Tuesday, 3 June 2008
Trial of Alcohol-Based Hand Gel in Critical Care Units.
Infect Control Hosp Epidemiol. 2008 Jun;29(6):577-578.
Related Articles, Links Mermel LA, Boyce JM, Voss A, Allegranzi B, Pittet D.
From the Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island (L.A.M.); the Hospital of St. Raphael, New Haven, Connecticut (J.M.B.); the Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, the Netherlands (A.V.); the World Health Organization (WHO) World Alliance for Patient Safety First Global Patient Safety Challenge, WHO Headquarters (J.M.B., A.V., B.A., D.P.), and the Infection Control Program, University of Geneva Hospitals and Faculty of Medicine (D.P.) , Geneva, Switzerland .Publication Types:
LETTER
Related Articles, Links Mermel LA, Boyce JM, Voss A, Allegranzi B, Pittet D.
From the Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island (L.A.M.); the Hospital of St. Raphael, New Haven, Connecticut (J.M.B.); the Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, the Netherlands (A.V.); the World Health Organization (WHO) World Alliance for Patient Safety First Global Patient Safety Challenge, WHO Headquarters (J.M.B., A.V., B.A., D.P.), and the Infection Control Program, University of Geneva Hospitals and Faculty of Medicine (D.P.) , Geneva, Switzerland .Publication Types:
LETTER
Bench-to-bedside review: Sepsis, severe sepsis and septic shock – does the nature of the infecting organism matter?
Review Bench-to-bedside review: Sepsis, severe sepsis and septic shock – does the nature of the infecting organism matter?
Hongmei Gao, Timothy W Evans, Simon J Finney
Critical Care 2008, 12:213 (6 May 2008)
Critical Care: Thematic Series - The thematic series provides substantial coverage of a topic through a group of concise articles on various aspects of a single theme, the latest of which is on the topic of infection. Please find below an example of a highly accessed review article taken from the Infection thematic series.
Hongmei Gao, Timothy W Evans, Simon J Finney
Critical Care 2008, 12:213 (6 May 2008)
Critical Care: Thematic Series - The thematic series provides substantial coverage of a topic through a group of concise articles on various aspects of a single theme, the latest of which is on the topic of infection. Please find below an example of a highly accessed review article taken from the Infection thematic series.
CINAHL articles
1. Heart rate variability measures as predictors of in-hospital mortality in ED patients with sepsis. Chen-WL, Chen-JH, Huang-CC, Kuo-CD, Huang-CI, Lee-LS. American Journal of Emergency Medicine, 2008 May, vol. 26, no. 4, p. 395-401, ISSN: 0735-6757.
2. Evaluation of ICU admission criteria and diagnostic methods for patients with severe community-acquired pneumonia: current practice survey.
Restrepo-MI, Bienen-T, Mortensen-EM, Anzueto-A, Metersky-ML, Escalante-P, Wunderink-RG, Mangura-BT. Chest, 2008 Mar, vol. 133, no. 3, p. 828-9, (4 ref), ISSN: 0012-3692.
3. Family member satisfaction with end-of-life decision making in the ICU. Gries-CJ, Curtis-JR, Wall-RJ, Engelberg-RA. Chest, 2008 Mar, vol. 133, no. 3, p. 704-12, (38 ref), ISSN: 0012-3692.
4. A comparative study of community-acquired pneumonia patients admitted to the ward and the ICU. Restrepo-MI, Mortensen-EM, Velez-JA, Frei-C, Anzueto-A. Chest, 2008 Mar, vol. 133, no. 3, p. 610-7, (32 ref), ISSN: 0012-3692.
5. The impact of critical illness on perceived health-related quality of life during ICU treatment, hospital stay, and after hospital discharge: a long-term follow-up study. Hofhuis-JG, Spronk-PE, van-Stel-HF, Schrijvers-GJ, Rommes-JH, Bakker- J. Chest, 2008 Feb, vol. 133, no. 2, p. 377-85, (37 ref), ISSN: 0012-3692.
6. Health-related quality of life: an outcome variable in critical care survivors. Azoulay-E, Kentish-Barnes-N, Pochard-F. Chest, 2008 Feb, vol. 133, no. 2, p. 339-41, (20 ref), ISSN: 0012-3692.
2. Evaluation of ICU admission criteria and diagnostic methods for patients with severe community-acquired pneumonia: current practice survey.
Restrepo-MI, Bienen-T, Mortensen-EM, Anzueto-A, Metersky-ML, Escalante-P, Wunderink-RG, Mangura-BT. Chest, 2008 Mar, vol. 133, no. 3, p. 828-9, (4 ref), ISSN: 0012-3692.
3. Family member satisfaction with end-of-life decision making in the ICU. Gries-CJ, Curtis-JR, Wall-RJ, Engelberg-RA. Chest, 2008 Mar, vol. 133, no. 3, p. 704-12, (38 ref), ISSN: 0012-3692.
4. A comparative study of community-acquired pneumonia patients admitted to the ward and the ICU. Restrepo-MI, Mortensen-EM, Velez-JA, Frei-C, Anzueto-A. Chest, 2008 Mar, vol. 133, no. 3, p. 610-7, (32 ref), ISSN: 0012-3692.
5. The impact of critical illness on perceived health-related quality of life during ICU treatment, hospital stay, and after hospital discharge: a long-term follow-up study. Hofhuis-JG, Spronk-PE, van-Stel-HF, Schrijvers-GJ, Rommes-JH, Bakker- J. Chest, 2008 Feb, vol. 133, no. 2, p. 377-85, (37 ref), ISSN: 0012-3692.
6. Health-related quality of life: an outcome variable in critical care survivors. Azoulay-E, Kentish-Barnes-N, Pochard-F. Chest, 2008 Feb, vol. 133, no. 2, p. 339-41, (20 ref), ISSN: 0012-3692.
Sleep and Pain
Edited by Giles Lavigne , Barry J . Sessle , Manon Choiniere , and Peter J . Soja
Author(s): Sanford , L . D .
ISSUE: 2008 ; VOL 31 ; PART 5
Journal Title: Sleep From UK PubMed Central (/2007 - 11/2007)
Page: 753-753
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Author(s): Sanford , L . D .
ISSUE: 2008 ; VOL 31 ; PART 5
Journal Title: Sleep From UK PubMed Central (/2007 - 11/2007)
Page: 753-753
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Too Weighty a Link Between Short Sleep and Obesity ?
Too Weighty a Link Between Short Sleep and Obesity ?
Author(s): Horne , J .
ISSUE: 2008 ; VOL 31 ; PART 5
Journal Title: Sleep From UK PubMed Central (/2007 - 11/2007)
Page: 595-598
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Author(s): Horne , J .
ISSUE: 2008 ; VOL 31 ; PART 5
Journal Title: Sleep From UK PubMed Central (/2007 - 11/2007)
Page: 595-598
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A Single Subjective Question Can Be An Effective Sleepiness Screening ToolMain
Category: Sleep / Sleep Disorders / Insomnia
Article Date: 16 Apr 2008 - 7:00
PDT email to a friend printer friendly view / write opinions rate article
A single subjective (SS) question may be an effective screening tool for excessive daytime sleepiness, according to a study published in the April 15 issue of the Journal of Clinical Sleep Medicine (JCSM).
Article Date: 16 Apr 2008 - 7:00
PDT email to a friend printer friendly view / write opinions rate article
A single subjective (SS) question may be an effective screening tool for excessive daytime sleepiness, according to a study published in the April 15 issue of the Journal of Clinical Sleep Medicine (JCSM).
Nova Scotia: No closing of ICUs health minister says
No closing of ICUs health minister says
report on intensive-care units incurrent system is unsustainabled' Entremont said.
"Wh..... News From CBC Health News
22 May 2008
report on intensive-care units incurrent system is unsustainabled' Entremont said.
"Wh..... News From CBC Health News
22 May 2008
Black patients with terminal cancer more likely to choose aggressive care at end of life
Black patients with terminal cancer more likely to choose aggressive care at end of life
whites to die in a hospital intensive.....
29 May 2008
CHICAGO—Black patients with advanced cancer were more likely than whites to die in a hospital intensive care unit, reflecting a greater preference among blacks for life-extending treatment even in the face of a terminal prognosis, according to a study led by researchers at Dana-Farber Cancer Institute in Boston. The findings (abstract 6506) will be presented at the annual meeting of the American Society of Clinical Oncology in Chicago on Monday, June 2, 3 - 6 p.m. CT, South Building, Hall100B.
"There is something different about the way black patients and white patients approach the end of life," Trice said, which may be based in cultural attitudes, religious beliefs, and how thoroughly they have been informed about and comprehend their prognosis, among other things.
whites to die in a hospital intensive.....
29 May 2008
CHICAGO—Black patients with advanced cancer were more likely than whites to die in a hospital intensive care unit, reflecting a greater preference among blacks for life-extending treatment even in the face of a terminal prognosis, according to a study led by researchers at Dana-Farber Cancer Institute in Boston. The findings (abstract 6506) will be presented at the annual meeting of the American Society of Clinical Oncology in Chicago on Monday, June 2, 3 - 6 p.m. CT, South Building, Hall100B.
"There is something different about the way black patients and white patients approach the end of life," Trice said, which may be based in cultural attitudes, religious beliefs, and how thoroughly they have been informed about and comprehend their prognosis, among other things.
Update on Methicillin-Resistant Staphylococcus Aureus (MRSA)
Update on Methicillin-Resistant Staphylococcus Aureus (MRSA)
ISSUE: 2008 ; VOL 28 ; PART 2
Journal Title: Urologic Nursing From EBSCO ( CINAHL with Full Text ) - via Athens (04/2001 - /)
From Proquest NHS [Full Text] (06/1998 - /)
Page: 143-148
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ISSUE: 2008 ; VOL 28 ; PART 2
Journal Title: Urologic Nursing From EBSCO ( CINAHL with Full Text ) - via Athens (04/2001 - /)
From Proquest NHS [Full Text] (06/1998 - /)
Page: 143-148
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The Continuing Saga of MRSA
The Continuing Saga of MRSA
Author(s): Flynn , N . ; Cohen , S . H .
ISSUE: 2008 ; VOL 197 ; PART 9
Journal Title:
Journal of Infectious Diseases From Free Medical Journals . com (/1997 - /Embargo: 1 year)
From Proquest NHS (03/1996 - 07/2006)
Page: 1217-1219
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Author(s): Flynn , N . ; Cohen , S . H .
ISSUE: 2008 ; VOL 197 ; PART 9
Journal Title:
Journal of Infectious Diseases From Free Medical Journals . com (/1997 - /Embargo: 1 year)
From Proquest NHS (03/1996 - 07/2006)
Page: 1217-1219
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Preventing infections from cannulas reduces MRSA
BMJ . British Medical Journal - International Edition From Publisher From Free Medical Journals . com (/1994 - /Embargo: 1 year)
From Proquest NHS (01/1994 - 12/2003)
Page: 1085 - 1086
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From Proquest NHS (01/1994 - 12/2003)
Page: 1085 - 1086
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Quantitative Analysis of Rest - Activity Patterns in Elderly Postoperative Patients with Delirium : Support for a Theory of Pathologic Wakefulness
Quantitative Analysis of Rest - Activity Patterns in Elderly Postoperative Patients with Delirium : Support for a Theory of Pathologic Wakefulness
Author(s): Jacobson , S . A . ; Dwyer , P . C . ; Machan , J . T . ; Carskadon , M . A .
ISSUE: 2008 ; VOL 4 ; PART 2
Journal Title: Journal of Clinical Sleep Medicine From UK PubMed Central (/2007 - 10/2007)
Page: 137-142
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Author(s): Jacobson , S . A . ; Dwyer , P . C . ; Machan , J . T . ; Carskadon , M . A .
ISSUE: 2008 ; VOL 4 ; PART 2
Journal Title: Journal of Clinical Sleep Medicine From UK PubMed Central (/2007 - 10/2007)
Page: 137-142
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Foundations of Evidence-Based Practice / Critical Care latest articles
American Journal of Critical Care From EBSCO ( CINAHL with Full Text ) - via Athens (11/2002 - /)
From Free Medical Journals . com From Proquest NHS (01/1998 - 05/2007)
Page: 190-193
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Critical Care-Latest articles
Author(s): Marjolein de Wit ; Chris Gennings ; Wendy I Jenvey and Scott K Epstein
ISSUE: 2008 ; VOL 12 (2008-01-03)
Journal Title:
Critical Care From BioMed Central [PDF] [Abstract]
From Free Medical Journals . com (/1997 - /Embargo: 2 years)
From UK PubMed Central (/1997 - /2008)
Page: R70
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From Free Medical Journals . com From Proquest NHS (01/1998 - 05/2007)
Page: 190-193
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Critical Care-Latest articles
Author(s): Marjolein de Wit ; Chris Gennings ; Wendy I Jenvey and Scott K Epstein
ISSUE: 2008 ; VOL 12 (2008-01-03)
Journal Title:
Critical Care From BioMed Central [PDF] [Abstract]
From Free Medical Journals . com (/1997 - /Embargo: 2 years)
From UK PubMed Central (/1997 - /2008)
Page: R70
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Intensity of Renal Support in Critically Ill Patients
Original Article: Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury
The VA/NIH Acute Renal Failure Trial Network
http://content.nejm.org/cgi/content/full/NEJMoa0802639?query=TOC
To coincide with a presentation at the International Conference of the American Thoracic Society, the following articles were published at www.nejm.org on May 20, 2008. They will appear in the July 3, 2008, issue of the Journal.
The VA/NIH Acute Renal Failure Trial Network
http://content.nejm.org/cgi/content/full/NEJMoa0802639?query=TOC
To coincide with a presentation at the International Conference of the American Thoracic Society, the following articles were published at www.nejm.org on May 20, 2008. They will appear in the July 3, 2008, issue of the Journal.
The pre-symptomatic prediction of sepsis in intensive care unit patients: a pilot study
Clin. Vaccine Immunol.
doi:10.1128/CVI.00486-07
Copyright (c) 2008,
American Society for Microbiology and/or the Listed Authors/Institutions.
All Rights Reserved.
R A Lukaszewski*, A M Yates, M C Jackson, K Swingler, J M Scherer, A J Simpson, P Sadler, P McQuillan, R W Titball, T JG Brooks, and M J Pearce
Dstl Porton Down, Salisbury, Wiltshire, UK. SP4 0JQ; INCITE Group, University of Stirling, Scotland; Department of Critical Care, Queen Alexandra Hospital, Cosham, Portsmouth, Hampshire, UK. PO6 3LY; HPA Centre for emergency preparedness and response, Porton Down, Salisbury, Wiltshire, UK; School of Biosciences, Geoffrey Pope Building, University of Exeter, Exeter, UK
* To whom correspondence should be addressed. Email: ralukaszewsk@dstl.gov.uk
Abstract:
Post-operative or post-traumatic sepsis remains one of the leading causes of morbidity and mortality in hospital populations, especially in populations in intensive care units (ICUs). Central to the successful control of sepsis-associated infections is the ability to rapidly diagnose and treat disease. The ability to identify sepsis patients before they show any symptoms would have major benefits for the healthcare of ICU patients. In this study ninety-two ICU patients, who had undergone procedures that increased the risk of developing sepsis, were recruited upon admission. Blood samples were taken daily until either a clinical diagnosis of sepsis was made or until the patient was discharged from ICU. In addition to standard clinical and laboratory parameter testing, the expression of Interleukins (IL) -1, -6, -8, -10, Tumour necrosis factor (TNF)-, FasL and CCL2 mRNA was also measured by real-time RT-PCR. Analysis of the data using a non-linear technique (neural network analysis) demonstrated discernible differences prior to the onset of overt sepsis. Neural networks using cytokine and chemokine data were able to correctly predict patient outcome in an average 83.09% of patient cases between 4 and 1 days before clinical diagnosis with high sensitivity and selectivity (91.43% and 80.20%, respectively). The neural network also had a predictive accuracy of 94.55% when data from 22 healthy volunteers was analysed in conjunction with the ICU patient data. Our observations from this pilot study indicate that it may be possible to predict the onset of sepsis in a mixed patient population using a panel of just 7 biomarkers.
doi:10.1128/CVI.00486-07
Copyright (c) 2008,
American Society for Microbiology and/or the Listed Authors/Institutions.
All Rights Reserved.
R A Lukaszewski*, A M Yates, M C Jackson, K Swingler, J M Scherer, A J Simpson, P Sadler, P McQuillan, R W Titball, T JG Brooks, and M J Pearce
Dstl Porton Down, Salisbury, Wiltshire, UK. SP4 0JQ; INCITE Group, University of Stirling, Scotland; Department of Critical Care, Queen Alexandra Hospital, Cosham, Portsmouth, Hampshire, UK. PO6 3LY; HPA Centre for emergency preparedness and response, Porton Down, Salisbury, Wiltshire, UK; School of Biosciences, Geoffrey Pope Building, University of Exeter, Exeter, UK
* To whom correspondence should be addressed. Email: ralukaszewsk@dstl.gov.uk
Abstract:
Post-operative or post-traumatic sepsis remains one of the leading causes of morbidity and mortality in hospital populations, especially in populations in intensive care units (ICUs). Central to the successful control of sepsis-associated infections is the ability to rapidly diagnose and treat disease. The ability to identify sepsis patients before they show any symptoms would have major benefits for the healthcare of ICU patients. In this study ninety-two ICU patients, who had undergone procedures that increased the risk of developing sepsis, were recruited upon admission. Blood samples were taken daily until either a clinical diagnosis of sepsis was made or until the patient was discharged from ICU. In addition to standard clinical and laboratory parameter testing, the expression of Interleukins (IL) -1, -6, -8, -10, Tumour necrosis factor (TNF)-, FasL and CCL2 mRNA was also measured by real-time RT-PCR. Analysis of the data using a non-linear technique (neural network analysis) demonstrated discernible differences prior to the onset of overt sepsis. Neural networks using cytokine and chemokine data were able to correctly predict patient outcome in an average 83.09% of patient cases between 4 and 1 days before clinical diagnosis with high sensitivity and selectivity (91.43% and 80.20%, respectively). The neural network also had a predictive accuracy of 94.55% when data from 22 healthy volunteers was analysed in conjunction with the ICU patient data. Our observations from this pilot study indicate that it may be possible to predict the onset of sepsis in a mixed patient population using a panel of just 7 biomarkers.
WEBSITE: ICUNurse.org
http://www.icunurse.org/
"This site, by a bedside nurse, for bedside nurses, is a wholly independent project of a member of Milwaukee’s Aurora Sinai Medical Center, ICU, Nurse Practice Council. It is intended to provide both the new and experienced Critical Care clinician with peer reviewed resources which are interesting and informative."
End-of-life care in the ICU
"This site, by a bedside nurse, for bedside nurses, is a wholly independent project of a member of Milwaukee’s Aurora Sinai Medical Center, ICU, Nurse Practice Council. It is intended to provide both the new and experienced Critical Care clinician with peer reviewed resources which are interesting and informative."
End-of-life care in the ICU
Improving rehabilitation following transfer from ICU.
Intensive Crit Care Nurs. 2008 May 8. [Epub ahead of print]
Links
Au: Ball C.
Royal Free Hampstead NHS Trust, Pond St, London NW3 2QN, United Kingdom; City Community and Health Sciences, City University, Northampton Square, London EC1V 0HB, United Kingdom.
PMID: 18472264 [PubMed - as supplied by publisher]
Links
Au: Ball C.
Royal Free Hampstead NHS Trust, Pond St, London NW3 2QN, United Kingdom; City Community and Health Sciences, City University, Northampton Square, London EC1V 0HB, United Kingdom.
PMID: 18472264 [PubMed - as supplied by publisher]
Experiences of critically ill patients in the ICU.
Intensive Crit Care Nurs. 2008 May 8. [Epub ahead of print]
Links: Hofhuis JG, Spronk PE, van Stel HF, Schrijvers AJ, Rommes JH, Bakker J.
Department of Intensive Care Medicine, Gelre Hospitals (location Lukas), Apeldoorn, The Netherlands; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
BACKGROUND: Experiences of critically ill patients are an important aspect of the quality of care in the intensive care (ICU).
OBJECTIVE: The aims of the study were firstly, to evaluate the perceptions of patients regarding nursing care in the ICU, and secondly, to explore patients' perceptions and experiences of ICU stay. METHOD: A qualitative approach using a semi-structured focused interview in 11 patients was used (phase 1), followed by a quantitative approach using a self-reported questionnaire in 100 patients, 62 were returned and 50 could be evaluated (phase 2).
RESULTS: A number of themes emerged from the interviews (phase 1), although support dominated as an important key theme. This was experienced as a continuum from the feeling being supported by the nurse to not being supported. This key theme was central to each of the three categories emerging from the data pertaining to: (1) providing the seriously ill patient with information and explanation, (2) placing the patient in a central position and (3) personal approach by the nurse. The responders to the subsequent questionnaire (phase 2) predominantly experienced sleeping disorders (48%), mostly related to the presence of noise (54%). Psychological problems after ICU stay were reported by 11% of the patients, i.e. fear, inability to concentrate, complaints of depression and hallucinations.
CONCLUSIONS: Although the nurses' expertise and technical skills are considered important, caring behaviour, relieving the patient of fear and worries were experienced as most valuable in bedside critical care.
PMID: 18472265 [PubMed - as supplied by publisher]
Links: Hofhuis JG, Spronk PE, van Stel HF, Schrijvers AJ, Rommes JH, Bakker J.
Department of Intensive Care Medicine, Gelre Hospitals (location Lukas), Apeldoorn, The Netherlands; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
BACKGROUND: Experiences of critically ill patients are an important aspect of the quality of care in the intensive care (ICU).
OBJECTIVE: The aims of the study were firstly, to evaluate the perceptions of patients regarding nursing care in the ICU, and secondly, to explore patients' perceptions and experiences of ICU stay. METHOD: A qualitative approach using a semi-structured focused interview in 11 patients was used (phase 1), followed by a quantitative approach using a self-reported questionnaire in 100 patients, 62 were returned and 50 could be evaluated (phase 2).
RESULTS: A number of themes emerged from the interviews (phase 1), although support dominated as an important key theme. This was experienced as a continuum from the feeling being supported by the nurse to not being supported. This key theme was central to each of the three categories emerging from the data pertaining to: (1) providing the seriously ill patient with information and explanation, (2) placing the patient in a central position and (3) personal approach by the nurse. The responders to the subsequent questionnaire (phase 2) predominantly experienced sleeping disorders (48%), mostly related to the presence of noise (54%). Psychological problems after ICU stay were reported by 11% of the patients, i.e. fear, inability to concentrate, complaints of depression and hallucinations.
CONCLUSIONS: Although the nurses' expertise and technical skills are considered important, caring behaviour, relieving the patient of fear and worries were experienced as most valuable in bedside critical care.
PMID: 18472265 [PubMed - as supplied by publisher]
Predicting death and readmission after intensive care discharge
Campbell AJ, Cook JA, Adey G, Cuthbertson BH.
Department of Anaesthesia, Western Infirmary, Glasgow G11 6NT, UK. alison.campbell3@nhs.net
BACKGROUND: Despite initial recovery from critical illness, many patients deteriorate after discharge from the intensive care unit (ICU). We examined prospectively collected data in an attempt to identify patients at risk of readmission or death after intensive care discharge.
METHODS: This was a secondary analysis of clinical audit data from patients discharged alive from a mixed medical and surgical (non-cardiac) ICU. RESULTS: Four hundred and seventy-five patients (11.2%) died in hospital after discharge from the ICU. Increasing age, time in hospital before intensive care admission, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and discharge Therapeutic Intervention Scoring System (TISS) score were independent risk factors for death after intensive care discharge. Three hundred and eighty-five patients (8.8%) were readmitted to intensive care during the same hospital admission. Increasing age, time in hospital before intensive care, APACHE II score, and discharge to a high dependency unit were independent risk factors for readmission. One hundred and forty-three patients (3.3%) were readmitted within 48 h of intensive care discharge. APACHE II scores and discharge to a high dependency or other ICU were independent risk factors for early readmission. The overall discriminant ability of our models was moderate with only marginal benefit over the APACHE II scores alone.
CONCLUSIONS: We identified risk factors associated with death and readmission to intensive care. It was not possible to produce a definitive model based on these risk factors for predicting death or readmission in an individual patient.
Department of Anaesthesia, Western Infirmary, Glasgow G11 6NT, UK. alison.campbell3@nhs.net
BACKGROUND: Despite initial recovery from critical illness, many patients deteriorate after discharge from the intensive care unit (ICU). We examined prospectively collected data in an attempt to identify patients at risk of readmission or death after intensive care discharge.
METHODS: This was a secondary analysis of clinical audit data from patients discharged alive from a mixed medical and surgical (non-cardiac) ICU. RESULTS: Four hundred and seventy-five patients (11.2%) died in hospital after discharge from the ICU. Increasing age, time in hospital before intensive care admission, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and discharge Therapeutic Intervention Scoring System (TISS) score were independent risk factors for death after intensive care discharge. Three hundred and eighty-five patients (8.8%) were readmitted to intensive care during the same hospital admission. Increasing age, time in hospital before intensive care, APACHE II score, and discharge to a high dependency unit were independent risk factors for readmission. One hundred and forty-three patients (3.3%) were readmitted within 48 h of intensive care discharge. APACHE II scores and discharge to a high dependency or other ICU were independent risk factors for early readmission. The overall discriminant ability of our models was moderate with only marginal benefit over the APACHE II scores alone.
CONCLUSIONS: We identified risk factors associated with death and readmission to intensive care. It was not possible to produce a definitive model based on these risk factors for predicting death or readmission in an individual patient.
A prospective observational study of ICU patient position and frequency of turning
Goldhill DR, Badacsonyi A, Goldhill AA, Waldmann C.
Related Articles, LinkOut
Anaesthesia. 2008 May;63(5):509-15. PMID: 18412649
[PubMed - indexed for MEDLINE]
Related Articles, LinkOut
Anaesthesia. 2008 May;63(5):509-15. PMID: 18412649
[PubMed - indexed for MEDLINE]
Insulin and pentastarch for severe sepsis
Van den Berghe G, Wilmer A, Bouillon R.
Related Articles,
Compound (MeSH Keyword), LinkOut
N Engl J Med. 2008 May 8;358(19):2073; author reply 2074-5. No abstract available. PMID: 18467979 [PubMed - indexed for MEDLINE]
Related Articles,
Compound (MeSH Keyword), LinkOut
N Engl J Med. 2008 May 8;358(19):2073; author reply 2074-5. No abstract available. PMID: 18467979 [PubMed - indexed for MEDLINE]
Comparison of the effect of protocol-directed sedation with propofol vs. midazolam by nurses in intensive care: efficacy, haemodynamic stability and p
Comparison of the effect of protocol-directed sedation with propofol vs. midazolam by nurses in intensive care: efficacy, haemodynamic stability and patient satisfaction
Author(s): Liou Huey - Ling ; Shih Chun - Che ; Tang Jen - Jen ; Lai Shau - Ting ; Chen Hsing - I
ISSUE: 2008 ; VOL 17 ; PART 11 (June 2008)
Journal Title: Journal of Clinical Nursing From Publisher [PDF] [Abstract] (/1997 - /)
From EBSCO ( CINAHL with Full Text ) - via Athens (01/1992 - /Embargo: 12 months)
Page: 1510-1517
Search the Web: [article] [author(s)]
see also:
Author(s): Liou Huey - Ling ; Shih Chun - Che ; Tang Jen - Jen ; Lai Shau - Ting ; Chen Hsing - I
ISSUE: 2008 ; VOL 17 ; PART 11 (June 2008)
Journal Title: Journal of Clinical Nursing From Publisher [PDF] [Abstract] (/1997 - /)
From EBSCO ( CINAHL with Full Text ) - via Athens (01/1992 - /Embargo: 12 months)
Page: 1510-1517
Search the Web: [article] [author(s)]
see also:
A qualitative study into the lived experience of post - CABG patients during mechanical ventilator weaning
A qualitative study into the lived experience of post - CABG patients during mechanical ventilator weaning
Author(s): Schou L . ; Egerod I .
ISSUE: 2008 ; VOL 24 ; PART 3 (06-2008)
Journal Title: Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing ) Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing )
Page: 171-179
Search the Web: [article] [author(s)]
Author(s): Schou L . ; Egerod I .
ISSUE: 2008 ; VOL 24 ; PART 3 (06-2008)
Journal Title: Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing ) Intensive and Critical Care Nursing ( Formerly : Intensive Care Nursing )
Page: 171-179
Search the Web: [article] [author(s)]
Sepsis articles:
Review of A Large Clinical Series : Paroxysmal Atrial Fibrillation in Critically Ill Patients With Sepsis
Author(s): Salam Salman
ISSUE: 2008 ; VOL 23 ; PART 3 (2008-May)
Journal Title: Journal of Intensive Care Medicine Journal of Intensive Care Medicine
Page: 178 - 183
Search the Web: [article] [author(s)]
Resuscitating the Microcirculation in Sepsis : The Central Role of Nitric Oxide , Emerging Concepts for Novel Therapies , and Challenges for Clinical Trials
Author(s): Trzeciak , S . ; Cinel , I . ; Phillip Dellinger , R . ; Shapiro , N . I . ; Arnold , R . C . ; Parrillo , J . E . ; Hollenberg , S . M .
ISSUE: 2008 ; VOL 15 ; PART 5 (2008/05/01)
Journal Title: Academic Emergency Medicine From Proquest NHS (07/2001 - 04/2006)
Page: 399-413
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Sepsis syndrome and death in trauma patients are associated with variation in the gene encoding tumor necrosis factor
Author(s): Menges , T . ; Konig , I . R . ; Hossain , H . ; Little , S . ; Tchatalbachev , S . ; Thierer , F . ; Hackstein , H . ; Franjkovic , I . ; Colaris , T . ; Martens , F .
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1456-1462
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Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients
Author(s):
Zakariah , A . N . ; Cozzi , S . M . ; Van Nuffelen , M . ; Clausi , C . M . ; Pradier , O . ; et al
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1507-1512
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Alterations in intracellular Ca^ 2^ +-homeostasis of skeletal muscle fibers during sepsis
Author(s): Zink , W . ; Kaess , M . ; Hofer , S . ; Plachky , J . ; Zausig , Y . A . ; Sinner , B . ; et al
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1559-1563
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Genes and sepsis: How tight is the fit ?
Author(s): Gordon , A . ; Knight , J . C . ; Hinds , C . J .
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1652-1653
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Author(s): Salam Salman
ISSUE: 2008 ; VOL 23 ; PART 3 (2008-May)
Journal Title: Journal of Intensive Care Medicine Journal of Intensive Care Medicine
Page: 178 - 183
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Resuscitating the Microcirculation in Sepsis : The Central Role of Nitric Oxide , Emerging Concepts for Novel Therapies , and Challenges for Clinical Trials
Author(s): Trzeciak , S . ; Cinel , I . ; Phillip Dellinger , R . ; Shapiro , N . I . ; Arnold , R . C . ; Parrillo , J . E . ; Hollenberg , S . M .
ISSUE: 2008 ; VOL 15 ; PART 5 (2008/05/01)
Journal Title: Academic Emergency Medicine From Proquest NHS (07/2001 - 04/2006)
Page: 399-413
Search the Web: [article] [author(s)]
Sepsis syndrome and death in trauma patients are associated with variation in the gene encoding tumor necrosis factor
Author(s): Menges , T . ; Konig , I . R . ; Hossain , H . ; Little , S . ; Tchatalbachev , S . ; Thierer , F . ; Hackstein , H . ; Franjkovic , I . ; Colaris , T . ; Martens , F .
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1456-1462
Search the Web: [article] [author(s)]
Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients
Author(s):
Zakariah , A . N . ; Cozzi , S . M . ; Van Nuffelen , M . ; Clausi , C . M . ; Pradier , O . ; et al
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1507-1512
Search the Web: [article] [author(s)]
Alterations in intracellular Ca^ 2^ +-homeostasis of skeletal muscle fibers during sepsis
Author(s): Zink , W . ; Kaess , M . ; Hofer , S . ; Plachky , J . ; Zausig , Y . A . ; Sinner , B . ; et al
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1559-1563
Search the Web: [article] [author(s)]
Genes and sepsis: How tight is the fit ?
Author(s): Gordon , A . ; Knight , J . C . ; Hinds , C . J .
ISSUE: 2008 ; VOL 36 ; PART 5
Journal Title: Critical Care Medicine http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=toc&D=ovft&AN=00003246-000000000-00000 [Full Text] (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1652-1653
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