scholarly journals Outcome of Patients Admitted To PICU and NICU In Relation To PRISM III Score in a Tertiary Care Hospital

2020 ◽  
Vol 8 (4) ◽  
pp. 13-18
Author(s):  
Khaleelullah MD Shakil ◽  
Pavan D. Kumar ◽  
Sreenivasa B. ◽  
Talatam Sivachand
Keyword(s):  
Mortality Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Area Under The Curve ◽  
Case Fatality ◽  
Pediatric Intensive Care ◽  
Care Hospital ◽  
Pupillary Reflex ◽  
Probability Of Death ◽  
Crucial Part

Introduction: Pediatric intensive care units (PICU) are an indispensable component of a successful health care establishment. They play a crucial part in reducing morbidity and mortality in the adolescent group. Several models and scores have been tried for internal auditing and in detecting the case fatality rate of a patient admitted in PICU and NICU. This helps the clinician in triaging patient care as and when required. The PRISM III score is widely used in PICU and NICU for the same. To evaluate the validity of the PRISM III score in predicting mortality in children admitted to PICU and NICU in a tertiary care hospital and to predict the probability of death of various PRISM III scores. Subjects and Methods: 260 patients admitted to PICU and NICU were included in the study after obtaining informed consent from parents/guardians. Each patient was evaluated for the parameters in the PRISM III score and blood was drawn to send for investigations and results were entered in the proforma and were evaluated. Results: There was an increase in mortality rate with raise in PRISM III score. PRISM III offered a fair predictive power with the area under the curve 0.7 with 95% C.I. Out of 260 patients included in the study 24(9.2%) were dead. Variables like systolic BP, abnormal mental status, pupillary reflex, acidosis, and low platelet counts were significantly associated with a higher mortality rate. Conclusion: Evaluation of mortality and outcome of a patient admitted in PICU in a tertiary care hospital is best predicted by PRISM III score.

scholarly journals Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yan-Jun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiao-Ying Liu ◽  
Ling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Severe Neutropenia ◽  
Care Hospital ◽  
The Impact

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not. Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

scholarly journals Clinico-epidemiological profile of patients admitted with Plasmodium vivax malaria in a tertiary care hospital, Delhi

2018 ◽  
Vol 5 (12) ◽  
pp. 5420 ◽  
Author(s):  
Geeta Yadav ◽  
Geeta Pardeshi ◽  
Neelam Roy
Keyword(s):  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Vivax Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Hospital ◽  
Who Criteria ◽  
Epidemiological Profile ◽  
Safdarjung Hospital

Background: Malaria is an important public health problem in India. Severe and complicated forms of malaria are usually associated with Plasmodium falciparum species. But recently published literature suggests that Plasmodium vivax infection also presents as severe malaria. The objective was to study clinical and epidemiological profile of patients with P. vivax malaria admitted in Safdarjung hospital.Methods: A record based retrospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, a tertiary care hospital in Delhi. Data were collected from all case records with ICD 10 codes for Malaria (B50-B54) for the year 2011 obtained from Medical Records Department, Safdarjung Hospital and analyzed using SPSS 21.0.Results: A total of 147 case records which had information about the test results for type of malaria infection were reviewed. Out of 147, 89 (60.5%) had P. vivax malaria. Of the 89 patients with P. vivax malaria, 47 (53%) were children and 63 (70.7%) were males. A peak in the number of inpatients was seen in September with median duration of hospital stay of 4 days and case fatality rate of 9%. A total of 56 (63%) patients had one or more severe manifestations of malaria as per WHO criteria. The most common severe manifestation was bleeding 27 (30%) followed by impaired consciousness 18 (20%).Conclusions: In more than half of the malaria patients admitted at the tertiary care centre the diagnosis was P. vivax malaria. Of them 63% patients had severe malaria as per WHO criteria.

scholarly journals FREQUENCY AND CAUSES OF PERINATAL MORTALITY IN A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

2018 ◽  
Vol 16 (1) ◽  
pp. 15-19
Author(s):  
Maimoona Qadir ◽  
Sohail Amir ◽  
Samina Jadoon ◽  
Muhammad Marwat
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Mortality Data ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical Disorders ◽  
Perinatal Mortality Rate

Background: Perinatal mortality rate indicates quality of care provided during pregnancy and delivery to the mother and to the neonate in its early neonatal period. The objective of this study was to determine the frequency and causes of perinatal mortality in a tertiary care hospital in Peshawar, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Gynaecology & Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 1st January 2016 to 31st December 2016. The inclusion criteria was all singleton gestation with gestational age of at least 24 weeks presenting with perinatal mortality. Data was collected for the following variables; age groups (up to 20 years, 21-30 years, 31-40 years and > 40 years), booking status (yes/ no), period of gestation (24-31+6, 32-36+6, 37-39+6 and > 40 weeks), Foetal weight ( 3.5 kg) and cause of perinatal mortality. Results: Out of 4508 deliveries there were 288 perinatal deaths, including 228 stillbirths and 60 neonatal deaths, so perinatal mortality rate was 63.8/1000 births. 90.28% women were unbooked. Most common cause was hypertensive disorders of pregnancy (27.78%) followed by antepartum haemorrhage (25.71%) and then mechanical causes (13.88%). Congenital anomalies comprised 11.8% cases, neonatal problems 10.07% and maternal medical disorders for 4.16% cases. Cause of 4.16% cases remained unexplained. Conclusion: Appropriate strategies like control of identifiable causes, proper antenatal and postnatal care, healthy delivery practices and availability of emergency neonatal care facilities can bring down perinatal mortality rates.

Comparison of Predictors of Mortality between Young and Elder Covid-19 Patients Admitted in Covid-19 Designated Tertiary Care Hospital

Healthline ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 46-54
Author(s):  
Sonal Shah ◽  
Manisha Kapdi ◽  
Jyoti Vora ◽  
Kuldeep Joshi ◽  
Pratik Patel ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Facility ◽  
Health Care Facility ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Predictors Of Mortality ◽  
Co Morbidity

Background: The outbreak of Covid-19 has led to a health emergency and economic crisis worldwide. Mortality in productive age further worsens the crisis, so it is important to understand reasons for death in productive age group. Objective: To identify predictors of mortality and to compare the intensity of rise in inflammatory markers of amongst young Covid-19 decedents in comparison with elder Covid-19 decedents. Method: Record based study of Covid-19 infected admitted patients was conducted in tertiary care hospital. Information of all (n=3131, 209 deceased and 2922 recovered patients) Covid-19 positive patient assessed . Their clinico epidemiological markers were compared between younger (18-45 years) decedents in comparision with elder decedents (>45 years). Mann–Whitney U-test and the Chi-square test for significance were used. Bivariate Multiple logistic regression was used to identify predictors in younger and elder decedents. Results: Case Fatality Rate (CFR) in Covid-19 infected patients was 2.4% and 9.7% amongst younger and elder group respectively. (OR 8.83 : 95% CI 5.9-13.2; p < 0.001). Biomarkers were raised and similar in both groups except Neutrophil Lymphocyte Ratio (NLR) was significantly higher in elder decedent while LDH was significantly higher in younger decedents. Conclusions: Males had higher CFR than females after 45 years of age, which was due to co-morbidity. Reaching late to the health care facility and high LDH were predictors in younger decedent, while male gender, co morbidities and high NLR were more important predictors in elder group.

scholarly journals Performance of PRISM score III in predicting the outcome of patients admitted in tertiary care pediatric intensive care unit (P.I.C.U.): A pilot study

2017 ◽  
Vol 1 (1) ◽  
pp. 28
Author(s):  
Laraib Malik
Keyword(s):  
Pilot Study ◽  
Tertiary Care Hospital ◽  
White Cell Count ◽  
Tertiary Care ◽  
Standards Of Care ◽  
Care Hospital ◽  
Pupillary Reflex ◽  
Prism Score ◽  
Poor Outcome ◽  
Arterial Blood

Introduction: P.I.C.U is a unit that provides care to the critically ill patients with purpose of reducing the rate of mortality and morbidity. Various scoring systems are used to assess and compare the standards of care of different P.I.C.U.s. Among them, PRISM III scoring has shown promising results, especially in developing countries. In Pakistan, these studies are fewer in numbers with conflicting results in different hospital settings (private and public sector). Since our hospital is also a tertiary care hospital, we planned a pilot study to evaluate PRISM III score in our P.I.C.U.    Objective: To evaluate the performance of PRISM III score in predicting the    outcome of patients admitted in P.I.C.U of tertiary care hospital of Karachi. Method: PRISM III is Pediatric Risk of Mortality Scoring system consisting of clinical    assessment (Glasgow Coma Scale, pupillary reflex, temperature, heart rate, systolic blood pressure) and lab parameters (arterial blood gas, urea, nitrogen, creatnine, blood sugar, potassium, white cell count, platelets, PT/APTT). It is a cross-sectional study and data was collected from admitted patients in P.I.C.U, Unit II of Abbasi Shaheed Hospital during 1st October to 31st December 2016. PRISM score is being calculated from all the patients within 24 hours of admission. Result: Total of 70  patients of which 51(72%) survived and 19(27%) expired. 49 were males and 21   females. Age range of non-survivors was 2 to 18 months. Duration of PI.C.U stay was 72 hours for survivors. Patients who were referred, had malnutrition, depressed  mental status, deranged renal functions and required mechanical ventilation during first hour of admission had poor outcome. Out of 19 non-survivors, PRISM III   predicted mortality in 15 patients (78.9%). Conclusion: High total PRISM III score was significantly associated with poor outcome i.e. death in this pilot study. Thus PRISM III score was found to be a valid predictor of outcome in our P.I.C.U. There is no conflict of interest keywords: P.I.C.U, Mortality, PRISM III score, Outcome.

scholarly journals Profile of Diabetic Foot Ulcer Patients at Tertiary Care Hospital in Surabaya, Indonesia

2021 ◽  
Vol 9 (3) ◽  
pp. 293
Author(s):  
Arisvia Sukma Hariftyani ◽  
Hermina Novida ◽  
Mouli Edward
Keyword(s):  
Mortality Rate ◽  
Diabetic Foot ◽  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Care Hospital ◽  
Precipitating Factors ◽  
Medical Histories

Background: Diabetic Foot Ulcer (DFU) has been associated with a high mortality rate of Diabetes Mellitus (DM) patients. Both behavioral and biological factors cause predisposition to DFU. Purpose: This research describes the profile of hospitalized DFU patients at a tertiary care hospital in Surabaya. Methods: A retrospective descriptive study that analyzed medical records of hospitalized T2DM patients with DFU in Dr. Soetomo General Hospital. Sampled respondents were patients ≥ 21 years old who were hospitalized between 2016–2018. Demographic data, clinical characteristics, medical histories, length of hospital stay, laboratory results, precipitating factors, microorganism culture results, treatment, and outcome were analyzed. Descriptive analysis is presented in the form of narratives, tables, and diagrams. Results: 9.08% of hospitalized Type 2 DM (T2DM) cases were related to foot ulcers. The average patient age was 57.00 ± 9.83 years with no gender predominance. DM was poorly controlled (Mean HbA1C 9.78±2.83%; RBG 251.83 ± 158.15 mg/dL). The majority of patients had sepsis (68.26%) and renal function impairment (62.72%). Ulcers with Wagner grades of 4–5 were frequent (41.31%). The highest percentage of sepsis (80.49%) and the average leukocyte level (22.60±11.95 x109/L) were found in gangrenous feet. Anemia was more predominant and severe in ulcers with higher Wagner grades. Trauma and Escherichia coli were the most common precipitating factors and microorganisms isolated, respectively. Amputation was performed for 82.36% of patients who were admitted to hospital with gangrene. The Lower Extremity Amputation (LEA) and mortality rates were 14.11% and 40.93%, respectively. Conclusion: DFUs were found to have a relatively high prevalence among T2DM patients, and must never be neglected due to the high associated mortality rate.

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