Association Between Poverty and Intensive Care Unit Admission and Clinical Outcomes Among Critically Ill Patients: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Danbee Kang ◽  
Hyejeong Park ◽  
Sungkeun Shim ◽  
Minwoong Kang ◽  
Jeonghyun Park ◽  
...  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Roberto Carlos Miranda-Ackerman ◽  
Mariana Lira-Trujillo ◽  
Alma Carolina Gollaz-Cervantez ◽  
Ana Olivia Cortés-Flores ◽  
Carlos José Zuloaga-Fernández del Valle ◽  
...  

2015 ◽  
Vol 29 (4) ◽  
pp. 324-335 ◽  
Author(s):  
Daren K Heyland ◽  
Peter Dodek ◽  
Sangeeta Mehta ◽  
Deborah Cook ◽  
Allan Garland ◽  
...  

Background: Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. Aim: To describe family members’ perspectives about care provided to very elderly critically ill patients. Design: Multicenter, prospective, cohort study. Participants and setting: In total, 535 family members of patients aged 80 years or older admitted to 22 intensive care units for more than 24 h. Results: Family members reported that the “patient be comfortable and suffer as little as possible” was their most important value and “the belief that life should be preserved at all costs” was their least important value considered in making treatment decisions. Most family members (57.9%) preferred that life support be used for their family member, whereas 24.1% preferred comfort measures only, and 14.4% were unsure of their treatment preferences. Only 57.3% reported that a doctor had talked to them about treatment options for the patient. Overall, 29.7% of patients received life-sustaining treatments for more than 7 days and 50.3% of these died in hospital. Families were most satisfied with the skill and competency of nurses and least satisfied with being included and supported in the decision-making process and with their sense of control over the patient’s care. Conclusion: There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.


2012 ◽  
Vol 27 (2) ◽  
pp. 65 ◽  
Author(s):  
Jaehwa Cho ◽  
Hun Jae Lee ◽  
Sang-Bum Hong ◽  
Gee Young Suh ◽  
Moo Suk Park ◽  
...  

Author(s):  
Charles Chin Han Lew ◽  
Gabriel Jun Yung Wong ◽  
Ka Po Cheung ◽  
Ai Ping Chua ◽  
Mary Foong Fong Chong ◽  
...  

There is limited evidence for the association between malnutrition and hospital mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 hours of ICU admission. Multivariate analyses were conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point decrease in the 7-point SGA]. No significant association was found between malnutrition and ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helen Teklie ◽  
Hywet Engida ◽  
Birhanu Melaku ◽  
Abdata Workina

Abstract Background The transfer time for critically ill patients from the emergency department (ED) to the Intensive care unit (ICU) must be minimal; however, some factors prolong the transfer time, which may delay intensive care treatment and adversely affect the patient’s outcome. Purpose To identify factors affecting intensive care unit admission of critically ill patients from the emergency department. Patients and methods A cross-sectional study design was conducted from January 13 to April 12, 2020, at the emergency department of Tikur Anbesa Specialized Hospital. All critically ill patients who need intensive care unit admission during the study period were included in the study. A pretested structured questionnaire was adapted from similar studies. The data were collected by chart review and observation. Then checked data were entered into Epi-data version 4.1 and cleaned data was exported to SPSS Version 25 for analysis. Descriptive statistics, bivariate and multivariate logistic regression were used to analyze the data. Result From the total of 102 critically ill patients who need ICU admission 84.3% of them had prolonged lengths of ED stay. The median length of ED stay was 13.5 h with an IQR of 7–25.5 h. The most common reasons for delayed ICU admission were shortage of ICU beds 56 (65.1%) and delays in radiological examination results 13(15.1%). On multivariate logistic regression p < 0.05 male gender (AOR = 0.175, 95% CI: (0.044, 0.693)) and shortage of ICU bed (AOR = 0.022, 95% CI: (0.002, 0.201)) were found to have a significant association with delayed intensive care unit admission. Conclusion there was a delay in ICU admission of critically ill patients from the ED. Shortage of ICU bed and delay in radiological investigation results were the reasons for the prolonged ED stay.


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