Comparison of the Predictive Ability of the Pediatric Risk of Mortality III, Pediatric Index of Mortality, and Pediatric Logistic Organ Dysfunction in Medical and Surgical Intensive Care Units

Latar belakang. Penilaian derajat kesakitan (severity score of illness) telah dikembangkan sejalan dengan meningkatnyaperhatian terhadap evaluasi dan pemantauan pelayanan kesehatan. Skor yang telah dikembangkanuntuk anak adalah pediatric logistic organ dysfunction, pediatric risk of mortality, dan pediatric index ofmortality.Tujuan. Membandingkan ketepatan pediatric index of mortality-2 dengan skor pediatric logistic organdysfunction dalam memprediksi kematian pasien sakit kritis pada anak.Metode. Rancangan observasi longitudinal dengan subjek penelitian anak yang menderita sakit kritis, dirawatdi Bagian Ilmu Kesehatan Anak RSHS pada bulan Februari-Mei 2008. Dilakukan anamnesis, pemeriksaanfisis, dan laboratorium untuk mendapatkan pediatric index of mortality 2 dan skor pediatric logistic organdysfunction. Analisis statistik dengan menggunakan receiver operating characteristic (ROC) untuk menilaidiskriminasi dan Hosmer-Lemeshow goodness-of-fit untuk menilai kalibrasi.Hasil. Didapatkan 1215 anak berobat ke Bagian Ilmu Kesehatan Anak RS Hasan Sadikin Bandung, 120di antaranya merupakan pasien kritis. Pediatric index of mortality 2 memberikan hasil diskriminasi yanglebih baik (ROC 0,783; 95% CI 0,688–0,878) dibandingkan dengan pediatric logistic organ dysfunction(ROC 0,706; 95% CI 0,592–0,820). Pediatric index of mortality-2 memberikan hasil kalibrasi yang baik(Hosmer-Lemeshow goodness-of-fit test p=0,33; SMR 0,85) dibandingkan pediatric logistic organ dysfunction(p=0,00; SMR 1,37). PIM2 dan skor PELOD mempunyai korelasi positif dihitung dengan menggunakanSpearman’s correlation, r=0,288 (p=0,001).Kesimpulan. Pediatric index of mortality-2 memiliki kemampuan diskriminasi dan kalibrasi lebih baikdibandingkan dengan pediatric logistic organ dysfunction.

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The Values of the Pediatric Logistic Organ Dysfunction (PELOD) Score and the Pediatric Index of Mortality (PIM) 2 Score in Emergency Department and Intensive Care Unit

The Korean Journal of Critical Care Medicine ◽

10.4266/kjccm.2010.25.3.144 ◽

2010 ◽

Vol 25 (3) ◽

pp. 144 ◽

Cited By ~ 1

Author(s):

Si Kyoung Jeong ◽

Woon Jeong Lee ◽

Yun Joo Moon ◽

Seon Hee Woo ◽

Yeon Young Kyong ◽

...

Keyword(s):

Intensive Care Unit ◽

Emergency Department ◽

Intensive Care ◽

Organ Dysfunction ◽

Logistic Organ Dysfunction ◽

Pediatric Index Of Mortality ◽

Pelod Score

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 Manuscript Status... GO Article Detail Pediatric Logistic Organ Dysfunction-2, Pediatric Risk Of Mortality-IV And Pediatric Index Of Mortality-3 For Predicting Mortality In Pediatric Surgery Patients With Sepsis

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2020.12.04.214 ◽

2020 ◽

Vol 12 (04) ◽

Keyword(s):

Organ Dysfunction ◽

Pediatric Surgery ◽

Logistic Organ Dysfunction ◽

Risk Of Mortality ◽

Pediatric Index Of Mortality

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Prevalence of multiple organ dysfunction in the pediatric intensive care unit: Pediatric Risk of Mortality III versus Pediatric Logistic Organ Dysfunction scores for mortality prediction

Revista Brasileira de Terapia Intensiva ◽

10.5935/0103-507x.20170029 ◽

2017 ◽

Vol 29 (2) ◽

Cited By ~ 3

Author(s):

Azza Abd Elkader El Hamshary ◽

Seham Awad El Sherbini ◽

HebatAllah Fadel Elgebaly ◽

Samah Abdelkrim Amin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Organ Dysfunction ◽

Pediatric Intensive Care ◽

Multiple Organ ◽

Mortality Prediction ◽

Multiple Organ Dysfunction ◽

Logistic Organ Dysfunction ◽

Risk Of Mortality

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PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd8-4/006 ◽

2019 ◽

Author(s):

Rabia Arshad

Keyword(s):

Intensive Care ◽

Antimicrobial Resistance ◽

Acinetobacter Baumannii ◽

Intensive Care Units ◽

Carbapenem Resistance ◽

Chronic Obstructive ◽

Surgical Intensive Care ◽

Carbapenem Resistant ◽

Number Of Patients ◽

Increased Risk

Background: Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs). Methods: This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis. Results: Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs. Conclusion: This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

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Pediatric Multi-Organ Dysfunction Syndrome: Analysis by an Untargeted “Shotgun” Lipidomic Approach Reveals Low-Abundance Plasma Phospholipids and Dynamic Recovery over 8-Day Period, a Single-Center Observational Study

Nutrients ◽

10.3390/nu13030774 ◽

2021 ◽

Vol 13 (3) ◽

pp. 774

Author(s):

Mara L. Leimanis-Laurens ◽

Karen Ferguson ◽

Emily Wolfrum ◽

Brian Boville ◽

Dominic Sanfilippo ◽

...

Keyword(s):

Mass Spectrometry ◽

Intensive Care ◽

Critically Ill ◽

Organ Dysfunction ◽

Lipid Profiles ◽

Critically Ill Children ◽

P Value ◽

Time Points ◽

Logistic Organ Dysfunction ◽

Multi Organ Dysfunction Syndrome

Lipids are molecules involved in metabolism and inflammation. This study investigates the plasma lipidome for markers of severity and nutritional status in critically ill children. Children with multi-organ dysfunction syndrome (MODS) (n = 24) are analyzed at three time-points and cross-referenced to sedation controls (n = 4) for a total of N = 28. Eight of the patients with MODS, needed veno-arterial extracorporeal membrane oxygenation (VA ECMO) support to survive. Blood plasma lipid profiles are quantified by nano-electrospray (nESI), direct infusion high resolution/accurate mass spectrometry (MS), and tandem mass spectrometry (MS/MS), and compared to nutritional profiles and pediatric logistic organ dysfunction (PELOD) scores. Our results show that PELOD scores were not significantly different between MODS and ECMO cases across time-points (p = 0.66). Lipid profiling provides stratification between sedation controls and all MODS patients for total lysophosphatidylserine (lysoPS) (p-value = 0.004), total phosphatidylserine (PS) (p-value = 0.015), and total ether-linked phosphatidylethanolamine (ether-PE) (p-value = 0.03) after adjusting for sex and age. Nutrition intake over time did not correlate with changes in lipid profiles, as measured by caloric and protein intake. Lipid measurement in the intensive care environment shows dynamic changes over an 8-day pediatric intensive care unit (PICU) course, suggesting novel metabolic indicators for defining critically ill children.

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Hand hygiene and the sequence of patient care

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.82 ◽

2021 ◽

pp. 1-6

Author(s):

Nai-Chung Chang ◽

Michael Jones ◽

Heather Schacht Reisinger ◽

Marin L. Schweizer ◽

Elizabeth Chrischilles ◽

...

Keyword(s):

Intensive Care ◽

Hand Hygiene ◽

Patient Care ◽

Intensive Care Units ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Resistant Bacteria ◽

Surgical Intensive Care ◽

Hygiene Compliance ◽

Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

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