scholarly journals Risk factors for death of trauma patients admitted to an Intensive Care Unit

2020 ◽  
Vol 28 ◽  
Author(s):  
Maicon Henrique Lentsck ◽  
Rosana Rosseto de Oliveira ◽  
Ligiana Pires Corona ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Prehospital Care ◽  
Multiple Logistic Regression Analysis ◽  
Trauma Patients ◽  
Multiple Logistic Regression ◽  
Factors Associated

Objective: To analyze the risk factors for death of trauma patients admitted to the intensive care unit (ICU). Method: Retrospective cohort study with data from medical records of adults hospitalized for trauma in a general intensive care unit. We included patients 18 years of age and older and admitted for injuries. The variables were grouped into levels in a hierarchical manner. The distal level included sociodemographic variables, hospitalization, cause of trauma and comorbidities; the intermediate, the characteristics of trauma and prehospital care; the proximal, the variables of prognostic indices, intensive admission, procedures and complications. Multiple logistic regression analysis was performed. Results: The risk factors associated with death at the distal level were age 60 years or older and comorbidities; at intermediate level, severity of trauma and proximal level, severe circulatory complications, vasoactive drug use, mechanical ventilation, renal dysfunction, failure to perform blood culture on admission and Acute Physiology and Chronic Health Evaluation II. Conclusion: The identified factors are useful to compose a clinical profile and to plan intensive care to avoid complications and deaths of traumatized patients.

Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Records ◽  
Injury Severity ◽  
University Hospital ◽  
Factors Associated ◽  
Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

scholarly journals Predictors of Mortality in COPD Exacerbation Cases Presenting to the Respiratory Intensive Care Unit

2020 ◽  
Author(s):  
Yang Cao ◽  
Zhenzhen Xing ◽  
Huangyu Long ◽  
Yilin Huang ◽  
Yanfei Guo
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Multiple Logistic Regression Analysis ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Hospital ◽  
Chronic Obstructive ◽  
Record System ◽  
Factors Associated

Abstract Background: Studies report high in-hospital mortality of chronic obstructive pulmonary disease (COPD) exacerbations especially for those who requiring intensive care unit (ICU) admission. Recognizing factors associated with mortality in those patients could reduce healthcare costs and improve end-of-life care. Methods: This retrospective cohort study included 384 patients with AECOPD admitted to the respiratory ICU (RICU) of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristic, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. Results: We finally enrolled 384 AECOPD patients, 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (CHD, 115 (29.9%)) and chronic heart failure (CHF, (76 (19.8%)). Multiple logistic regression analysis revealed the independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia combined with CHF and the requirement for invasive mechanical ventilation (IMV).Conclusions: The in-hospital mortality of patients with COPD exacerbation requiring RICU admission is high. Lymphocytes<0.8×109/L, leukopenia, requirement for IMV, combined with CHF could be identified as risk factors associated with increased mortality rates.

Factors associated with infection amongst paediatric patients with systemic lupus erythematosus treated in the intensive care unit

Lupus ◽  
2019 ◽  
Vol 28 (9) ◽  
pp. 1141-1147 ◽  
Author(s):  
M Restrepo-Escobar ◽  
N A Ríos ◽  
LJ Hernández-Zapata ◽  
M Velásquez ◽  
R Eraso
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Lupus Erythematosus ◽  
Retrospective Cohort ◽  
Systemic Lupus ◽  
Factors Associated ◽  
Multivariate Adjustment

Objective To identify determinants and outcomes associated with infection in paediatric systemic lupus erythematosus (SLE) patients at admission and during hospitalization in intensive care units (ICUs). Patients and methods A retrospective cohort study of paediatric SLE patients admitted to two ICUs was conducted. Frequency and risk factors of infection as well as mortality were studied. Results Seventy-three infection episodes amongst 55 patients were analysed. The median age was 14.4 years (IQR 12.5–16). The median SLEDAI was 16 (IQR 12–20). Twenty-nine episodes were documented at admission; the CRP was higher in these patients (6.58 versus 1.04 mg/dl, p<0.001) than in non-infected patients, even after multivariate adjustment (OR 8.6, 95% CI = 2.1–34.8, p = 0.003). Twenty-five (34.7%) episodes occurred during hospitalization. Lupus activity (OR 1.14, 95% CI = 1.01–1.27, p = 0.029), cyclophosphamide (OR 17.9, 95% CI = 2–156, p = 0.009) and mechanical ventilation (OR 16, 95% CI = 2.1–122, p = 0.008) were associated with infection. Ten episodes (14%) led to death. Admission to the ICU due to infection was strongly associated with mortality (90% versus 31.8%, OR 19.4, 95% CI = 2.3–163, p = 0.006). Conclusion In paediatric lupus patients admitted to the ICU, elevated CRP should alert clinicians to possible infection. During hospitalization, SLE activity and cyclophosphamide were associated with infection. Infection at admission to the ICU was strongly associated with mortality.

scholarly journals Risk factors for acute kidney injury in a pediatric intensive care unit: a retrospective cohort study

Medwave ◽  
2017 ◽  
Vol 17 (03) ◽  
pp. e6940-e6940 ◽  
Author(s):  
Lina María Serna-Higuita ◽  
John Fredy Nieto-Ríos ◽  
Jorge Eduardo Contreras-Saldarriaga ◽  
Juan Felipe Escobar-Cataño ◽  
Luz Adriana Gómez-Ramírez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Pediatric Intensive Care

Outcomes and prognostic factors of patients with anti-melanoma differentiation-associated protein 5 and anti-aminoacyl-RNA synthetase antibodies positive idiopathic inflammatory myopathies in intensive care unit

2020 ◽  
Author(s):  
Shiyao Wang ◽  
Xinran Zhang ◽  
Yanhong Ren ◽  
Yi Zhang ◽  
Ye Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Serum Ferritin ◽  
Factors Associated ◽  
Overall Mortality

Abstract Background: This study aims to identify prognostic factors for mortality of patients with anti-melanoma differentiation-associated protein 5 (anti-MDA5) or anti-aminoacyl-RNA synthetase (anti-ARS) antibodies positive and acute respiratory failure in the intensive care unit.Methods: Clinical characteristics, laboratory test findings, imaging performance, and management were retrospectively collected in all cases with anti-MDA5 and anti-ARS antibodies positive, as well as follow-up survival data. Risk factors related to prognosis were identified by Cox regression analysis.Results: The 28-day mortality of all patients was 68.8% (n=44/64). The patients who died were more likely to have anti-MDA5 antibody(p<0.001), presented more Gottron papules(p=0.021) or heliotrope rash(p=0.008), had a relatively lower level of WBC(p=0.038), CRP(p=0.004), and had a higher level of LDH(p=0.029), serum ferritin(p=0.002). The main risk factors associated with 28-day mortality were anti-MDA5 antibody positive [HR 10.827 (95% CI: 4.261-27.514), p<0.001], presence of Gottron papules [2.299 (1.203-4.394), p=0.012], heliotrope rash [3.423 (1.773-6.606), p<0.001], and arthritis/arthralgia [2.365 (1.130-4.948), p=0.022). At a median of 14 (IQR 6.33-35.0) months of follow-up, the overall mortality of all patients was 75.0% (n=48/64). The non-survivors were more likely to own anti-MDA5 antibody(p<0.001), had a higher rate of Gottron papules(p=0.020) or heliotrope rash(p=0.014), had lower PFR(p=0.032) while ICU admission, and existed a higher level of serum ferritin(p=0.005). Main risk factors associated with overall mortality were consistent with risk factors for 28-day mortality. Conclusions: Anti-MDA5 antibody positive, presence of Gottron papules, heliotrope rash, or arthritis/arthralgia were the main independent risk factors of poor prognosis for IIM patients admitted to the ICU due to acute respiratory failure.

Risk Factors for Falls among Hospitalized Trauma Patients

2013 ◽  
Vol 79 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Carlos V. R. Brown ◽  
Sadia Ali ◽  
Romeo Fairley ◽  
Bryan K. Lai ◽  
Justin Arthrell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Fall Prevention ◽  
Male Gender ◽  
Trauma Patients ◽  
Inpatient Falls ◽  
Serious Injury

Inpatient falls lead to an injury in 30 per cent of cases and serious injury in 5 per cent. Increasing staffing and implementing fall prevention programs can be expensive and require a significant use of resources. We hypothesized that trauma patients have unique risk factors to sustain a fall while hospitalized. This is a retrospective cohort study from 2005 to 2010 of all trauma patients admitted to an urban Level I trauma center. Patients who fell while hospitalized were compared with patients who did not fall to identify risk factors for sustaining an inpatient fall. There were 16,540 trauma patients admitted during the study period and 128 (0.8%) fell while hospitalized. Independent risk factors for a trauma patient to fall while hospitalized included older age (odds ratio [OR], 1.02 [1.01 to 1.03], P < 0.001), male gender (OR, 1.6 [1.0 to 2.4], P = 0.03), blunt mechanism (OR, 5.1 [1.6 to 16.3], P = 0.006), Glasgow Coma Score at admission (OR, 0.59 [0.35 to 0.97], P = 0.04), intensive care unit admission (OR, 2.3 [1.4 to 3.7], P = 0.001), and need for mechanical ventilation (OR, 2.2 [1.2 to 3.9], P = 0.01). Trauma patients who fell while hospitalized sustained an injury in 17 per cent of cases and a serious injury in 5 per cent. Inpatient falls in hospitalized trauma patients are uncommon. Risk factors include older age, male gender, blunt mechanism, lower Glasgow Coma Score, and the need for intensive care unit admission or mechanical ventilation. Trauma patients with these risk factors may require higher staffing ratios and should be enrolled in a formal fall prevention program.

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