Journal of critical care
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Journal of critical care · Feb 2021
A simplified critical illness severity scoring system (CISSS): Development and internal validation.
To create a simplified critical illness severity scoring system with high prediction accuracy for 30-day mortality using only commonly available variables. ⋯ CISSS has very good performance and requires only commonly used variables that can be easily extracted by electronic health records.
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Journal of critical care · Feb 2021
Association of gender, age, and race on renal outcomes and mortality in patients with severe sepsis and septic shock.
The association of age, gender and race with renal outcomes in patients with severe sepsis and septic shock (SEP) is not completely elucidated. We aimed to shed light on these relationships. ⋯ Female gender is associated with a lower risk of poor renal outcomes and death among patients with SEP, while AA race places patients at higher risk of poor outcomes in that setting. Increasing age is generally associated with adverse outcomes.
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Journal of critical care · Feb 2021
Predictors of dysrhythmias with norepinephrine use in septic shock.
Norepinephrine (NE) is recommended first-line for treatment of septic shock, partly due to its intrinsically low effect on heart rate. While dysrhythmias secondary to NE are still reported, factors associated with development of this adverse effect have not been described. Our study sought to investigate factors associated with dysrhythmias in patients receiving NE for septic shock. ⋯ Development of dysrhythmia is associated with increased mortality and is independently associated with longer duration of NE infusion and higher NE doses.
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Journal of critical care · Feb 2021
Tuberculous ARDS is associated with worse outcome when compared with non-tuberculous infectious ARDS.
Patients with tuberculosis (TB) developing acute respiratory distress syndrome (ARDS) may have a higher mortality when compared with ARDS of other infectious etiology. ⋯ Patients with TB-ARDS presented sicker and had higher mortality when compared with ARDS due to non-TB infectious etiology.
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Journal of critical care · Feb 2021
Observational StudyDischarge from hospital with newly administered antipsychotics after intensive care unit delirium - Incidence and contributing factors.
Delirium in the intensive care unit (ICU) is often treated with haloperidol or atypical antipsychotics. Antipsychotic treatment can lead to severe adverse effects and excess mortality. After initiation in the ICU, patients are at risk of having their antipsychotics continued unnecessarily at ICU and hospital discharge. This study aims to determine the incidence of, and risk factors for antipsychotic continuation at hospital discharge after ICU delirium. ⋯ Approximately one in five patients were discharged from the hospital with continued antipsychotics. Hospital policies should implement strategies for systematic antipsychotic tapering and better follow-up of antipsychotics at transitions of care.