Risk Factors and Precipitants Associated With Delirium in Critical Ill Patients: Proposal of a Predictive Model

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 396A
Author(s):  
Florencia Ballestero ◽  
Emiliano Descotte ◽  
Micaela Ferreyra ◽  
Fernando Grassi ◽  
Estefania Requesens ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Model ◽  
Critical Ill Patients ◽  
Critical Ill

scholarly journals Acute kidney injury at early stage as a negative prognostic indicator of patients with COVID-19: a hospital-based retrospective analysis

2020 ◽  
Author(s):  
Shen Xu ◽  
Lin Fu ◽  
Jun Fei ◽  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Early Stage ◽  
Kidney Injury ◽  
Oxygenation Index ◽  
Prognostic Indicator ◽  
Critical Ill Patients ◽  
Patients With Diabetes ◽  
Independent Risk Factors ◽  
Critical Ill

AbstractCoronavirus disease 2019 (COVID-19) is a newly emerged infection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been pandemic all over the world. This study described acute kidney injury (AKI) at early stage of COVID-19 and its clinical significance. Three-hundred and fifty-five COVID-19 patients with were recruited and clinical data were collected from electronic medical records. Patient’s prognosis was tracked and risk factors of AKI was analyzed. Of 355 COVID-19 patients, common, severe and critical ill cases accounted for 63.1%, 16.9% and 20.0%, respectively. On admission, 56 (15.8%) patients were with AKI. Although AKI was more common in critical ill patients with COVID-19, there was no significant association between oxygenation index and renal functional indices among COVID-19 patients with AKI. By multivariate logistic regression, male, older age and comorbidity with diabetes were three important independent risk factors predicting AKI among COVID-19 patients. Among 56 COVID-19 patients with AKI, 33.9% were died on mean 10.9 day after hospitalization. Fatality rate was obviously higher among COVID-+19 patients with AKI than those without AKI (RR=7.08, P<0.001). In conclusion, male elderly COVID-19 patients with diabetes are more susceptible to AKI. AKI at early stage may be a negative prognostic indicator for COVID-19.

P1282 Risk factors and outcome of critical ill patients with candidaemia

2007 ◽  
Vol 29 ◽  
pp. S353-S354
Author(s):  
M. Pratikaki ◽  
E. Platsouka ◽  
C. Routsi ◽  
C. Sotiropoulou ◽  
A. Priovolos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critical Ill Patients ◽  
Critical Ill

scholarly journals Incidence, Risk Factors and Outcomes of Sepsis in Post-Craniotomy Critical Ill Patients

2021 ◽  
Author(s):  
Jianfang Zhou ◽  
Xu-Ying Luo ◽  
Guang-Qiang Chen ◽  
Hong-Liang Li ◽  
Linlin Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Costs ◽  
Primary Diagnosis ◽  
Apache Ii Score ◽  
Critical Ill Patients ◽  
Hospital Patients ◽  
Incidence Risk ◽  
Critical Ill

Abstract Background: Data about the epidemiology of sepsis in post-craniotomy critical ill patients are scarce. This study aims to assess the incidence, risk factors, and outcomes of sepsis in this population.Methods: We conducted a prospective cohort study between January 1, 2017, and December 31, 2018, in the intensive care unit (ICU) of Beijing Tiantan Hospital. Patients admitted to ICU after intracranial operations and meeting the inclusion criteria were screened daily for the presence of infection and sepsis. We also collected demographics, primary diagnosis, chronic comorbidities, information about surgery, infection, and patients’ outcomes. Results: Of the 900 included patients, 509 (56.6%) were with infection, and 300 developed sepsis. The cumulative incidence of sepsis was 33.3% [95% CI, 30.2%-36.4%]. Male sex, older in age, supratentorial surgery, the sellar region tumors, postoperative hydrocephalus, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher Sequential Organ Failure Assessment (SOFA) score, and lower Glasgow Coma Scale (GCS) were independent risk factors of sepsis. Sepsis was associated with a higher hospital mortality rate (13.7% vs. 8.3%, p =0.012), lower Glasgow Outcome Scale (GOS) at discharge (3 vs. 4, p<0.001), longer ICU length of stay (LOS) (14 vs. 4 days, p<0.001), longer hospital LOS (31 vs. 19 days, p<0.001), and higher total medical costs (RMB 138,394 vs 75,918 Yuan, p<0.001). Conclusions: Sepsis is a frequent complication in post-craniotomy critical ill patients, and is associated with increased hospital mortality rate, increased hospital costs, prolonged ICU LOS, and hospital LOS.Trial registration: Clinicaltrials.gov number: NCT03803813

scholarly journals Risk Factors of ICU-Acquired Weakness in Critical Ill Patients with ECMO Support: A Retrospective Study

2021 ◽  
Author(s):  
xinyi chen ◽  
xiong lei ◽  
xin xu ◽  
Man Huang
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Muscle Weakness ◽  
Ecmo Support ◽  
Case Report Form ◽  
Mechanical Ventilation Duration ◽  
Critical Ill Patients ◽  
Sum Score ◽  
Icu Acquired Weakness ◽  
Critical Ill

Abstract Background Muscle weakness is exceedingly common in critical illness patients and is well described. However, information on the risk factors of muscle weakness in critically ill patients who received extracorporeal membrane oxygenation (ECMO) support are lacking. Our study aims to clarify the risk factors of ICU-acquired weakness (ICU-AW) in ECMO patients to help early recognize potential weakness. Methods We conducted a retrospective study of critical ill patients who used ECMO during their ICU stay. ICU-AW was diagnosed at the time when patients discharged and had a muscle strength sum score < 48 out of a maximal score of 60. Baseline characters and therapy details were collected from the case report form and inspection report. Results 63 patients receiving ECMO support were divided to ICU-AW group and no ICU-AW group according to the Medical Research Council (MRC) score when discharged. A total of 50 of the 63 patients were diagnosed with ICU-AW. On logistic regression analysis, the use of adrenaline apparently increased the odds of developing ICU-AW (OR=6.8,95%CI 1.19-38.92, p=0.032), and it was independent of all other established risk factors for ICU-AW. Meanwhile, the occurrence of infection during ECMO support significantly increased the risks of ICU-AW (OR=7.3,95% CI 1.28-41.24, p=0.025) and was independently associated with the outcome of ICU-AW. Other factors such as mechanical ventilation duration, steroid use and neuromuscular blockade did not differ significantly between the groups in our analysis. Conclusion Infection during ECMO support and use of adrenaline were found independently associated with the development of ICU-AW.

scholarly journals FP263A COMPARISON BETWEEN BIOIMPEDANCE DATA, LUNG ULTRASONOGRAPHY AND FLUID ACCCUMULATION. THREE CARDS TO DETERMINATE THE STATE OF EUVOLEMIA AND FLUID OVERLOAD IN CRITICAL ILL PATIENTS

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i119-i119
Author(s):  
Francisco Javier Centellas Pérez ◽  
Mercedes Martínez Díaz ◽  
Angela Prado Mira ◽  
Agustín Ortega Cerrato ◽  
Jaime López Tendero ◽  
...  
Keyword(s):  
Fluid Overload ◽  
The State ◽  
Lung Ultrasonography ◽  
Critical Ill Patients ◽  
Critical Ill

Pantoprazole-induced Thrombocytopenia: Unresponsive to Corticosteroid and Thrombocyte Concentrate Transfusion

2021 ◽  
pp. 089719002110647
Author(s):  
Widyati ◽  
Nurul Latifah ◽  
Maya Ramadhani
Keyword(s):  
Platelet Count ◽  
Prophylactic Therapy ◽  
Immune Mechanism ◽  
Drug Induced ◽  
Stress Ulcers ◽  
Present Case Report ◽  
Once Daily ◽  
Mucosal Disease ◽  
Critical Ill Patients ◽  
Critical Ill

Introduction Pantoprazole is a proton pump inhibitor (PPI) class drug that is widely used in the treatment of SRMD (stress-related mucosal disease in critical ill patients. PPI are one class of drugs used commonly both for treatment and prophylactic therapy for stress ulcers in intensive care unit (ICU). Case We report a case of a 51-year old male who was referred to PKU Hospital. He was admitted to ICU with diagnosis of Hyperosmolar Hyperglymic State and bronchopneumonia. Thrombocytopenia was noted in admission. There was more than 70% decrease in platelet count after initiation of pantoprazole. Patient received Thrombocyte Concentrate (TC) transfusion and corticosteroid iv for several days, but only had minor increase in platelet count. The platelets recovered after stopping pantoprazole. Discussion In the present case report, another exposures to parenteral pantoprazole in a dose of 40 mg once daily reproduced the same adverse drug reaction. In comparison to lansoprazole, thrombocytopenia from pantoprazole is more severe that necessitate TC transfusion and corticosteroid trial. However, in the present case, TC transfusion and corticosteroid fail to escalate platelet count. This finding suggests probability of non-immune mechanism of pantoprazole-induced thrombocytopenia. Conclusion Pantoprazole may induce thrombocytopenia with new features that were immediately developed, resulting a decrease in platelet count >70%. The mechanism found in this case may be non-immune. Drug-induced thrombocytopenia is one of the rare complications that has to be kept in mind with the use of pantoprazole.

scholarly journals Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia: A Retrospective Study of 173 Patients in Wuhan, China

2020 ◽  
Author(s):  
Yang Zhang ◽  
Jun Xue ◽  
Mi Yan ◽  
Jing Chen ◽  
Hai Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Model ◽  
Disease Severity ◽  
Roc Curve ◽  
Predictive Value ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Lactic Dehydrogenase ◽  
Older Age ◽  
Hospital Outcome

Abstract Background: COVID-19 is a globally emerging infectious disease. As the global epidemic continues to spread, the risk of COVID-19 transmission and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia from Wuhan. Methods: Patients with COVID-19 pneumonia admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female. The mean age of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension (24.9%). The most common symptoms on admission were fever (67.6%) and cough (60.1%), digestive symptoms (22.0%) was also very common. Older age (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea and lymphopenia need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

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