Journal of critical care
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Journal of critical care · Aug 2014
The cost-effectiveness ratio of a managed protocol for severe sepsis.
Severe sepsis is a time-dependent disease, and implementation of early treatment has been associated with mortality rate reduction. However, the literature is controversial regarding cost-effectiveness analysis of this intervention. The aim was to assess the cost-effectiveness of a managed protocol for the treatment of severe sepsis. ⋯ Given that the incremental cost was lower than or equal to zero, the effectiveness of the protocol was justified by the significant increase in the life-years saved and the reduced mortality.
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Journal of critical care · Aug 2014
Hyperglycemia, hypoglycemia, and glycemic complexity are associated with worse outcomes after surgery.
The purpose of this study was to determine if glycemic complexity, along with hypoglycemia and hyperglycemia, was associated with worse outcomes after cardiac surgery. ⋯ We found that hypoglycemia (glucose<71 mg/dL) and hyperglycemia (glucose>140 mg/dL) were associated with increased risk of complications, whereas greater complexity of the glucose time series was associated with mortality.
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Journal of critical care · Aug 2014
Antiphospholipid antibodies in critically ill patients with cancer: A prospective cohort study.
The purpose of this study is to evaluate the prevalence and the prognostic impact of antiphospholipid antibodies (aPL) in critically ill cancer patients. ⋯ Lupus anticoagulants were frequent in critically ill cancer patients. However, they were not associated with medium-term survival in these patients.
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Journal of critical care · Aug 2014
Women are more than twice as likely to die from burns as men in Australia and New Zealand: An unexpected finding of the Burns Evaluation And Mortality (BEAM) Study.
While the risk of death after nonthermal trauma and sepsis may be higher for men, sex differences in outcome after burns are inconsistently reported. The Burns Evaluation And Mortality Study examined the outcomes of all patients admitted after thermal injury to the intensive care unit (ICU) at 8 of 9 burn referral centers in Australia and New Zealand between January 1, 2005, and December 31, 2011. There were 348 women and 1367 men treated for acute burns. ⋯ After adjusting for confounding factors, women had more than double the risk of death compared with men (odds ratio, 2.35; 95% confidence interval, 1.38-4.01; P=.002). Our study conclusively shows worse outcomes for women with burns admitted to ICUs in Australia and New Zealand. Further research is required to determine why this is happening.
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Journal of critical care · Aug 2014
Prognostic factors in critically ill cancer patients admitted to the intensive care unit.
The objective of this study is to identify factors predicting intensive care unit (ICU) mortality in cancer patients admitted to a medical ICU. ⋯ Intensive care unit mortality rate was 55% in our cancer patients, which suggests that patients with cancer can benefit from ICU admission. We also found that ICU mortality rates of patients with hematological malignancies and solid tumors were similar.