scholarly journals Incidence of falls in a cohort of critical adults: a cause for concerns?

2020 ◽  
Vol 41 (spe) ◽  
Author(s):  
Andréia Martins Specht ◽  
Gabriele Peres de Sousa ◽  
Mariur Gomes Beghetto
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Confidence Interval ◽  
Descriptive Analysis ◽  
Adult Intensive Care Unit ◽  
Care Practices ◽  
South Of Brazil ◽  
Safe Care ◽  
Made In

ABSTRACT Objective: To describe the incidence and to report the cases of falls in a cohort of critical adults. Method: A prospective cohort study, conducted in 2018 at an adult Intensive Care Unit (ICU) in the south of Brazil. The patients were followed up from admission to discharge; observations were made in the morning and afternoon. The clinical and care variables were evaluated. The descriptive analysis was performed followed by the reporting of the cases. Results: 551 patients were monitored during 6 [3-12.7] days of hospitalization, generating 7,839 observations. There were four cases of falls, with an incidence rate of 5.1/10.000 observations/day - confidence interval of 99% [0.9 to 16] and density of incidence of 7/10.000 observations/day - confidence interval of 99% [1.2 to 22]. No serious harms were observed. Conclusion: Falls occur less in the ICU, which can be explained by the use of safe care practices.

scholarly journals Incidence of injuries confused with pressure injuries in oncology intensive care unit

2019 ◽  
Author(s):  
José Pires Júnior ◽  
Eline Borges ◽  
Josimare Spira
Keyword(s):  
Body Mass Index ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Ethics Committee ◽  
Normal Body Mass Index ◽  
Inclusion Criteria ◽  
Skin Changes ◽  
Adult Intensive Care Unit ◽  
Belo Horizonte

Objectives: Estimate the incidence of the confounding lesions (CL) with pressure injuries in an intensive care unit of an oncology hospital, to characterize the patients and the confused injuries. Methods: Prospective cohort study conducted in an adult intensive care unit of an oncology hospital in Belo Horizonte, Minas Gerais. The sample consisted of 67 patients who met the inclusion criteria. The data were collected during the period of one month by single researcher stomatherapist and registered in the form prepared for this purpose. The study was approved by the Research Ethics Committee. Results: 58.1% were women, 65.1% were elderly, 51.2% were white, with gastrointestinal cancer predominating, 71.6% were using adjuvant chemotherapy, with below-normal body mass index, 100% had urinary incontinence or fecal and diaper use. The incidence of these injuries was 35.8%, and the average time for their onset was 11 days after admission. Most patients had skin changes such as maceration, peeling, erythema, dehydration, and edema. Conclusion: We can conclude that the incidence of confused injuries is high in oncology patients admitted to intensive care units. It was possible to describe the demographic and clinical profile of the patients of the sample and to characterize the injuries and the skin around them.

scholarly journals The clinical implications of sinus tachycardia in mild COVID-19 infection: A retrospective cohort study

2021 ◽  
Vol 9 ◽  
pp. 205031212110549
Author(s):  
Jenny Yi Chen Hsieh ◽  
Juliana Yin Li Kan ◽  
Shaikh Abdul Matin Mattar ◽  
Yan Qin
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Sinus Tachycardia ◽  
High Dependency ◽  
General Wards

Objectives: This study aims to estimate the prevalence of sinus tachycardia in hospitalized patients with mild COVID-19 infection and to identify the clinical, radiological, and biological characteristics associated with sinus tachycardia. Methods: A retrospective cohort study was conducted on patients with mild COVID-19 infection and sinus tachycardia during hospitalization. Outcomes measured included incidences of venous thromboembolism, high-dependency/intensive care unit admission, laboratory parameters, and radiological findings. Results: A total of 236 COVID-19 positive patients admitted to Singapore General Hospital isolation general wards from 1 June 2020 to 30 June 2020 were included in this study. Ninety-seven (41.1%) patients had sinus tachycardia on or during their admission. All patients were monitored in general wards and discharged to community quarantine facilities. None required oxygen support or high-dependency/intensive care unit admission. Sinus tachycardia was associated with increased C-reactive protein level (odds ratio = 1.033, 95% confidence interval = 1.002–1.066), abnormal chest X-ray findings (odds ratio = 3.142, 95% confidence interval = 1.390–7.104), and longer hospitalization (odds ratio = 1.117, 95% confidence interval = 1.010–1.236). There was no significant statistical association between sinus tachycardia and incidences of venous thromboembolism. Conclusion: This study suggests that patients with mild COVID-19 infection and concurrent sinus tachycardia are more likely to have higher inflammatory marker levels, abnormal imaging, and prolonged hospitalization. However, no significant association between sinus tachycardia and thromboembolism is identified in mild COVID-19 infection.

Obesity-related excess mortality rate in an adult intensive care unit: A risk-adjusted matched cohort study*

2004 ◽  
Vol 32 (4) ◽  
pp. 998-1003 ◽  
Author(s):  
Nicolas Bercault ◽  
Thierry Boulain ◽  
Kaldhoun Kuteifan ◽  
Manuel Wolf ◽  
Isabelle Runge ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Mortality Rate ◽  
Excess Mortality ◽  
Matched Cohort ◽  
Adult Intensive Care Unit ◽  
Matched Cohort Study

scholarly journals Effect of maternal near miss on neonatal mortality in selected hospitals: Prospective cohort study, Southeast Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110422
Author(s):  
Ahmednur Adem Aliyi ◽  
Negussie Deyessa ◽  
Mengistu Yilma Dilnessie
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Confidence Interval ◽  
Neonatal Mortality ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
History Of

Objective: The objective of this study was to assess effect of maternal near miss on neonatal mortality. Methods: Prospective cohort study was conducted on 384 pregnant women who came for delivery to purposely selected hospitals. The cohort was made up of 128 exposed (near miss) mothers and 256 non-exposed (non-near-miss) mothers. Women who came for delivery were only included. Those who came for services other than delivery such as abortion care, women who developed life-threatening condition not related to delivery, and those who come from no phone network area were excluded. A purposive sampling technique was used by including all mothers with near miss consecutively until the required sample size was obtained. Two non-near-miss mothers were selected using lottery for every near-miss mother. Survival analysis was done for both groups using Cox regression to look for effect of maternal near miss on neonatal mortality. Verbal informed consent from study participants was obtained. Results: A total of 354 (118 with near miss and 236 without near miss) women completed the follow-up time, yielding response rate of 92.2%. Of all, 55 (15.5%) of them have previous history of abortion, 44 (12.4%) were admitted to the intensive care unit during delivery, and 22 (6.2%) have history of past delivery of still birth. Severe preeclampsia with intensive care unit admission and severe anemia with transfusion of greater than 2 units of blood were common complications leading to maternal near miss. There were 17 (48 per 1000 live birth) neonatal death at the end of the study, of which 15 occurred among mothers with near miss. Monthly income (adjusted hazard ratio = 998, 95% confidence interval = 0.996–0.999), fetal presentation (adjusted hazard ratio = 6.48, 95% confidence interval = 1.84–22.73), APGAR score (adjusted hazard ratio = 0.746, 95% confidence interval = 0.620–0.898), and being near miss mother (adjusted hazard ratio = 8.40, 95% confidence interval = 1.638–43.118) were significantly affecting neonatal mortality. Conclusion: Maternal near miss and other fetal and general maternal characteristics have effect on occurrence of neonatal mortality. Therefore, due attention should be given to these factors for improvement of neonatal survival.

scholarly journals Standardization of the duty shift in a General Adult Intensive Care Unit

2019 ◽  
Vol 72 (suppl 1) ◽  
pp. 88-95
Author(s):  
Roselene Campos Corpolato ◽  
Maria de Fátima Mantovani ◽  
Mariluci Hautsch Willig ◽  
Luciana Aparecida Soares de Andrade ◽  
Ângela Taís Mattei ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Delphi Technique ◽  
Descriptive Analysis ◽  
Standard Operating Procedure ◽  
Communication Failure ◽  
Adult Intensive Care Unit ◽  
Intensive Care Nurses ◽  
Transmission Of Information ◽  
Structured Questionnaire

ABSTRACT Objective: To standardize the duty shift in a General Adult Intensive Care Unit. Method: Multi-method research, which used action research, descriptive study and content validation. Participants included 11 care nurses and 4 intensive care nurses. For the data collection, a semi-structured questionnaire was used, meetings with participants and validation with specialists. In this step, the modified online Delphi Technique was used. For data treatment, the Discourse of the Collective Subject (DCS) was used, descriptive analysis and Content Validity Index. Results: Three DCS on duty change, a Standard Operating Procedure (SOP) and an information registration instrument, validated in appearance, clarity, suitability and content. Final considerations: The instrument assists in the transmission of information, strengthening patient safety and SOP will outline the shift, these tools can improve ICU shift, minimizing the risks of communication failure.

scholarly journals The FRAIL-FIT study: Frailty’s relationship with adverse-event incidence in the longer term, at one year following intensive care unit treatment – A retrospective observational cohort study

2019 ◽  
Vol 21 (2) ◽  
pp. 124-133 ◽  
Author(s):  
David Hewitt ◽  
Malcolm G Booth
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Confidence Interval ◽  
Observational Cohort Study ◽  
Clinical Frailty Scale ◽  
Frail Patients ◽  
Observational Cohort ◽  
One Year ◽  
Retrospective Observational Cohort Study

Introduction Frailty is a syndrome of decreased reserve and heightened vulnerability. Frailty scoring has potential to facilitate more informed decisions in the intensive care unit. To validate this, its relationship with outcomes must be tested extensively. This study aimed to investigate frailty’s impact on adverse outcomes after intensive care unit admission, primarily one-year mortality. Methods This single-centre retrospective observational cohort study examined prospectively collected data from 400 intensive care unit patients. Frailty was assessed using the Clinical Frailty Scale and defined as Clinical Frailty Scale ≥ 5. Unadjusted and adjusted analyses tested the relationships of frailty, covariates and outcomes. Results Of 400 eligible patients, 111 (27.8%) were frail and 289 (72.3%) were non-frail. Compared to non-frail patients, frail patients were older (62 vs. 56, p < 0.001) and had higher Acute Physiology and Chronic Health Evaluation II scores (22 vs. 19, p < 0.001). Females were more likely to be frail than males (34.1% vs. 22.9% frail, p = 0.018). Frail patients were less likely to survive the intensive care unit (p = 0.03), hospital (p = 0.003) or to one year (p < 0.001). Frailty significantly increased one-year mortality hazards in unadjusted analyses (hazard ratio 1.96; 95% confidence interval 1.41–2.72; p < 0.001) and covariate adjusted analyses (hazard ratio 1.41; 95% confidence interval 1.00–1.98; p = 0.0497). Frail patients had more hospital admissions (p = 0.014) and longer hospital stays within both one year before (p = 0.002) and one year after intensive care unit admission (p = 0.012). Conclusions Frailty was common and associated with greater age, female gender, higher sickness severity and more healthcare use. Frailty was significantly associated with greater risks of mortality in both unadjusted and adjusted analyses. Frailty scoring is a promising tool which could improve decision making in intensive care.

Multicentric study of monitoring alarms in the adult intensive care unit (ICU): a descriptive analysis

1999 ◽  
Vol 25 (12) ◽  
pp. 1360-1366 ◽  
Author(s):  
M.-C. Chambrin ◽  
P. Ravaux ◽  
D. Calvelo-Aros ◽  
A. Jaborska ◽  
C. Chopin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Descriptive Analysis ◽  
Multicentric Study ◽  
Adult Intensive Care Unit
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