scholarly journals Prevalence of Delirium and Its Clinical Outcome in Adult Filipino Patients Admitted in The Intensive Care Unit

2019 ◽  
Vol 2 (4) ◽  
Author(s):  
Abram P Tanuatmadja ◽  
Jacqueline R Vea
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring Method ◽  
Icu Admission ◽  
Icu Stay ◽  
Manpower Requirement ◽  
Tertiary Teaching ◽  
Metro Manila ◽  
Tertiary Teaching Hospital ◽  
Dsm Iv

Delirium is common in the ICU setting and is associated with increased morbidity, manpower requirement, and costs. This study aims to investigate the prevalence of delirium and its outcome in terms of 14-days mortality and length of ICU stay in ICU patients. The study was done at a 150-bed tertiary teaching hospital, located in Quezon City, Metro Manila, February to September 2016. This is a prospective studyinvolving 136 adults. Screening for delirium was done within 24 hours of ICU admission using both CAM-ICU scoring method and DSM-IV-TR criteria for delirium. Delirium prevalence was found to be 5.15%. The average age was higher in the subjects positive for delirium (70.14 + 21.15 years versus 60.43 + 16.10 years, p=0.1286). At the time of ICU admission, 11.54% of sedated patients were positive for delirium compared to 3.64% of non-sedated patients, p=0.1513 ;OR 3.457. Delirium was associated with higher 14 days mortality (OR 16.8, p=0.0212). Subjects positive for delirium had 2.74 longer days average ICU stay compared to the other group, with p=0.026. We concluded delirium was associated with higher 14-days mortality and longer ICU stay. Keywords : delirium, prevalence, Intensive Care Unit

scholarly journals The Epidemiology of Vancomycin-Resistant Enterococcus Colonization in a Medical Intensive Care Unit

2003 ◽  
Vol 24 (4) ◽  
pp. 257-263 ◽  
Author(s):  
David K. Warren ◽  
Marin H. Kollef ◽  
Sondra M. Seiler ◽  
Scott K. Fridkin ◽  
Victoria J. Fraser
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiple Logistic Regression Analysis ◽  
Control Measures ◽  
Icu Patients ◽  
Icu Admission ◽  
Contact Precautions ◽  
Icu Stay ◽  
Vancomycin Resistant

AbstractObjective:To determine the epidemiology of colonization with vancomycin-resistant Enterococcus (VRE) among intensive care unit (ICU) patients.Design:Ten-month prospective cohort study.Setting:A 19-bed medical ICU of a 1,440-bed teaching hospital.Methods:Patients admitted to the ICU had rectal swab cultures for VRE on admission and weekly thereafter. VRE-positive patients were cared for using contact precautions. Clinical data, including microbiology reports, were collected prospectively during the ICU stay.Results:Of 519 patients who had admission stool cultures, 127 (25%) had cultures that were positive for VRE. Risk factors for VRE colonization identified by multiple logistic regression analysis were hospital stay greater than 3 days prior to ICU admission (adjusted odds ratio [AOR], 3.6; 95% confidence interval [CI95], 2.3 to 5.7), chronic dialysis (AOR, 2.4; CI95, 1.2 to 4.5), and having been admitted to the study hospital one to two times (AOR, 2.3; CI95,1.4 to 3.8) or more than two times (AOR, 6.5; CI95, 3.7 to 11.6) within the past 12 months. Of the 352 VRE-negative patients who had one or more follow-up cultures, 74 (21%) became VRE positive during their ICU stay (27 cases per 1,000 patient-ICU days).Conclusion:The prevalence of VRE culture positivity on ICU admission was high and a sizable fraction of ICU patients became VRE positive during their ICU stay despite contact precautions for VRE-positive patients. This was likely due in large part to prior VRE exposures in the rest of the hospital where these control measures were not being used.

Charge and Reimbursement Analysis for Intensive Care Unit Patients in a Large Tertiary Teaching Hospital

DICP ◽  
1991 ◽  
Vol 25 (11) ◽  
pp. 1231-1235
Author(s):  
Joseph F. Dasta ◽  
Catherine A. Gundlach ◽  
Thomas P. Faulkner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

THYROIDECTOMY AT CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL: IS ROUTINE ADMISSION TO INTENSIVE CARE UNIT JUSTIFIED?

2020 ◽  
Vol 7 (10) ◽  
pp. 6-11
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Surgical Approach ◽  
Healthy Patient ◽  
Academic Hospital ◽  
Intensive Care Admission ◽  
Icu Admission ◽  
Icu Stay ◽  
Elective Setting

Introduction: Thyroidectomy is the commonest endocrine operation performed often in healthy patient at elective setting. Patients are discharged early and the post-operative course is mainly uneventful. The need for intensive care is not essential in most cases. This article reviews the cases of thyroidectomy at CHBAH that are sent to intensive care routinely to assess the relevance of this practice. Objectives: To establish the profile, the outcome of thyroidectomy patients admitted in intensive care and the incidence of uneventful ICU stay. Method: Review of all thyroidectomy admitted in intensive care from January 2013 to July 2017 Results: In 88.42% of cases, intensive care admission was not justified. Of the 11.57% that needed ICU, 90.90% was predicted pre-operatively by the underlying comorbidity and the surgical approach. Altogether only 1.06% of cases had unpredicted ICU admission. Conclusion: Routine intensive care admission was unnecessary in most cases.

Acute Kidney Injury and COVID-19: A Picture from an Intensive Care Unit

2021 ◽  
pp. 1-5
Author(s):  
Francesco Alessandri ◽  
Valentina Pistolesi ◽  
Chiara Manganelli ◽  
Franco Ruberto ◽  
Giancarlo Ceccarelli ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Kidney Injury ◽  
Icu Mortality ◽  
Icu Stay ◽  
Renal Function Recovery ◽  
Tertiary Teaching

<b><i>Introduction:</i></b> Acute kidney injury (AKI) is a frequent complication in coronavirus disease 2019 (COVID-19) patients admitted to intensive care unit (ICU) for severe respiratory failure. The aim is to evaluate the rate of AKI, defined according to Kidney Disease: Improving Global Outcome guidelines, in a series of critical COVID-19 patients admitted to the ICU of a single tertiary teaching hospital. <b><i>Methods:</i></b> From April to May 2020, all consecutive critically ill COVID-19 patients admitted to the ICU who did not meet exclusion criteria (length of ICU stay &#x3c;48 h, ESRD requiring dialysis, and patients still hospitalized in ICU at the time of data analysis) were enrolled in this study. Patients were stratified according to the highest AKI stage attained during ICU stay. <b><i>Results:</i></b> Sixty-one patients were included in the analysis. AKI was observed in 35/61 patients (57.4%): 25/35 episodes (71.4%) were observed within the first 7 days. AKI was classified as follows: 17.1% stage 1, 25.7% stage 2, and 57.2% stage 3. Fourteen out of 20 stage-3 patients required continuous renal replacement therapy (CRRT), mostly related to persistent oliguria. The overall ICU mortality was 68.9%, and it was higher in patients developing AKI if compared to no-AKI patients (<i>p</i> = 0.006). Renal function recovery of any grade was observed in 14 out of 35 AKI patients (40%). Among patients undergoing CRRT, 13 patients were still dialysis dependent at the time of death. <b><i>Conclusion:</i></b> In critical COVID-19 patients, ICU mortality is particularly high, especially in patients developing AKI. An accurate monitoring of renal function in early phases of respiratory failure should be ensured in order to timely apply any strategy aimed at limiting renal complications during ICU stay.

scholarly journals Factors Associated with Intensive Care Unit (ICU) Admission Among Inpatients with and without Diabetes in South Western Sydney Public Hospitals Using the New South Wales Admission Patient Data Collection (2014 and 2017).

2021 ◽  
Author(s):  
Uchechukwu L Osuagwu ◽  
Matthew Xu ◽  
Milan K Piya ◽  
Kingsley E Agho ◽  
David Simmons
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
New South ◽  
Public Hospitals ◽  
Admission Diagnosis ◽  
Icu Admission ◽  
Icu Stay ◽  
System Disease ◽  
South Wales

Abstract Background South Western Sydney (SWS) is a hotspot for diabetes in Australia. We compared intensive care unit (ICU) admission risk between people with and without diabetes admitted to public hospitals in this metropolitan health district. Methods Retrospective study of all admissions to ICU in the New South Wales Admitted Patient Data Collection (APDC) over three years. Data on demographic and health insurance status, primary admission diagnosis, comorbidities including death in admission for public hospital inpatients aged ≥18 years residing in South Western Sydney were analysed. The ICU length of stay was the main outcome variable classified into short stay (≤48hrs) and long stay (>48 hrs) were analysed. Potential predictors were analysed for possible association with long ICU stay among people with and without diabetes admitted to the hospital. Results Of the 187660 inpatients from SWS in the three years, 3.5% spent at least one hour in ICU [5.0% with diabetes versus 3.3% without diabetes, P<0.001]. The median length of ICU stay was similar between people with and without diabetes [40hrs IQR 16-88 hrs versus 43hrs IQR 19-79hrs] as well as the prevalence of long ICU stay [44.9%, 95%CI 42.1, 47.7% versus 43.6%, 95%CI 42.2, 44.9%], respectively. A primary admission diagnosis of circulatory system disease was associated with long ICU stay in both groups, while male sex and a primary diagnosis of nervous system disease was associated with long ICU stay in the non-diabetes group only. Long ICU stay was associated with 1.6 times higher in-hospital mortality in people with diabetes. Conclusions ICU admission was more common in people with diabetes. One in every two admissions to ICU had a long stay, thereby increasing the resource utilization and was associated with higher in-hospital mortality. The predictors identified in the study can target this group to improve resource utilization and efficiency of ICU care. Additional population-based approaches to diabetes care are needed to reduce the risks of acute hospital admission.

scholarly journals Methicillin-resistant Staphylococcus aureus nasal colonization and infection in an intensive care unit of a university hospital in China

2018 ◽  
Vol 46 (9) ◽  
pp. 3698-3708 ◽  
Author(s):  
Fu Qiao ◽  
Wenzhi Huang ◽  
Lin Cai ◽  
Zhiyong Zong ◽  
Weijia Yin
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Mainland China ◽  
Methicillin Resistant ◽  
Icu Admission ◽  
Icu Stay ◽  
Nasal Swabs ◽  
Mrsa Colonization

Objective This study was performed to determine the prevalence and risk factors associated with nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization upon intensive care unit (ICU) admission and during the ICU stay in mainland China. Methods A prospective observational study was performed in a 50-bed general ICU of a 4300-bed teaching hospital in China from 2011 to 2013. Nasal swabs for MRSA detection were obtained upon ICU admission and at discharge for patients having stayed in the ICU for longer than 3 days. Results In total, 115 patients (4.1%; 95% confidence interval [CI], 3.4–4.9) were already colonized with MRSA on ICU admission, and another 185 patients (10.7%; 95% CI, 9.3–12.2) acquired MRSA during their ICU stay. Development of an MRSA infection was significantly more likely in patients with than without MRSA colonization on ICU admission (odds ratio [OR], 2.8; 95% CI, 1.1–7.3). Patients who acquired MRSA had significantly prolonged lengths of stay in the ICU (23.3 days) and higher hospital bills (135,171 RMB; about 19,590 USD) than those who tested negative for MRSA. Conclusion The MRSA colonization rate among ICU patients in mainland China is high. Patients with MRSA-positive nasal swabs are more likely to develop MRSA infections.

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