scholarly journals The Influence of Infection and Colonization on Outcomes in Inpatients With COVID-19: Are We Forgetting Something?

2021 ◽  
Vol 9 ◽  
Author(s):  
Jose Luis Alfonso-Sanchez ◽  
Adriana Agulto-Ramirez ◽  
María A. Chong-Valbuena ◽  
Isabel De-Jesús-María ◽  
Paula Julián-Paches ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Odds Ratio ◽  
Complete Information ◽  
Tertiary Hospital ◽  
First Year ◽  
Candida Auris ◽  
Factors Associated ◽  
Risk Of Death ◽  
Number Of Patients

The COVID-19 epidemic has been a great challenge to health systems and especially hospitals. A prospective observational epidemiological study was planned as of February 26, 2020 in a tertiary hospital in the Valencia region. The total number of patients followed up with complete information during the first year was 2,448. Among other variables, the comorbidities of the patients were collected (and grouped in the Charson index), the stay in the intensive care unit (ICU), the co-infections, and the colonizations. Data on nosocomial infections due to said virus were also collected. The median days from the onset of symptoms to diagnosis were 4 + 4.6, while an additional 4.4 days had to pass for the patients to be admitted to the ICU. The factors associated with a higher risk of death were those with coinfection, especially with Candida auris [odds ratio (OR): 4.6], a situation that also occurred in the ICU (OR: 3.18). Charlson Index comorbidity and C. auris colonization were also very important both in general hospitalization and in the ICU.

Risk Factors Associated with Hospital-Acquired Venous Thromboembolism in the Pediatric Intensive Care Unit

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2313-2313
Author(s):  
Minh Q Tran ◽  
Steven L Shein ◽  
Hong Li ◽  
Sanjay P Ahuja
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Odds Ratio ◽  
Pediatric Intensive Care ◽  
Primary Diagnosis ◽  
Factors Associated ◽  
Hospital Acquired

Abstract Introduction: Venous thromboembolism (VTE) in Pediatric Intensive Care Unit (PICU) patients is associated with central venous catheter (CVC) use. However, risk factors for VTE development in PICU patients with CVCs are not well established. The impact of Hospital-Acquired VTE in the PICU on clinical outcomes needs to be studied in large multicenter databases to identify subjects that may benefit from screening and/or prophylaxis. Method: With IRB approval, the Virtual Pediatric Systems, LLC database was interrogated for children < 18yo admitted between 01/2009-09/2014 who had PICU length of stay (LOS) <1 yr and a CVC present at some point during PICU care. The exact timing of VTE diagnosis was unavailable in the database, so VTE-PICU was defined as an "active" VTE that was not "present at admission". VTE-prior was defined as a VTE that was "resolved," "ongoing" or "present on admission." Variables extracted from the database included demographics, primary diagnosis category, and Pediatric Index of Mortality (PIM2) score. PICU LOS was divided into quintiles. Chi squared and Wilcoxon rank-sum were used to identify variables associated with outcomes, which were then included in multivariate models. Our primary outcome was diagnosis of VTE-PICU and our secondary outcome was PICU mortality. Children with VTE-prior were included in the mortality analyses, but not the VTE-PICU analyses. Data shown as median (IQR) and OR (95% CI). Results: Among 143,524 subjects, the median age was 2.8 (0.47-10.31) years and 55% were male. Almost half (44%) of the subjects were post-operative. The median PIM2 score was -4.11. VTE-prior was observed in 2498 patients (1.78%) and VTE-PICU in 1741 (1.2%). The incidence of VTE-PICU were 852 (1.7%) in patients ≤ 1 year old, 560 (0.9%) in patients 1-12 years old, and 303 (1.1%) in patients ≥ 13 years old (p < 0.0001). In univariate analysis, variables associated with a diagnosis of VTE-PICU were post-operative state, four LOS quintiles (3-7, 7-14, and 14-21 and >21 days) and several primary diagnosis categories: cardiovascular, gastrointestinal, infectious, neurologic, oncologic, genetic, and orthopedic. Multivariate analysis showed increased risk of VTE with cardiovascular diagnosis, infectious disease diagnosis, and LOS > 3 d (Table 1). The odds increased with increasing LOS: 7 d < LOS ≤ 14 d (5.18 [4.27-6.29]), 14 d < LOS ≤ 21 d (7.96 [6.43-9.82]), and LOS > 21 d (20.73 [17.29-24.87]). Mortality rates were 7.1% (VTE-none), 7.2% (VTE-prior), and 10.1% (VTE-PICU) (p < 0.0001). In the multivariate model, VTE-PICU (1.25 [1.05-1.49]) and VTE-prior (1.18 [1.002-1.39]) were associated with death vs. VTE-none. PIM2 score, trauma, and several primary diagnosis categories were also independently associated with death (Table 2). Conclusion: This large, multicenter database study identified several variables that are independently associated with diagnosis of VTE during PICU care of critically ill children with a CVC. Children with primary cardiovascular or infectious diseases, and those with PICU LOS >3 days may represent specific populations that may benefit from VTE screening and/or prophylaxis. Hospital-Acquired VTE in PICU was independently associated with death in our database. Additional analysis of this database, including adding specific diagnoses and secondary diagnoses, may further refine risk factors for Hospital-Acquired VTE among PICU patients with a CVC. Table 1. Multivariate analysis of Factors Associated with VTE-PICU. Factors Odds Ratio 95% Confidence Interval 3d < LOS ≤ 7d vs LOS ≤ 3d 2.19 1.78-2.69 7d < LOS ≤ 14d vs LOS ≤ 3d 5.18 4.27-6.29 14d < LOS ≤ 21d vs LOS ≤ 3d 7.95 6.44-9.82 LOS > 21d vs LOS ≤ 3d 20.73 17.29-24.87 Age 1.00 0.99-1.01 Post-operative 0.89 0.80-0.99 PIM2 Score 1.47 1.01-1.07 Primary Diagnosis: Cardiovascular 1.50 1.31-1.64 Primary Diagnosis: Infectious 1.50 1.27-1.77 Primary Diagnosis: Genetics 0.32 0.13-0.78 Table 2. Multivariate Analysis of Factors Associated with PICU Mortality. Factors Odds Ratio 95% ConfidenceInterval VTE-prior 1.18 1.00-1.39 VTE-PICU 1.25 1.05-1.49 PIM2 Score 2.08 2.05-2.11 Trauma 1.92 1.77-2.07 Post-operative 0.45 0.42-0.47 Primary Diagnosis: Genetic 2.07 1.63-2.63 Primary Diagnosis: Immunologic 2.45 1.51-3.95 Primary Diagnosis: Hematologic 1.63 1.30-2.06 Primary Diagnosis: Metabolic 0.71 0.58-0.87 Primary Diagnosis: Infectious 1.47 1.36-1.59 Primary Diagnosis: Neurologic 1.37 1.27-1.47 Disclosures No relevant conflicts of interest to declare.

Analysis of Candida auris candidemia cases in an Intensive Care Unit of a tertiary hospital

2021 ◽  
Author(s):  
C. Ferrer Gómez ◽  
P. Solís Albamonte ◽  
C. Delgado Navarro ◽  
C. Salvador García ◽  
N. Tormo Palop ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Hospital ◽  
Candida Auris

scholarly journals Perfil dos pacientes atendidos no primeiro ano de funcionamento de uma unidade de terapia intensiva: um estudo retrospectivo

2021 ◽  
Vol 21 (82) ◽  
Author(s):  
Allana Dupont Gonçalves ◽  
Talía Da Silva Evaldt ◽  
Mariana Freitas Comin ◽  
Karina Cardoso Gulbis ◽  
Valdemira Santina Dagostin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Records ◽  
Field Method ◽  
First Year ◽  
Santa Catarina ◽  
Risk Of Death ◽  
Terapia Intensiva ◽  
Quantitative Descriptive ◽  
One Year

Introdução: A unidade de terapia intensiva é um setor onde o risco de morte é constante e há grande número de procedimentos de alta complexidade. Objetivos: Analisar o perfil dos pacientes internados na UTI de um hospital de um município no Extremo Sul Catarinense, após um ano de abertura do setor. Métodos: O estudo desenvolvido foi de abordagem quantitativa, do tipo descritivo, retrospectivo, com o uso do método documental e de campo. Foram incluídos no estudo, todos os prontuários de pacientes internados no primeiro ano de funcionamento de UTI (2019/2020), num total de 293 prontuários. Resultados: Realizada em uma UTI, composta por 10 leitos, sendo 2 de isolamento, com aparato tecnológico atual, sendo tecnologias de ponta. Mostraram que foram internados mais homens, com idade entre 60-74 anos, casados, alfabetizados e católicos, com sepse, com HAS e DM como comorbidades, originados na região dos municípios da região Carbonífera de Santa Catarina, a maioria em ventilação mecânica, em uso de vasodilatadores, com alta por melhora. Conclusão: Conhecer o perfil dos pacientes internados na UTI permite melhor planejamento do exercício profissional na promoção a saúde, prevenção ou recuperação.Palavras-chave: Unidade de terapia intensiva, perfil, pacientes, enfermagem Profile of patients treated in the first year of operation of an intensive care unit: a retrospective study ABSTRACTIntroduction: The intensive care unit is a sector where the risk of death is constant and there are many procedures of high complexity. Objective: To analyze the profile of patients admitted to the ICU of a hospital in a municipality in the Extreme South of Santa Catarina, after one year of opening of the sector. Methods: The study was conducted using a quantitative, descriptive, retrospective approach, using the documentary and field method. All medical records of patients admitted in the first year of ICU operation (2019/2020) were included in the study, totaling 293 medical records. Results: Performed in an ICU, composed of 10 beds, being 2 of isolation, with current technological apparatus, being state-of-the-art technologies. They showed that more men, aged between 60-74 years, married, literate and catholic, with sepsis, with SAH and DM as comorbidities, originated in the Carbonífera region of Santa Catarina state, the majority in mechanical ventilation, in use of vasodilators, with discharge for improvement. Conclusion: Knowing the profile of patients hospitalized in the ICU allows better planning of professional exercise in health promotion, prevention, or recovery.Keywords: Intensive care unit, profile, patients, nursing

scholarly journals Risk Factors for Sepsis in the Neonatal Intensive Care Unit of a Tertiary Hospital in Mexico

2021 ◽  
Vol 2 (12) ◽  
pp. 1183-1186
Author(s):  
Ilse Lizeth Villegas-Velasquez ◽  
Luz Irene Pascual-Mathey ◽  
Olga Lidia Valenzuela-Limon ◽  
Patricia Elisa Molina-Prior ◽  
Jose Locia-Espinoza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Tertiary Hospital ◽  
Factors Associated ◽  
Newborn Weight

Neonatal Sepsis (NS) is a systemic infection caused by bacteria, fungi, or viruses during the first month of life. Although various studies have identified the factors associated with NS, it is a public health problem due to its high morbidity and mortality. The study aimed to identify the risk factors associated with neonatal sepsis in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital in Mexico. A case-control study was carried out using records of neonates (with sepsis 39 and without sepsis 39) from January to December 2017. The risk factors studied were the sociodemographic and clinical characteristics of the mother and clinics of the neonate. The data were analyzed using the Chi2 test, Fisher's exact test, Student's t-test, and the Odds Ratio (OR). The risk factors associated with NS were gestational age (OR 0.77, CI 95% = 0.64-0.91, p = 0.004), newborn weight (OR 0.45, CI95% = 0.23-0.86, p = 0.017) and days of hospital stay (OR 1.06, CI95% = 1.02-1.10, p = 0.0014). The mother's sociodemographic and clinical factors were not associated with NS. Risk factors associated with NS were gestational age, newborn weight, and days of hospital stay.

scholarly journals Predictors of Mortality in COPD Exacerbation Cases Presenting to the Respiratory Intensive Care Unit

2020 ◽  
Author(s):  
Yang Cao ◽  
Zhenzhen Xing ◽  
Huangyu Long ◽  
Yilin Huang ◽  
Yanfei Guo
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Multiple Logistic Regression Analysis ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Hospital ◽  
Chronic Obstructive ◽  
Record System ◽  
Factors Associated

Abstract Background: Studies report high in-hospital mortality of chronic obstructive pulmonary disease (COPD) exacerbations especially for those who requiring intensive care unit (ICU) admission. Recognizing factors associated with mortality in those patients could reduce healthcare costs and improve end-of-life care. Methods: This retrospective cohort study included 384 patients with AECOPD admitted to the respiratory ICU (RICU) of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristic, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. Results: We finally enrolled 384 AECOPD patients, 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (CHD, 115 (29.9%)) and chronic heart failure (CHF, (76 (19.8%)). Multiple logistic regression analysis revealed the independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia combined with CHF and the requirement for invasive mechanical ventilation (IMV).Conclusions: The in-hospital mortality of patients with COPD exacerbation requiring RICU admission is high. Lymphocytes<0.8×109/L, leukopenia, requirement for IMV, combined with CHF could be identified as risk factors associated with increased mortality rates.

scholarly journals Risk Factors Associated with Vancomycin-ResistantEnterococcusin Intensive Care Unit Settings in Saudi Arabia

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mahmoud Shorman ◽  
Jaffar A. Al-Tawfiq
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Multiorgan Failure ◽  
Tertiary Hospital ◽  
Oral Contrast ◽  
Factors Associated ◽  
Icu Admission

Background. Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens worldwide. There is one report about the epidemiology of VRE in Saudi Arabia.Objective. To determine the risk factors associated with VRE infection or colonization in intensive care unit (ICU) settings.Design. This is a descriptive, epidemiologic hospital-based case-control study of patients with VRE from February 2006 to March 2010 in ICU in a tertiary hospital in Saudi Arabia.Methods. Data were collected from hospital records of patients with VRE. The main outcome measure was the adjusted odds ratio estimates of potential risk factors for VRE.Results. Factors associated with VRE included ICU admission for multiorgan failure, chronic renal failure, prior use of antimicrobial agents in the past three months and before ICU admission, gastrointestinal oral contrast procedure, and hemodialysis. Being located in a high risk room (roommate of patients colonized or infected with VRE) was found to be protective.Conclusions. Factors associated with VRE acquisition are often complex and may be confounded by local variables.

scholarly journals Outcome of management of neurosurgical patients in the intensive care unit: An early clinical audit of a single institution from a developing country

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Joseph Obande ◽  
Ega Otorkpa ◽  
Elizabeth Obande
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Head Injury ◽  
Teaching Hospital ◽  
Tertiary Hospital ◽  
Factors Associated ◽  
Overwhelming Evidence ◽  
Neurosurgical Patients ◽  
Neurological Patients ◽  
Therapeutic Tools

Care of neurosurgical patients in the Intensive Care Unit (ICU) has been evolving in recent times. This included fast growing new techniques in neuromonitoring, neuroimaging and enhanced therapeutic tools. The pace of evolution has not been replicated in resource-constrained setting such as in Nigeria, despite overwhelming evidence of its benefit to neurological patients. Patients’ outcome, including death, in the ICU is a reflection of quality of care assessed during the hospitalization process; as many neurosurgical patients require ICU bed in the course of hospital care. The objective was to characterize the profile of the patients, mortality and factors associated with mortality while in the ICU at the dawn of commencement of neurosurgical services at our centre. A descriptive retrospective study utilizing patients’ datasets of all neurosurgical admissions into the ICU of a tertiary hospital, University of Abuja Teaching Hospital, Abuja, between 2013 and 2015 were analyzed for deaths and factors associated to death. During the 3-years period, 19 neurosurgical deaths occurred in the ICU of University of Abuja Teaching Hospital, translating to a mortality of 63.3%. The majority of the deceased patients (n=22, 71%), was of the young age group and died from head trauma. 14 (73.7%) presented late to the hospital, and all the deceased presented late to the ICU. 17 (89.5%) had head injury, of which, 84.2% was from severe head injury. All the deceased who were administered mannitol died. The early data suggest an unusually high mortality among neurosurgical patients managed in the ICU. A reflected application of modern intensive care measures might lead to increased survival of neurocritically ill patients.

Sportliche Leistung von Pferden, die als Fohlen intensivmedizinischer Behandlung bedurften

2019 ◽  
Vol 47 (06) ◽  
pp. 399-399
Author(s):  
Lukas Demattio
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sich Eine ◽  
Factors Associated ◽  
Intensivmedizinische Behandlung ◽  
Sportliche Leistung

Studies AC, Chidlow H, Ere SG et al. Factors associated with long-term athletic outcome in Thoroughbred neonates admitted to an intensive care unit. Equine Vet J 2019; 51: 716–719 Für viele Pferdezüchter stellt sich immer wieder die Frage, wie viel Geld in ein Fohlen investiert werden soll, wenn dieses tierärztlicher Behandlung bedarf. Lohnt sich eine intensivmedizinische Behandlung für ein Fohlen, das für eine sportliche Nutzung vorgesehen ist? Diese Frage versuchten die Autoren in der Studie zu beantworten.

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