half of participant (59.6%) had Moderate malnutritions. There was no significant correlation between low nutritional satus and variable of gender p=1.000, education p=0.404, family knowledge p=0.767, and culture p=0.310. The significant correlation was occupational status with p=0.043. The binary logistic regression showed that tuberculosis patient with unoccupied are 1.286 times more likely to have a low nutritional status. Occupational status was the one factor that significantly related to the low nutritional status among TB patients in Malang City. 


1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.


Author(s):  
Laima Alam

Objectives:Relation of demographics of hepatocellular-carcinoma with the aetiology.Tumour characteristics in relation to anti-viral therapy and presence of viral-DNA/RNATreatment modalities offeredMethods: This cross-sectional study enrolled all the patients aged 18-70 years with diagnosed hepatocellular carcinoma either through Triphasic Contrast-Enhanced-CT scan and/or Magnetic Resonance Imaging or biopsy presenting to the Outpatient-Department or multi-disciplinary-team meetings for the year 2019. Demographic variables, biochemical analysis including liver profile and stage of cirrhosis, viral-status, tumour staging and the treatment modalities offered were all noted. ANOVA (normal) and Kruskal-Wallis (non-normal) tests were used to compare quantitative data whereas chi-square-test and fisher-exact-test were used to compare qualitative-data.Results: Out of 195 patients with hepatocellular carcinoma, 76% were males in their fifth to sixth decades of life, 96% had cirrhosis, 94% corresponded to viral hepatocellular-carcinoma (82% Hepatitis-C-Virus, 9% Hepatitis-B-Virus and 3% coinfection), 60% of the cirrhotics landed in Child-Pugh A category with tumour staging BCLC-B being the predominant one (43.6%) and single and multiple bilateral nodules were the commonest lesions encountered. Platelets and Alanine-Transaminase had a significant relation across aetiological groups. Lymph-nodes were the most common extra-hepatic organs for metastasis and the presence of viral PCR had a significant impact on the tumour aggressiveness. Thirty-two percent of the patients were amenable to curative treatment.Conclusion: Viral infection is the main cause of rising prevalence of this tumour in Pakistan. Treatment modalities are expensive and expertise are lacking. A nationwide cancer registry is required for the exact disease burden and tumour behaviour for our population. Continuous....


PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 918-922 ◽  
Author(s):  
Gabriel J. Escobar ◽  
Allen Fischer ◽  
De Kun Li ◽  
Robert Kremers ◽  
Mary Anne Armstrong

Background. Measurement of the severity of illness is a research area of growing importance in neonatal intensive care. Most severity of illness scales have been developed in tertiary care settings. Their applicability in community neonatal intensive care units has not been tested. Objectives. Our goal was to assess the operational characteristics of the score for neonatal acute physiology (SNAP): the relationship to birth weight, the length of total hospital stay, and in-hospital mortality. Methods. We assigned SNAP scores prospectively to all inborn admissions at three community neonatal intensive care units during an 11-month period. Data on other neonatal predictors (eg, birth weight and the presence of congenital heart disease) were also collected. We measured in-hospital mortality, the experience of interhospital transport to a higher level of care, and total hospital stay. Results. We found that the SNAP's relationship to birth weight was similar to previous reports. The SNAP's perinatal extension is a reliable predictor of newborn in-hospital mortality, with an area under the receiver operator characteristic curve of 0.95. The SNAP is also a good predictor of total hospital length of stay, whether by itself (by which it can explain 31% of the total stay) or in combination with other variables. Its predictive ability is better among infants of low birth weight (&lt;2500 g) than among those of normal birth weight (≥2500 g). The SNAP's predictive power was most limited among infants admitted to rule out sepsis. The predictive ability of a model containing birth weight, the SNAP, and transport status was not improved by the inclusion of two major diagnostic categories, the presence of congenital heart disease or complex illness. Conclusion. Although it has definite limitations among infants who weigh 2500 g or more, the SNAP is a potent tool for outcomes research. Modification of some of its parameters could result in a multifunctional scale suitable for use with all birth weights.


2016 ◽  
Vol 50 (2) ◽  
pp. 263-271 ◽  
Author(s):  
Sandra Maria Sampaio Enes ◽  
Simone Perufo Opitz ◽  
André Ricardo Maia da Costa de Faro ◽  
Mavilde de Luz Gonçalves Pedreira

Abstract OBJECTIVE To identify the presence of phlebitis and the factors that influence the development of this complication in adult patients admitted to hospital in the western Brazilian Amazon. METHOD Exploratory study with a sample of 122 peripheral intravenous catheters inserted in 122 patients in a medical unit. Variables related to the patient and intravenous therapy were analyzed. For the analysis, we used chi-square tests of Pearson and Fisher exact test, with 5% significance level. RESULTS Complication was the main reason for catheter removal (67.2%), phlebitis was the most frequent complication (31.1%). The mean duration of intravenous therapy use was 8.81 days in continuous and intermittent infusion (61.5%), in 20G catheter (39.3%), inserted in the dorsal hand vein arc (36.9 %), with mean time of usage of 68.4 hours. The type of infusion (p=0.044) and the presence of chronic disease (p=0.005) and infection (p=0.007) affected the development of phlebitis. CONCLUSION There was a high frequency of phlebitis in the sample, being influenced by concomitant use of continuous and intermittent infusion of drugs and solutions, and more frequent in patients with chronic diseases and infection.


Author(s):  
Deivy Cirayow ◽  
Arthur Hendrik Philips Mawuntu ◽  
Herlyani Khosama

FACTORS THAT INFLUENCE HIV ASSOCIATED PERIPHERAL NEUROPATHY IN MANADOABSTRACTIntroduction: There are  several sociodemographic and clinical factors that influence the development of HIV associated peripheral  neuropathy (HIV-PN). Manado has different sociodemographic and clinical characteristics  from other regions. However, the percentage of HIV-PN and its influencing factors are unknown.Aims: To know the percentage of HIV-PN and factors that influence this disorder in Manado.Methods: A crosssectional study conducted in HIV/AIDS clinic R.D. Kandou hospital Manado between November2016–January 2017. Neuropathy evaluation was performed using brief peripheral neuropathy screening (BPNS), neuropathic pain diagnostic questionnaire (DN4), and electroneurography. A Chi-square or Fisher exact test was done to analyze categorical variables, independent T or Mann-Whitney test was done for numerical variables, and linear regression was done in multivariate analysis.Results: 50 subjects were included, most were male (70%), and the mean age was 32.98 (±9.726) years, with HIV- NP percentage was 46%. Age >30 years old, low hemoglobin count, CD4, and low international  HIV dementia scale (IHDS) significantly associated with HIV-NP. Working subjects were 13.6 times more likely to have HIV-PN.Discussion: HIV-PN prevalence was relatively high, influenced by age >30 years old an low hemoglobin, CD4, andIHDS. As a factor, working was escalating the likelihood of NP-HIV by 13.9 times.Keywords: HIV/AIDS, influencing factors, peripheral neuropathyABSTRAKPendahuluan: Neuropati perifer terkait human immunodeficiency virus/HIV (NP-HIV) dapat dipengaruhi oleh beberapa faktor klinis dan sosiodemografis. Manado mempunyai karakteristik yang berbeda dengan daerah lain, namun belum diketahui persentase NP-HIV dan faktor-faktor yang memengaruhinya.Tujuan: Mengetahui persentase NP-HIV dan faktor-faktor yang memengaruhinya di Manado.Metode: Penelitian potong lintang terhadap pasien HIV/AIDS di poliklinik HIV/AIDS RSUP Prof. dr. R.D. Kandou, Manado, pada November 2016–Januari 2017.  Evaluasi neuropati dilakukan menggunakan brief peripheral  neuropathy screening (BPNS), neuropathic pain diagnostic questionnaire (DN4), dan elektroneurografi. Digunakan uji Chi-square atau Fisher exact untuk menganalisis variabel kategorik, uji T independen atau Mann-Whitney untuk variabel numerik, dan regresi linear untuk analisis multivariat.Hasil: Didapatkan 50 subjek yang memenuhi kriteria penelitian dengan mayoritas laki-laki (70%), rerata usia32,98±9,726 tahun, dan mengalami NP-HIV sebanyak 46%. Usia >30 tahun, kadar hemoglobin, jumlah CD4, dan skor international  HIV dementia scale (IHDS) yang rendah berhubungan secara bermakna dengan adanya NP-HIV. Adapun subjek yang bekerja berisiko 13,6 kali lebih besar mengalami NP-HIV.Diskusi: Didapatkan prevalensi NP-HIV yang cukup tinggi dengan dipengaruhi oleh usia >30 tahun serta kadar hemoglobin, CD4, dan skor IHDS yang rendah. Faktor bekerja juga meningkatkan kecenderungan 13,9 kali mengalami NP terkait HIV.Kata kunci: Faktor-faktor yang memengaruhi, HIV/AIDS, neuropati perifer


2018 ◽  
Vol 16 (2) ◽  
pp. 236-244
Author(s):  
Happy Marthalena Simanungkalit

Latar Belakang : Air Susu Ibu (ASI) selain merupakan makanan paling baik untuk bayi, juga terbukti dapat mencegah penyakit pada bayi dan memberi manfaat bagi ibu, keluarga, dan masyarakat. Memberikan ASI selama 6 bulan dapat menyelamatkan 1,3 juta jiwa di seluruh dunia. Tahun 2016 capaian pemberian ASI eksklusif di Wilayah Kerja Puskesmas Jekan Raya masih rendah. Tujuan Penelitian: Penelitian ini merupakan crosssectional study yang bersifat analitik Populasinya adalah seluruh ibu yang memiliki anak usia 6-12 bulan. Metode Penelitian: Penelitian ini menggunakan penelitian observasional analitik dengan metode Cross Sectional. Jumlah sampel yaitu sebanyak 79 responden. Adapun cara pengumpulan data dengan wawancara. Uji statistik yang digunakan adalah uji Chi-square (X2) dan Fisher Exact Test. Hasil penelitian: Variabel yang memiliki hubungan dengan pemberian ASI eksklusif yaitu pengetahuan (p=0,000). Sedangkan untuk variabel lainnya, yaitu umur (Fisher Exact Test = 0,120), pendidikan (p = 0,075) dan pekerjaan (p = 0,976) tidak menunjukkan adanya hubungan dengan pemberian ASI eksklusif. Kesimpulan: Variabel pengetahuan menunjukkan hubungan yang bermakna dengan pemberian ASI eksklusif. Variabel umur, pendidikan dan pekerjaan menunjukkan hubungan yang tidak bermakna dengan pemberian ASI eksklusif.


2021 ◽  
Vol 38 (2) ◽  
pp. 154-158
Author(s):  
Nur DOKUZEYLUL GÜNGÖR ◽  
Tuğba GÜRBÜZ ◽  
Selma Bozkurt ZİNCİR ◽  
Banu DOKUZEYLÜL ◽  
Erman OR ◽  
...  

Cats are the main host of Toxoplasma gondii and pregnant women who own cats at home may be at risk. This condition may cause anxiety and stress in pregnant women. The aim of this study is to evaluate toxoplasmosis risk on anxiety and perception of cat owner pregnant women. The study group consisted of 59 pregnant women feeding cats in the home and 369 pregnant women not feeding cats. A Health Anxiety Inventory (HAI-18) was used to measure the anxiety of all participants. Age and anxiety variables were analyzed using a two-sample independent t-test. Gravida, education, and job status were analyzed using chi-square tests, and live to abort ratio & pregnancy number were analyzed using Fisher exact test. Measurement of the anxiety level between the two groups showed that anxiety is significantly higher among the pregnant women who feed cats in their house with an average of 32.03±8.72. The average anxiety level among the pregnant women who don't have cats in their house was 25.94±8.99. The difference between the Health Anxiety Inventory of the two groups was significant (p= 0.0001) It was shown in the literature that pets can reduce anxiety but not studied in pregnant women, yet. Our results showed that pregnant women who own cats at home had more environmental anxiety than women who don’t feed cats at home which is possibly associated with fear of Toxoplasma gondii transmission. This anxiety may also cause unfavorable pregnancy outcomes like eclampsia, preterm birth, low birth weight and high incidence of cesarean delivery.


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