Journal of critical care
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To investigate if patient sex affects intensive care unit (ICU) admission and discharge patterns. Specifically, we investigate if the patients sex affects length of stay (LOS) and probability of ICU discharge and 30- and 90-day mortality. ⋯ In this large cohort study of critically ill patients we have shown that women and men had an equal length of stay, but women had a significantly higher probability of being discharged. There was no difference in mortality between women and men.
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Journal of critical care · Feb 2020
Multicenter StudyFamily ratings of ICU care. Is there concordance within families?
To examine heterogeneity of quality-of-care ratings within families and to examine possible predictors of concordance. ⋯ The finding that variance is higher within than between families suggests the value of including multiple participants within a family in order to capture varying points of view.
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Journal of critical care · Feb 2020
Frailty as a predictor of short- and long-term mortality in critically ill older medical patients.
Frailty is a common condition among critically ill patients. Usually evaluated in a mixed population of medical, cardiac and surgical patients, we aimed to assess the impact of frailty on short- and long-term mortality exclusively in critically ill older medical patients. ⋯ Frailty (CFS ≥ 5) was independently associated with short- and long-term mortality in older patients admitted to ICU exclusively due to a medical reason.
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Journal of critical care · Feb 2020
A novel mortality risk score predicting intensive care mortality in cardiogenic shock patients treated with veno-arterial extracorporeal membrane oxygenation.
Mortality after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implantation remains a major problem in patients with cardiogenic shock. Our objective was to assess the utility of the SOFA score in combination with markers of right ventricular (RV) dysfunction in predicting mortality in the ICU. ⋯ Adding RV-function to the existing SOFA score improves significantly the prediction of ICU mortality in patients on VA-ECMO. Dedicated evaluation of RV function in patients with VA-ECMO is therefore recommended.
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Journal of critical care · Feb 2020
Delayed vasopressor initiation is associated with increased mortality in patients with septic shock.
Mortality rate for septic shock, despite advancements in knowledge and treatment, remains high. Treatment includes administration of broad-spectrum antibiotics and stabilization of the mean arterial pressure (MAP) with intravenous fluid resuscitation. Fluid-refractory shock warrants vasopressor initiation. There is a paucity of evidence regarding the timing of vasopressor initiation and its effect on patient outcomes. ⋯ Vasopressor initiation after 6 h from shock recognition is associated with a significant increase in 30-day mortality. Vasopressor administration within 6 h was associated with shorter time to achievement of MAP goals and higher vasopressor-free hours within the first 72 h.