Journal of critical care
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Journal of critical care · Feb 2018
Factors associated with in-hospital mortality among critically ill surgical patients with multidrug-resistant Gram-negative infections.
Multidrug-resistant (MDR) Gram-negative infection increases risk of mortality, other complications, and costs. The objective of this study was to determine the prevalence of and identify factors associated with in-hospital mortality among critically ill surgical patients. ⋯ MDR Gram-negative infection is associated with significant in-hospital mortality among critically ill surgical patients. Source control, along with prior ICU LOS, mechanical ventilation status, vasopressor use, and definitive antibiotic choice, are important predictors of survival in this population.
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Journal of critical care · Feb 2018
Delirium characteristics and outcomes in medical and surgical lnpatients: A subgroup analysis.
Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. ⋯ The findings that patient type and timing of postoperative delirium are associated with differential delirium outcomes suggest that targeted screening and intervention approaches may be needed. Medical patients were more likely to be discharged before recovery from delirium compared with surgical patients. Differences in underlying chronic medical conditions may account for the observed differences in discharge condition between medical and surgical patients with delirium.
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Journal of critical care · Feb 2018
Impact of restarting home neuropsychiatric medications on sedation outcomes in medical intensive care unit patients.
This single-center, retrospective cohort study investigated the effects of timing of initiating home neuropsychiatric medications (NPMs) on sedation-related outcomes. ⋯ Restarting home NPMs was associated with lighter sedation levels and less delirium.
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Journal of critical care · Feb 2018
Observational StudyRisk factors and outcomes of critically ill patients with acute brain failure: A novel end point.
To determine the incidence, risk factors and outcomes of acute brain failure (ABF) in a mixed medical and surgical cohort of critically ill patients and its effect on ICU & hospital mortality. ⋯ ABF is a common complication of critical illness and is associated with increased short and long term mortality. The risk of ABF was particularly high in older patients with baseline dementia, COPD, diabetes, liver and renal disease and those treated with invasive mechanical ventilation.
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Journal of critical care · Feb 2018
Elevated modified shock index in early sepsis is associated with myocardial dysfunction and mortality.
The aim of this study was to explore the association of an elevated modified shock index (MSI) in sepsis and myocardial dysfunction. ⋯ Elevated modified shock index during early sepsis is associated with the development of myocardial dysfunction and depression, SOFA score and mortality.