scholarly journals Pneumorrhachis: A Rare Prognostic Lesson

2021 ◽  
pp. 1-3
Author(s):  
Rosa Sun ◽  
Rosa Sun ◽  
Imran Haq
Keyword(s):  
Intensive Care ◽  
Spinal Canal ◽  
Poor Prognosis ◽  
Ct Images ◽  
Neurological Deterioration ◽  
Initial Presentation ◽  
Important Clue

Objective: We present a case of poly-traumatic epidural pneumorrhachis of an 87-year-old gentleman who had unremarkable neurology on presentation. We give an overview of aetiology and indications for intervention in pneumorrhachis. Background: Pneumorrhachis is the presence of air within the spinal canal, aetiologically it is widely variable though its observation in practice is rare. Methods: Descriptive. Results: We show figures illustrating CT images of pneumorrhachis at C3/4 level. The patient underwent progressive neurological deterioration over the course of four days on intensive care, and subsequently passed away. Conclusion: The presence of pneumorrhachis is well known to be associated with poor prognosis, and in our case predicted his subsequent neurological decline despite initial presentation. The presence of pneumorrhachis also serves as an important clue for hidden injuries.

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

scholarly journals Postanoxic Burst Suppression Electroencephalogram in a Comatose Child Associated with Spontaneous Eyelid Opening

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
John R. Crawford
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Burst Suppression ◽  
Pathophysiological Mechanism ◽  
Rare Phenomenon ◽  
Anoxic Injury ◽  
Eye Opening ◽  
Insight Into

Spontaneous eye opening associated with burst suppression electroencephalogram has been reported in adults following postanoxic injury. Previous reports have correlated the onset of epileptiform bursts with the eye opening and attribute it to a brainstem-release phenomenon associated with poor prognosis. The author presents a case of a 12-year-old boy with burst suppression electroencephalogram following severe anoxic injury where the eye opening occurred at the conclusion of the bursts that has never been previously reported. These electroencephalographic findings are important for intensive care physicians to recognize and may provide further insight into the pathophysiological mechanism of this rare phenomenon.

A promising predictor of mortality— A cohort study (Preprint)

2021 ◽  
Author(s):  
Ji Ha Ling
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Medical Information ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Clinical Biomarker ◽  
Secondary Result

UNSTRUCTURED Severe inflammation leads to poor prognosis for intensive care unit hospitalized patients. The is a biomarker used to monitor inflammation and immune response, which can predict poor prognosis of various diseases. However, it is unclear whether NLR is associated with all-cause mortality in ICU patients. This study investigated the correlation between MLR and ICU results. Extract clinical data from Medical Information Mart for Intensive Care III (MIMIC-III) database, which contains health data of more than 50,000 patients. The main result was 30-day mortality, and the secondary result was 90-day mortality. Use the Cox proportional hazards model to reveal the association between MLR and results. Multivariable analyses were used to control for confounders. NLR is a promising clinical biomarker, which can be used as a available predictor of ICU mortality.

scholarly journals P012: Mortality rate of cancer patients by type presenting to the intensive care unit with sepsis.

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S67
Author(s):  
S. Beckett ◽  
E. Karreman ◽  
R. Hughes
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Solid Tumors ◽  
Predictive Factors ◽  
Poor Prognosis ◽  
Solid Tumours ◽  
Icu Mortality ◽  
Icu Admission

Introduction: Sepsis in cancer patients is associated with higher mortality rates than non-cancer patients. As a whole, hematological or solid tumor cancers have not demonstrated a prognostic link to sepsis survival rates in intensive care units (ICU), however poor-prognosis solid tumours (less than 25% 5-year survival) have not been investigated. This study examined ICU mortality rate and its predictive factors of patients with sepsis and poor-prognosis solid tumors in comparison to patients with higher prognosis solid tumours. Methods: A 6-year retrospective chart review of 79 patients with sepsis and solid tumour cancers and/or metastatic cancers admitted to the ICU was conducted. Information regarding mortality rate within 14 days, length of ICU stay, incidence of intubation, and other primary reasons for ICU admission was collected. Data was analysed using logistic regression. Results: Logistic regression results showed intubation as the only significant factor contributing to patient mortality (p &lt; .001), with the odds of mortality being 12.3 times higher for intubated than non-intubated patients. Five-year cancer survival rate was the second best predictor (p = .082), while age, sex, and metastasis were also not significant predictive factors for survival. Intubated patients with poor prognosis cancers had the lowest survival chance as further indicated by the 16 patients who met this criterion, of which 14 died within two weeks of ICU admission. Conclusion: The fact that poor prognosis cancers in sepsis were not significantly predictive of ICU mortality supports current literature regarding solid tumors in general, while intubation being a significant predictor for mortality in patients with sepsis and cancer regardless of type builds on previous research. A limitation of this study is the relative low number of included cases with poor-prognosis cancer types. Further evaluation is needed to understand the implications of our results for end-of-life care and ICU admission for patients with these characteristics.

Coping with Poor Prognosis in the Pediatric Intensive Care Unit

1984 ◽  
pp. 221-234
Author(s):  
David A. Waller ◽  
I. David Todres ◽  
Ned H. Cassem ◽  
Ande Anderten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Poor Prognosis ◽  
Pediatric Intensive Care

scholarly journals A Case of Torsion of the Gallbladder Suspected with SPECT-CT: Review and Recommendations

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Eric Bergeron ◽  
Etienne Désilets ◽  
Xuan Vien Do ◽  
Daniel McNamara ◽  
Sami Chergui ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Rare Case ◽  
Relevant Literature ◽  
Ct Images ◽  
Hida Scan ◽  
Torsion Of The Gallbladder ◽  
Rare Situation

Torsion or volvulus of the gallbladder is a rare situation that rapidly progresses to gangrene and linked with a poor prognosis, even death, if unrecognized and untreated. An interesting and rare case of gallbladder volvulus in which diagnosis was obtained by comparing CT images and HIDA scan with SPECT-CT is presented. Relevant literature is reviewed, and recommendations are outlined.

scholarly journals Early Plasma Osmolality Levels and Clinical Outcomes in Children Admitted to the Pediatric Intensive Care Unit: A Single-Center Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Huabin Wang ◽  
Zhongyuan He ◽  
Jiahong Li ◽  
Chao Lin ◽  
Huan Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Regression Model ◽  
Clinical Outcomes ◽  
Poor Prognosis ◽  
Logistic Regression Model ◽  
Plasma Osmolality ◽  
Pediatric Intensive Care ◽  
Linear Spline

Objective: Identifying high-risk children with a poor prognosis in pediatric intensive care units (PICUs) is critical. The aim of this study was to assess the predictive value of early plasma osmolality levels in determining the clinical outcomes of children in PICUs.Methods: We retrospectively assessed critically ill children in a pediatric intensive care database. The locally weighted-regression scatter-plot smoothing (LOWESS) method was used to explore the approximate relationship between plasma osmolality and in-hospital mortality. Linear spline functions and stepwise expansion models were applied in conjunction with a multivariate logistic regression to further analyze this relationship. A subgroup analysis by age and complications was performed.Results: In total, 5,620 pediatric patients were included in this study. An approximately “U”-shaped relationship between plasma osmolality and mortality was detected using LOWESS. In the logistic regression model using a linear spline function, plasma osmolality ≥ 290 mmol/L was significantly associated with in-hospital mortality [odds ratio (OR) 1.020, 95% confidence interval (CI) 1.010–1.031], while plasma osmolality &lt;290 mmol/L was not significantly associated with in-hospital mortality (OR 0.990, 95% CI 0.966–1.014). In the logistic regression model with plasma osmolality as a tri-categorical variable, only high osmolality was significantly associated with in-hospital mortality (OR 1.90, 95% CI 1.38–2.64), whereas low osmolality was not associated with in-hospital mortality (OR 1.28, 95% CI 0.84–1.94). The interactions between plasma osmolality and age or complications were not significant.Conclusion: High osmolality, rather than low osmolality, can predict a poor prognosis in children in PICUs.

Physician Attitudes in Romania toward Withholding and Withdrawal of Intensive Care for Infants with Very Poor Prognosis

2013 ◽  
Vol 31 (06) ◽  
pp. 477-482
Author(s):  
Anca Bivoleanu ◽  
Maria Stamatin ◽  
Silvia-Maria Stoicescu ◽  
Edward Bell
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Physician Attitudes

scholarly journals Outcome and Predictive Factors in Rapid Progressive Cervical Spondylotic Myelopathy: A Retrospective Case-Control Study

2020 ◽  
Author(s):  
Haimiti Abuduaini ◽  
Hao Liu ◽  
Beiyu Wang ◽  
Yang Meng ◽  
Yi Yang ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Compression Ratio ◽  
Spinal Canal ◽  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
Neurological Deterioration ◽  
Neurological Dysfunction ◽  
Canal Diameter ◽  
History Of ◽  
Disc Level

Abstract Background: To evaluate epidemiological, clinical and radiographic features in the development and prognosis of rapid progressive cervical spondylotic myelopathy (rp-CSM).Methods: A retrospective study of 175 patient records was performed between March 2011 and January 2017. Patients were divided into rp-CSM group and chronic CSM (c-CSM) group according to the deterioration time and severity of preoperative neurological dysfunction. After selection, 25 rp-CSM patients were matched to a control group of 75 patients with c-CSM. The clinical outcomes were assessed by the Modified Japanese Orthopaedic Association (mJOA) score at six different follow-up time points. The imaging parameters including Torg-Pavlov Ratio (TPR) on conventional lateral x-ray and magnetic resonance images (MRI), intervertebral disc level compression ratio and increased signal intensity (ISI) on T2W1 were analyzed between the two groups, and predictors for rapid neurological dysfunction in CSM patients were evaluated using multivariate analysis.Results: Twenty-five patients experienced rp-CSM (18 males; median age 59.04 ± 12.81 years) and were matched with Seventy-five control subjects that with CSM without rapid progression (54 males; median age 56.88 ± 12.31 years). The average time to develop severe neurological deterioration was 0.8 month in rp-CSM group and 24 month in c-CSM group (p=0.001), preoperative mJOA were 6 in rp-CSM patients and 12 in c-CSM patients (p=0.014) and rp-CSM patients demonstrated worse outcomes than the controls in one year after surgery (mJOA improvement rate 54.5% and 80%, p=0.021). There were no differences between the two groups except the history of diabetes and the long-term smoking in basic condition, radiographic measurements signified that TPR MRI, intervertebral disc level compression ratio and increased signal intensity (ISI) on T2W1 were inferior in patients with rp-CSM than patients with c-CSM. Regression analysis verified that the history of diabetes, TPR MRI < 0.4, compression ratio ≥50%, the sagittal diameter of ISI ≥50% of spinal canal diameter on T2W1 have significant correlations with the rapid progressive neurological dysfunction in patients with CSM. Conclusion: The prognosis of rapid progressive CSM is worse than that of common chronic CSM. The rapid neurological deterioration can be identified by TPR MRI (< 0.4), compression ratio (≥50%), sagittal diameter of ISI (≥50% of spinal canal diameter). Besides, a history of diabetes was also a negative factor for these patients.

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