Outcome of Early Mobilization of Critically Ill Patients: A Propensity Score Matching Trial

2018 ◽  
Vol 04 (03) ◽  
Author(s):  
Waleed Tharwat Aletreby ◽  
Shahzad Ahmed Mumtaz ◽  
Abdulrahman Mishaal Al Harthy ◽  
Saima Akhtar Shahzad ◽  
Omar Elsayed Ramadan ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Early Mobilization ◽  
Matching Trial

scholarly journals Adjunctive Therapy with Ascorbic in Critically Ill Patients with COVID-19: A Multicenter Propensity Score Matched Study

2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Hisham A. Badreldin ◽  
Khalid Bin Salah ◽  
Abdullah Al Harthi ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lower Incidence ◽  
Adjunctive Therapy ◽  
P Value ◽  
Relative Safety ◽  
Severity Scores

Abstract Background: Due to its supposed clinical efficacy, relative safety, and low cost, ascorbic acid represents an appealing option for clinicians to utilize in the context of a global health pandemic of COVID-19 patients.Objectives: The aim of this study was to evaluate the efficacy and safety of using ascorbic acid as adjunctive therapy in critically ill patients with COVID-19. Methods: This was a multi-center, non-interventional, retrospective cohort study. All critically ill adult patients admitted to ICU with a confirmed COVID-19 between March 1st to December 31st, 2020 were included in the final analysis. The study was conducted at two large governmental tertiary hospitals in Saudi Arabia. The purpose was to investigate the association between clinical outcomes with ascorbic acid use as an adjunctive therapy in COVID-19 after propensity score matching using baseline severity scores, systemic use of corticosteroids and study centers. Results: A 739 patients were included in this study; 296 patients were included after propensity score matching. There was no association between the administration of ascorbic acid and in-hospital mortality nor 30-day ICU mortality (OR (95%CI): 0.77 (0.476, 1.234), p-value=0.2738 and OR (95%CI): 0.73 (0.438 ,1.204), p-value=0.215 respectively). Using ascorbic acid was associated with lower incidence of thrombosis compared with the non-ascorbic acid group (6.1% vs. 13% respectively); OR (95%CI): 0.42 (0.184, 0.937), p-value=0.0342).Conclusion: Ascorbic acid use as an adjunctive therapy in COVID19 critically ill patients was not associated with mortality benefits; but associated with lower incidence of thrombosis. Further studies are required to confirm these findings.

scholarly journals Evaluation of Zinc Sulfate as an Adjunctive Therapy in COVID-19 Critically Ill Patients: a Two Center Propensity-score Matched Study

2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Abdulrahman I Al Shaya ◽  
Abdullah Kharbosh ◽  
Raed Kensara ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Adjunctive Therapy ◽  
Zinc Sulfate ◽  
Kidney Injury ◽  
Icu Stay ◽  
Increased Risk ◽  
Beta Coefficient

Abstract Background: Zinc is a trace element that plays a role in stimulating innate and acquired immunity. The role of zinc in critically ill patients with COVID-19 remains unclear. This study aims to evaluate the efficacy and safety of zinc sulfate as adjunctive therapy in critically ill patients with COVID-19.Methods: Patients aged ≥ 18 years with a COVID-19 who were admitted to the intensive care unit (ICU) in two tertiary hospitals in Saudi Arabia were retrospectively assessed for zinc use, from 01 March 2020 until 31-December 2020. We assessed the association of zinc use as adjunctive therapy with the in-hospital and 30-day mortality after propensity score matching. Secondary outcomes included mechanical ventilation (MV) duration, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay. Results: A total of 266 patients were included in this study after using propensity score matching. Zinc sulfate as adjunctive therapy during ICU stay was not associated with statistically significant reduction in 30-day mortality nor in-hospital mortality compared to those who did not receive zinc (HR= 0.65 CI = 0.41,1.01; p= 0.05 and HR= 0.67 CI = 0.45,1.00; p= 0.05; respectively). Moreover, MV duration (Beta coefficient 0.10 CI = -0.19,0.39; p= 0.48), ICU LOS (Beta coefficient 0.19 CI = -0.02,0.40; p=0.08) and hospital LOS (Beta coefficient 0.15 CI = -0.02,0.32; p=0.08) were not statistically significant between the two groups. Patients who received zinc have a higher odds of acute kidney injury (AKI) during ICU stay (OR= 1.80 CI = 1.08-3.0; p= 0.02). Conclusion: Zinc sulfate as adjunctive therapy in critically ill patients with COVID-19 may have survival benefit; however, was not statistically significant. Zinc use was linked with an increased risk of AKI development during ICU stay.

scholarly journals Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

Critical Care ◽  
2012 ◽  
Vol 16 (3) ◽  
pp. R105 ◽  
Author(s):  
Francisco J González de Molina ◽  
Cristóbal León ◽  
Sergio Ruiz-Santana ◽  
Pedro Saavedra ◽  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Attributable Mortality ◽  
Propensity Score Matching Analysis

scholarly journals Early oseltamivir treatment improves survival in critically ill patients with influenza pneumonia

2021 ◽  
pp. 00888-2020
Author(s):  
Gerard Moreno ◽  
Alejandro Rodríguez ◽  
Jordi Sole-Violán ◽  
Ignacio Martín-Loeches ◽  
Emili Díaz ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Early Treatment ◽  
Survival Rates ◽  
Icu Mortality ◽  
Icu Length Of Stay ◽  
Influenza Pneumonia

Background and aimsThe relationship between early oseltamivir treatment (within 48 h of symptom onset) and mortality in patients admitted to intensive care units (ICUs) with severe influenza is disputed. This study aimed to investigate the association between early oseltamivir treatment and ICU mortality in critically ill patients with influenza pneumonia.MethodsThis was an observational study of patients with influenza pneumonia admitted to 184 ICUs in Spain. The primary outcome was to evaluate the association between early oseltamivir treatment and ICU mortality compared to later treatment. Secondary outcomes were to compare the duration of mechanical ventilation (MV) and the ICU length of stay between the early and later oseltamivir treatment groups. To reduce biases related to observational studies, propensity score matching and a competing risk analysis were performed.ResultsDuring the study period, 2124 met the inclusion criteria. All patients had influenza pneumonia and received oseltamivir before ICU admission. Of these, 529 (24.9%) received early oseltamivir treatment. In the multivariate analysis, early treatment was associated with reduced ICU mortality (OR 0.69, 95% CI 0.51–0.95). After propensity score matching, early oseltamivir treatment was associated with improved survival rates in the Cox regression (HR 0.77, 95% CI 0.61–0.99) and competing risk (sHR 0.67, 95% CI 0.53–0.85) analyses. The ICU length of stay and duration of MV were shorter in patients receiving early treatment.ConclusionsEarly oseltamivir treatment is associated with improved survival rates in critically ill patients with influenza pneumonia and may decrease ICU length of stay and MV duration.

scholarly journals Ascorbic acid as an adjunctive therapy in critically ill patients with COVID-19: a propensity score matched study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Aljuhani ◽  
Khalid Bin Saleh ◽  
Hisham A. Badreldin ◽  
Abdullah Al Harthi ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lower Incidence ◽  
Adjunctive Therapy ◽  
Low Dose ◽  
P Value ◽  
Severity Scores

AbstractAscorbic acid represents an appealing option for clinicians to utilize in the context of the global COVID-19 pandemic due to its proposed clinical efficacy, relative safety, and low cost. The aim of this study was to evaluate the efficacy and safety of using ascorbic acid in supplemental doses as adjunctive therapy for patients critically ill with COVID-19. This was a two-center, non-interventional, retrospective cohort study. All critically ill adult patients admitted to ICU with a confirmed COVID-19 diagnosis between March 1st and December 31st, 2020, were included in the final analysis. The study was conducted at two large governmental tertiary hospitals in Saudi Arabia. The purpose was to investigate the clinical outcomes of low-dose ascorbic acid as adjunctive therapy in COVID-19 after propensity score matching using baseline severity scores, systematic use of corticosteroids, and study centers. A number of 739 patients were included in this study, among whom 296 patients were included after propensity score matching. There was no association between the administration of ascorbic acid and in-hospital mortality or the 30-day mortality [OR (95% CI) 0.77 (0.47, 1.23), p value = 0.27 and OR (95% CI) 0.73 (0.43, 1.20), p value = 0.21, respectively]. Using ascorbic acid was associated with a lower incidence of thrombosis compared with the non-ascorbic-acid group [6.1% vs. 13% respectively; OR (95% CI) 0.42 (0.184, 0.937), p value = 0.03]. Low dose of ascorbic acid as an adjunctive therapy in COVID-19 critically ill patients was not associated with mortality benefits, but it was associated with a lower incidence of thrombosis. Further studies are required to confirm these findings.

scholarly journals Effects of Dexmedetomidine Administration on Outcomes in Critically Ill Patients with Acute Kidney Injury: A Propensity Score-Matching Analysis

2021 ◽  
Author(s):  
Aixiang Yang ◽  
Jing Yang ◽  
Biying Zhou ◽  
Jinxian Qian ◽  
Liyang Jiang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Length Of Stay ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Kidney Injury ◽  
Cox Proportional Hazards Model

Abstract Background Dexmedetomidine (DEX) had organ protection effects and could decrease mortality in animal models, but its association with mortality and length of stay (LOS) in ICU and hospital in critically ill patients was conflicting. Whether acute kidney injury (AKI) subgroup of critically ill patients could benefit from DEX was unknown. The present study aimed to evaluate the effects of DEX on clinical outcomes of critically ill patients with AKI. Methods Data were extracted from the Medical Information Mart for Intensive Care Ⅲ database (MIMIC Ⅲ). Propensity score matching (PSM) analysis (1:3), cox proportional hazards model, linear regression and logistic regression model were used to assess the effect of DEX on clinical outcomes. Results After PSM, 324 pairs of patients were matched between the patients with DEX administration and those without. DEX administration was associated with decreased in-hospital mortality [hazard ratio (HR) 0.287; 95% CI 0.151–0.542; P < 0.001] and 90-day mortality [HR 0.344; 95% CI 0.221–0.534; P < 0.001], and it was also associated with reduced length of stay (LOS) in ICU [4.54(3.13,7.72) versus 5.24(3.15,10.91), P < 0.001] and LOS in hospital [11.63(8.02,16.79) versus 12.09(7.83,20.44), P = 0.002]. Subgroup analysis showed the above associations existed only in mild and moderate AKI subgroups, but not in severe AKI subgroup. Nevertheless, DEX administration was not associated with the recovery of renal function [HR 1.199; 95% CI 0.851–1.688; P = 0.300]. Conclusions DEX administration improved outcomes in critically ill patients with mild and moderate AKI and could be a good choice of sedation.

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