Journal of critical care
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Journal of critical care · Oct 2014
Model for End-Stage Liver Disease score predicts mortality in critically ill cirrhotic patients.
Cirrhosis is a common condition that complicates the management of patients who require critical care. There is interest in identifying scoring systems that may be used to predict outcome because of the poor odds for recovery despite high-intensity care. We sought to evaluate how Model for End-Stage Liver Disease (MELD), an organ-specific scoring system, compares with other severity of illness scoring systems in predicting short- and long-term mortality for critically ill cirrhotic patients. ⋯ Our results demonstrate that the prognostic ability of a variety of scoring systems strongly depends on the patient population. In the MICU population, each model (MELD + SOFA, MELD, and SOFA) demonstrates excellent discrimination for 28-day and 1-year mortality. However, these scoring systems did not predict 28-day mortality in the surgical ICU group but were significant for 1-year mortality. This suggests that patients admitted to a surgical ICU will behave similarly to their MICU cohort if they survive the perioperative period.
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Journal of critical care · Oct 2014
CHADS2 and CHA2DS2-VASc scores can predict thromboembolic events after supraventricular arrhythmia in the critically ill patients.
Prediction of arterial thromboembolic events (ATEs) in relation to supraventricular arrhythmia (SVA) has been poorly investigated in the intensive care unit (ICU). We aimed at evaluating CHADS2 and CHA2DS2-VASc scores to predict SVA-related ATE in the ICU. ⋯ CHADS2 and CHA2DS2-VASc scores are predictive of SVA-related thromboembolism in the critically ill patient.
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Journal of critical care · Oct 2014
Observational StudyImpact of seasonal temperature environment on the neurologic prognosis of out-of-hospital cardiac arrest: A nationwide, population-based cohort study.
The relationship between environmental factors, such as winter or cold environments, and the onset of out-of-hospital cardiac arrest (OHCA) is well known. However, the association between environmental factors and the neurologic outcome of OHCA is poorly understood. This study aimed to assess the impact of the ambient temperature on the neurologic outcome of adult OHCA. ⋯ The seasonal ambient temperature is likely to affect favorable neurologic outcome. A lower seasonal ambient temperature may exacerbate the neurologic outcome of OHCA.
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Journal of critical care · Oct 2014
Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis.
The purpose of the study is to evaluate the prevalence and clinical significance of hypolipidemia and the relationship to cytokine concentrations and outcomes in septic patients. ⋯ Low cholesterol and lipoprotein concentrations are detected in septic patients, especially in individuals with poor outcome. High-density lipoprotein cholesterol concentration seems to be an early independent predictive marker of survival in severe sepsis.
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Journal of critical care · Oct 2014
Cost savings with interventions to reduce aerosolized bronchodilator use in mechanically ventilated patients.
The purpose of this evaluation is to describe the cost savings associated with multimodal interventions aimed at reducing aerosolized bronchodilator use in mechanically ventilated patients without adversely affecting costs associated with length of stay (LOS). ⋯ Multimodal efforts to restrict aerosolized bronchodilator therapy in mechanically ventilated patients were successful and led to sustained reductions in use that was associated with substantial reductions in cost, without affecting LOS.