scholarly journals Early Bronchoscopy Improves Extubation Rates after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Analysis

2021 ◽  
Vol 10 (14) ◽  
pp. 3055
Author(s):  
Gregor S. Zimmermann ◽  
Jana Palm ◽  
Anna Lena Lahmann ◽  
Friedhelm Peltz ◽  
Rainer Okrojek ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Hospital Admission ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Optimal Timing ◽  
Test Results ◽  
Microbiological Test ◽  
Retrospective Cohort Analysis ◽  
Hospital Cardiac Arrest

Background: Patients suffering from out-of-hospital cardiac arrest (OHCA) frequently receive a bronchoscopy after being admitted to the ICU. We investigated the optimal timing and the outcome in these patients. Methods: All patients who suffered from OHCA and were treated in our ICU from January 2013 to December 2018 were retrospectively analyzed. The data were collected from the patients’ medical files, and included duration of mechanical ventilation, antibiotics, microbiological test results and neurological outcome. The outcome was the effect of early bronchoscopy (≤48 h after administration) on the rate of intubated patients on day five and day seven. Results: From January 2013 to December 2018, 190 patients were admitted with OHCA. Bronchoscopy was performed in 111 patients out of the 164 patients who survived the first day. Late bronchoscopy >48 h was associated with higher rates of intubation on day five (OR 4.94; 95% CI 1.2–36.72, 86.7% vs. 55.0%, p = 0.036) and day seven (OR 4.96; 95% CI 1.38–24.69; 80.0% vs. 43.3%, p = 0.019). Conclusion: This study shows that patients who suffered from OHCA might have a better outcome if they receive a bronchoscopy early after hospital admission. Our data suggests an association of early bronchoscopy with a shorter intubation period.

Dual defibrillation in out-of-hospital cardiac arrest: A retrospective cohort analysis

Resuscitation ◽  
2016 ◽  
Vol 106 ◽  
pp. 14-17 ◽  
Author(s):  
Elliot M. Ross ◽  
Theodore T. Redman ◽  
Stephen A. Harper ◽  
Julian G. Mapp ◽  
David A. Wampler ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Retrospective Cohort Analysis ◽  
Hospital Cardiac Arrest

scholarly journals Do Women Have a Higher Mortality Risk Than Men following ICU Admission after Out-of-Hospital Cardiac Arrest? A Retrospective Cohort Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4286
Author(s):  
Christiaan van Wees ◽  
Wim Rietdijk ◽  
Loes Mandigers ◽  
Marisa van der Graaf ◽  
Niels T. B. Scholte ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Mortality Risk ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Cerebral Performance Category ◽  
Secondary Outcome ◽  
Icu Length Of Stay ◽  
Retrospective Cohort Analysis ◽  
Icu Discharge ◽  
Hospital Cardiac Arrest

Purpose: previous studies showed that women have a higher mortality risk than men after out-of-hospital cardiac arrest (OHCA). This sex difference may disappear after adjustment for cardiac arrest characteristics. Most studies also included patients who were not admitted to the intensive care unit (ICU). We analyzed whether sex impacts the mortality of ICU-admitted OHCA patients. Methods: a retrospective cohort analysis of 1240 OHCA patients admitted to the ICU (310 women, 25%, AgeMedian 64.0 (IQR 53.8–73.0)) at an academic hospital in the Netherlands between 1 January 2007 and 31 December 2018. The primary outcome was 90-day mortality; the secondary outcome was a favorable cerebral performance category (CPC) score at ICU discharge and ICU length of stay (ICU LOS). Results: we found no association between sex and 90-day mortality (hazard ratio (HR) 0.867; 95% confidence interval (95% CI) 0.678–1.108) after adjusting for relevant cardiac arrest characteristics. Similarly, we found no difference for favorable CPC score (OR 1.117; 95% CI 0.777–1.608) or ICU LOS between sexes (Beta 0.428; 95% CI −0.442 to 1.298). Conclusions: after adjusting for cardiac arrest characteristics, we found no difference between women and men with respect to 90-day mortality, ICU LOS, and CPC score.

scholarly journals Breakthrough Invasive Candidiasis in Children

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S81-S81
Author(s):  
Sara Dong ◽  
Stella Antonara ◽  
Joseph Stanek ◽  
Monica I Ardura
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Candidiasis ◽  
Retrospective Cohort ◽  
Independent Risk Factor ◽  
Cohort Analysis ◽  
Candida Spp ◽  
Retrospective Cohort Analysis ◽  
Sterile Site ◽  
Vasopressor Use ◽  
Microbiological Data

Abstract Background Breakthrough invasive candidiasis (bIC) has been described in adults, but the epidemiology and outcomes in children are unknown. Methods Retrospective cohort analysis of children diagnosed with IC from 9/1/09 to 1/30/17. bIC was defined as isolation of Candida spp. from sterile site despite receiving ≥3 doses of antifungal (AF) to which isolate is susceptible. Clinical and microbiological data, management, and outcomes were collected. Non-parametric and logistic regression statistics were applied. Results There were 92 patients with IC, 23 of which were bIC (Table 1). Underlying conditions included GI (n = 26), hem/onc (n = 17), prematurity (n = 16), cardiac (n = 15), HCT (n = 4), SOT (n = 5), and other (n = 9). Patients received an azole (n = 17), micafungin (n = 5), or amphotericin B (n = 1) for median of 20 days [3–522] before bIC as: prophylaxis (n = 8), targeted therapy (n = 5), or empiric fever driven therapy (n = 10). bIC was caused by non-albicans Candida in 16/23 (70%) cases. Compared with IC controls, children with bIC had increased ICU admission, vasopressor use, mechanical ventilation, and renal failure (all with P < 0.01). In multivariate analysis, immunosuppression was an independent risk factor for bIC (OR 39.4, 95% CI 7.5–205). Death attributable to IC occurred in bIC group (n = 3, P = 0.04). Conclusion bIC in our cohort was caused most frequently by non-albicans Candida spp. and associated with significantly worse outcomes, including mortality. Disclosures All authors: No reported disclosures.

scholarly journals Impact of emergency hospital admissions on patterns of primary care prescribing: a retrospective cohort analysis of electronic records in England

2020 ◽  
Vol 70 (695) ◽  
pp. e399-e405
Author(s):  
Rachel Denholm ◽  
Richard Morris ◽  
Sarah Purdy ◽  
Rupert Payne
Keyword(s):  
Hospital Admission ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Cohort Analysis ◽  
Post Discharge ◽  
Emergency Hospital ◽  
Obstetrics And Gynaecology ◽  
Emergency Hospital Admission ◽  
Retrospective Cohort Analysis ◽  
The Impact

BackgroundLittle is known about the impact of hospitalisation on prescribing in UK clinical practice.AimTo investigate whether an emergency hospital admission drives increases in polypharmacy and potentially inappropriate prescriptions (PIPs).Design and settingA retrospective cohort analysis set in primary and secondary care in England.MethodChanges in number of prescriptions and PIPs following an emergency hospital admission in 2014 (at admission and 4 weeks post-discharge), and 6 months post-discharge were calculated among 37 761 adult patients. Regression models were used to investigate changes in prescribing following an admission.ResultsEmergency attendees surviving 6 months (N = 32 657) had a mean of 4.4 (standard deviation [SD] = 4.6) prescriptions before admission, and a mean of 4.7 (SD = 4.7; P<0.001) 4 weeks after discharge. Small increases (<0.5) in the number of prescriptions at 4 weeks were observed across most hospital specialties, except for surgery (−0.02; SD = 0.65) and cardiology (2.1; SD = 2.6). The amount of PIPs increased after hospitalisation; 4.0% of patients had ≥1 PIP immediately before pre-admission, increasing to 8.0% 4 weeks post-discharge. Across hospital specialties, increases in the proportion of patients with a PIP ranged from 2.1% in obstetrics and gynaecology to 8.0% in cardiology. Patients were, on average, prescribed fewer medicines at 6 months compared with 4 weeks post-discharge (mean = 4.1; SD = 4.6; P<0.001). PIPs decreased to 5.4% (n = 1751) of patients.ConclusionPerceptions that hospitalisation is a consistent factor driving rises in polypharmacy are unfounded. Increases in prescribing post-hospitalisation reflect appropriate clinical response to acute illness, whereas decreases are more likely in patients who are multimorbid, reflecting a focus on deprescribing and medicines optimisation in these individuals. Increases in PIPs remain a concern.

Are perceptual disorder signs in diplegic cerebral palsied children stable over time? A retrospective cohort analysis

2020 ◽  
Vol 72 (2) ◽  
Author(s):  
Silvia Alboresi ◽  
Alice Sghedoni ◽  
Giulia Borelli ◽  
Stefania Costi ◽  
Laura Beccani ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Retrospective Cohort Analysis ◽  
Over Time
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