Journal of critical care
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Journal of critical care · Sep 2010
The association between deprivation and hospital mortality for admissions to critical care units in England.
Few studies have investigated the association between level of social deprivation and acute hospital outcome for admissions to adult general critical care units. It is important to be aware if an association exists because risk prediction models do not adjust for deprivation. ⋯ There is an association between increasing deprivation and increasing risk of mortality for admissions to adult general critical care unit units in England. Further research is required to identify other unmeasured potential confounders (eg, smoking, alcohol consumption) as possible explanations for this association.
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Journal of critical care · Sep 2010
Unplanned discharges from a surgical intensive care unit: readmissions and mortality.
There is great patient turnover every day on surgical intensive care units (SICUs). Surgical intensive care unit beds are provided for major elective surgery. Emergency admissions trigger unplanned discharges. Those patients are at risk for a worse outcome. ⋯ Earlier-than-planned discharge from a SICU leads to a substantially higher readmission rate. Readmission correlates with an elevated risk of death. Most readmissions in a surgical clinic are due to surgical complications. Readmission for respiratory failure accounts for most of the mortality.
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Journal of critical care · Sep 2010
Practice of sedation and the perception of discomfort during mechanical ventilation in Chinese intensive care units.
The purpose of this study was to investigate sedation practices and the perception of discomfort during mechanical ventilation in Chinese intensive care units (ICUs). ⋯ Mechanically ventilated ICU patients in Chinese academic hospitals were inadequately treated for discomfort. Protocolized sedation can effectively improve patient comfort.
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Journal of critical care · Sep 2010
Brain autopsy findings in intensive care unit patients previously suffering from delirium: a pilot study.
Delirium affects 50% to 80% of intensive care unit (ICU) patients and is associated with increased risk of mortality. Given the paucity of data reporting the neuropathologic findings in ICU patients experiencing delirium, the purpose of this pilot, hypothesis-generating study was to evaluate brain autopsies in ICU patients who suffered from delirium to explore possible neuroanatomical correlates. ⋯ Hypoxic ischemic injury in multiple locations of the brain was a common finding. The biological plausibility of hippocampal lesions as a contributor to long-term cognitive impairment warrants postmortem investigation on a larger scale with comparison to patients not experiencing ICU delirium.
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Journal of critical care · Sep 2010
The effect of comorbidity and age on hospital mortality and length of stay in patients with sepsis.
Sepsis is believed to be responsible for substantial health care burden, but there is limited information about its magnitude and the factors affecting health outcomes in Asian population. The aim of the study was to assess the disease burden of sepsis and to test the usefulness of Charlson Comorbidity Index (CCI) and age as risk-adjusted hospital mortality predictors in patients with sepsis using hospital administrative database. ⋯ The sepsis-related mortality and resource utilization are high in this population as well. Comorbidities and advanced age were some of the most important contributors to hospital mortality and resource utilization.