scholarly journals Association of hormonal changes with disease severity and mortality rate in critically ill patients

2015 ◽  
Author(s):  
Neslihan Cuhaci ◽  
Berna Ogmen ◽  
Cihan Doger ◽  
Burcak Polat ◽  
Seval Izdes ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hormonal Changes

scholarly journals Association of Hormonal Changes with Disease Severity and Mortality in Critically-ill Patients

2017 ◽  
Vol 21 (1) ◽  
pp. 1-8
Author(s):  
Neslihan Çuhacı ◽  
Berna Öğmen ◽  
Cihan Doğer ◽  
Burçak Polat ◽  
Seval İzdeş ◽  
...  
Keyword(s):  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hormonal Changes

scholarly journals Prognostic impact of elevated lactate levels on mortality in critically ill patients with and without preadmission metformin treatment: a Danish registry-based cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rene A. Posma ◽  
Trine Frøslev ◽  
Bente Jespersen ◽  
Iwan C. C. van der Horst ◽  
Daan J. Touw ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
Lower Mortality ◽  
Prognostic Impact ◽  
Icu Admission ◽  
Lactate Levels ◽  
Restricted Cubic Splines

Abstract Background Lactate is a robust prognostic marker for the outcome of critically ill patients. Several small studies reported that metformin users have higher lactate levels at ICU admission without a concomitant increase in mortality. However, this has not been investigated in a larger cohort. We aimed to determine whether the association between lactate levels around ICU admission and mortality is different in metformin users compared to metformin nonusers. Methods This cohort study included patients admitted to ICUs in northern Denmark between January 2010 and August 2017 with any circulating lactate measured around ICU admission, which was defined as 12 h before until 6 h after admission. The association between the mean of the lactate levels measured during this period and 30-day mortality was determined for metformin users and nonusers by modelling restricted cubic splines obtained from a Cox regression model. Results Of 37,293 included patients, 3183 (9%) used metformin. The median (interquartile range) lactate level was 1.8 (1.2–3.2) in metformin users and 1.6 (1.0–2.7) mmol/L in metformin nonusers. Lactate levels were strongly associated with mortality for both metformin users and nonusers. However, the association of lactate with mortality was different for metformin users, with a lower mortality rate in metformin users than in nonusers when admitted with similar lactate levels. This was observed over the whole range of lactate levels, and consequently, the relation of lactate with mortality was shifted rightwards for metformin users. Conclusion In this large observational cohort of critically ill patients, early lactate levels were strongly associated with mortality. Irrespective of the degree of hyperlactataemia, similar lactate levels were associated with a lower mortality rate in metformin users compared with metformin nonusers. Therefore, lactate levels around ICU admission should be interpreted according to metformin use.

Glucocorticoid Sensitivity Is Highly Variable in Critically Ill Patients With Septic Shock and Is Associated With Disease Severity*

2016 ◽  
Vol 44 (6) ◽  
pp. 1034-1041 ◽  
Author(s):  
Jeremy Cohen ◽  
Carel J. Pretorius ◽  
Jacobus P. J. Ungerer ◽  
John Cardinal ◽  
Antje Blumenthal ◽  
...  
Keyword(s):  
Septic Shock ◽  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Glucocorticoid Sensitivity

Characteristics and Outcomes of Critically Ill Patients with COVID-19 Disease in Jordan

2020 ◽  
pp. 1-3
Author(s):  
Hasan Ibrahim Al-Balas ◽  
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Hospital ◽  
Published Data ◽  
First Case ◽  
Global Health Care ◽  
Novel Coronavirus ◽  
Overall Mortality

Introduction: Coronavirus disease 2019 (COVID-19) is an emerging global health care threat that is caused by a novel coronavirus named 2019-nCoV (SARS-CoV-2). The first case of diagnosed COVID-19 patient was declared in Jordan in early March 2020. As of June 8, Jordan had confirmed 831 cases, with 9 deaths, with an overall mortality rate of 1.08%. As there is no published data about critically ill patients in Jordan, we aimed to describe the characteristics and outcomes of critically ill COVID-19 patients in a tertiary hospital in Jordan.

scholarly journals Low albumin levels are associated with poorer outcomes in a case series of COVID-19 patients in Spain: a retrospective cohort study

2020 ◽  
Author(s):  
Roberto de la Rica ◽  
Marcio Borges ◽  
María Aranda ◽  
Alberto del Castillo ◽  
Antonia Socias ◽  
...  
Keyword(s):  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Case Series ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Limited Information ◽  
Icu Patients ◽  
Epidemiological Features ◽  
Initial Symptoms

ABSTRACTOBJECTIVETo describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior hospitalization, in one of the main hospitals in The Balearic Islands health care system.DESIGNRetrospective observational studySETTINGSon Llatzer University Hospital in Palma de Mallorca (Spain)PARTICIPANTSAmong a cohort of 52 hospitalized patients as of 31 March 2020, 48 with complete demographic information and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test, were analyzed. Data were collected between March 15th, 2020, and March 31th 2020, inclusive of these dates.MAIN OUTCOMESClinical, vital signs and routine laboratory outcomes at the time of hospitalization, including symptoms reported prior to hospitalization. Demographics and baseline comorbidities were also collected. Mortality was reported at the end of the study.RESULTS48 patients (27 non-ICU and 21 ICU) resident in Mallorca, Spain (mean age, 66 years, [range, 33-88 years]; 67% males) with positive SARS-CoV-2 infection were analyzed. There were no differences in age or sex among groups (p >.05). Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). The majority of patients in this case series were hospitalized because of low SpO2 (SpO2 below 90%) and presentation of bilateral pneumonia (94%) at triage. ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs 61%, p = .022). Acute respiratory syndrome (ARDS) was presented in 100% of the ICU-patients. All the patients included in the study required oxygen therapy. ICU-patients had lymphopenia as well as hypoalbuminemia. Inflammatory markers such as lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < .001).Lower albumin levels were associated with poor prognosis measured as longer hospital length (r= −0.472, p <.001) and mortality (r= −0.424, p=.003). Interestingly we also found, that MCV was lower among of those patients who died (p=.0002). As of April 28, 2020, 10 patients (8 ICU and 2 non-ICU) had died (21% mortality) and while 100% of the non-ICU patients had been discharged, 33% of ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward).CONCLUSIONCritically ill patients with COVID-19 present lymphopenia, hypoalbuminemia as well high levels of inflammation. Lower levels of albumin were associated with poorer outcomes in COVID-19 patients. Albumin might be of importance because of its association with disease severity in patients infected with SARS-CoV-2.WHAT IS ALREADY KNOWN IN THIS TOPICSpain has been hit particularly hard by the pandemic. By the time that this manuscript was written more than 25.000 deaths related to COVID-19 have been confirmed. There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for COVID-19. Also, it is important to know the characteristics of the hospitalized patients who become critically illWHAT THIS STUDY ADDSThis small case series provides the first steps towards a comprehensive clinical characterization of severe and critical COVID-19 adult patients in Spain. The overall mortality in our patients was 21%. To our knowledge this is the first report with reporting these features in Spain. At triage the majority of patients had lower SpO2 (<90%) and bilateral pneumonia. The most common comorbidities were hypertension (70%), dyslipidemia (62%) and cardiovascular disease (30%). Critically ill patients present hypoalbuminemia and lymphopenia, as well as higher levels of inflammation. Albumin might be of importance because of its association with disease severity and mortality in patients infected with SARS-CoV-2.

scholarly journals Critically Ill vs. Non-Critically Ill Patients With COVID-19 Pneumonia: Clinical Features, Laboratory Findings, and Prediction

2021 ◽  
Vol 11 ◽  
Author(s):  
Wandong Hong ◽  
Qin Chen ◽  
Songzan Qian ◽  
Zarrin Basharat ◽  
Vincent Zimmer ◽  
...  
Keyword(s):  
Critical Illness ◽  
Disease Severity ◽  
Critically Ill ◽  
Clinical Features ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Discharge Rate ◽  
Laboratory Data ◽  
Laboratory Findings ◽  
Laboratory Parameters

ObjectivesThe objective of this study was to investigate the clinical features and laboratory findings of patients with and without critical COVID-19 pneumonia and identify predictors for the critical form of the disease.MethodsDemographic, clinical, and laboratory data of 63 COVID-19 pneumonia patients were retrospectively reviewed. Laboratory parameters were also collected within 3–5 days, 7–9 days, and 11–14 days of hospitalization. Outcomes were followed up until March 12, 2020.ResultsTwenty-two patients developed critically ill pneumonia; one of them died. Upon admission, older patients with critical illness were more likely to report cough and dyspnoea with higher respiration rates and had a greater possibility of abnormal laboratory parameters than patients without critical illness. When compared with the non-critically ill patients, patients with serious illness had a lower discharge rate and longer hospital stays, with a trend towards higher mortality. The interleukin-6 level in patients upon hospital admission was important in predicting disease severity and was associated with the length of hospitalization.ConclusionsMany differences in clinical features and laboratory findings were observed between patients exhibiting non-critically ill and critically ill COVID-19 pneumonia. Non-critically ill COVID-19 pneumonia also needs aggressive treatments. Interleukin-6 was a superior predictor of disease severity.

scholarly journals N-terminal pro-brain natriuretic peptide and high-sensitivity troponin T exhibit additive prognostic value for the outcome of critically ill patients

2018 ◽  
Vol 9 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Max Lenz ◽  
Konstantin A Krychtiuk ◽  
Georg Goliasch ◽  
Klaus Distelmaier ◽  
Johann Wojta ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Brain Natriuretic Peptide ◽  
Critically Ill ◽  
Natriuretic Peptide ◽  
Critically Ill Patients ◽  
Plasma Levels ◽  
Troponin T ◽  
High Sensitivity ◽  
The Individual

Background: Patients treated at medical intensive care units suffer from various pathologies and often present with elevated troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Both markers may reflect different forms of cardiac involvement in critical illness. Therefore, the aim of our study was to examine the synergistic prognostic potential of NT-proBNP and high-sensitivity TnT (hs)TnT in unselected critically ill patients. Methods: We included all consecutive patients admitted to our intensive care unit within one year, excluding those suffering from acute myocardial infarction or undergoing cardiac surgery and measured NT-proBNP and TnT plasma levels on the day of admission and 72 hours thereafter. Results: Of the included 148 patients, 52% were male, mean age was of 64.2 ± 16.8 years and 30-day mortality was 33.2%. Non-survivors showed significantly higher NT-proBNP and TnT plasma levels as compared with survivors ( p<0.01). An elevation of both markers exhibited an additive effect on mortality, as those with both NT-proBNP and TnT levels above the median had a 30-day mortality rate of 51.0%, while those with both markers below the median had a 16.7% mortality rate (hazard ratio 3.7). These findings were independent of demographic and clinical parameters ( p<0.05). Conclusions: Our findings regarding the individual predictive properties of NT-proBNP and TnT are in line with literature. However, we were able to highlight that they exhibit additive prognostic potential which exceeds their individual value. This might be attributed to a difference in underlying pathomechanisms and an assessment of synergistic risk factors.

scholarly journals Tigecycline Therapy for Nosocomial Pneumonia due to Carbapenem-Resistant Gram-Negative Bacteria in Critically Ill Patients Who Received Inappropriate Initial Antibiotic Treatment: A Retrospective Case Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaomai Wu ◽  
Yefei Zhu ◽  
Qiuying Chen ◽  
Liuyang Gong ◽  
Jian Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Critically Ill ◽  
Nosocomial Pneumonia ◽  
Critically Ill Patients ◽  
Standard Dose ◽  
High Dose ◽  
Gram Negative Bacteria ◽  
Loading Dose ◽  
Icu Mortality ◽  
Carbapenem Resistant

Background. Nosocomial pneumonia due to carbapenem-resistant Gram-negative bacteria (CRGNB) is a growing concern because treatment options are limited and the mortality rate is high. The effect of tigecycline (TGC) on nosocomial pneumonia due to CRGNB in patients who have received inappropriate initial empiric antibiotic treatment (IIAT) is unclear. Therefore, this study aimed to examine the effect of TGC on nosocomial pneumonia due to CRGNB in critically ill patients who had received IIAT. Methods. A retrospective study was conducted in an adult respiratory intensive care unit. Data were obtained and analyzed for all patients who were treated with TGC ≥ 3 days for microbiologically confirmed nosocomial pneumonia due to CRGNB and had experienced initial antibiotic failure. Clinical and microbiological outcomes were investigated. Results. Thirty-one patients with hospital-acquired pneumonia or ventilator-associated pneumonia were included in the study. The majority of the responsible organisms were carbapenem-resistant Acinetobacter baumannii (67.7%), followed by Klebsiella pneumoniae (16.1%) and Escherichia coli (9.7%). Twenty patients were treated with high-dose TGC therapy (100 mg every 12 h after a 200 mg loading dose), and the others received a standard-dose therapy (50 mg every 12 h after a 100 mg loading dose). The duration of TGC therapy was 14.3±2.8 days. The global clinical cure rate and the microbiological eradication rate were 48.4% and 61.3%, respectively. The overall ICU mortality rate was 45.2%. A higher score on the Acute Physiology and Chronic Health Evaluation II and a longer duration of IIAT were associated with clinical failure. High-dose TGC therapy had a higher clinical success rate [65.0% (13/20) versus 18.2% (2/11), P=0.023] and a lower ICU mortality rate [30.0% (6/20) versus 72.7% (8/11), P=0.031] than the standard-dose therapy. Conclusions. TGC, especially a high-dose regimen, might be a justifiable option for critically ill patients with nosocomial pneumonia due to CRGNB who have received IIAT when the options for these patients are limited.

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