Critical care medicine
-
Critical care medicine · Jan 2012
Multicenter StudyLow serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality.
We hypothesized that deficiency in 25-hydroxyvitamin D at critical care initiation would be associated with all-cause mortalities. ⋯ Deficiency of 25-hydroxyvitamin D at the time of critical care initiation is a significant predictor of all-cause patient mortality in a critically ill patient population.
-
Critical care medicine · Jan 2012
Multicenter StudyThe Eldicus prospective, observational study of triage decision making in European intensive care units: part I--European Intensive Care Admission Triage Scores.
Life and death triage decisions are made daily by intensive care unit physicians. Scoring systems have been developed for prognosticating intensive care unit mortality but none for intensive care unit triage. The objective of this study was to develop an intensive care unit triage decision rule based on 28-day mortality rates of admitted and refused patients. ⋯ The initial refusal score and final triage score provide objective data for rejecting patients that will die even if admitted to the intensive care unit and survive if refused intensive care unit admission.
-
Critical care medicine · Jan 2012
Multicenter StudyThe role of the medical emergency team in end-of-life care: a multicenter, prospective, observational study.
To investigate the role of medical emergency teams in end-of-life care planning. ⋯ Issues around end-of-life care and limitations of medical therapy arose in approximately one-third of calls, suggesting a mismatch between patient needs for end-of-life care and resources at participating hospitals. These calls frequently occur in elderly medical patients and out of hours. Many such patients do not return home, and half die in hospital. There is a need for improved advanced care planning in our hospitals, and to confirm our findings in other organizations.
-
Critical care medicine · Jan 2012
Multicenter StudyThe Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: intensive care benefit for the elderly.
Life and death triage decisions are made daily by intensive care unit physicians. Admission to an intensive care unit is denied when intensive care unit resources are constrained, especially for the elderly. ⋯ Despite the fact that elderly patients have more intensive care unit rejections than younger patients and have a higher mortality when admitted, the mortality benefit appears greater for the elderly. Physicians should consider changing their intensive care unit triage practices for the elderly.
-
Critical care medicine · Jan 2012
Multicenter StudyImpact of case volume on survival of septic shock in patients with malignancies.
Septic shock is a frequent and severe complication in the course of malignancies. In a large multicenter cohort of septic shock patients with hematologic malignancies and solid tumors, we assessed the temporal trend in survival and the prognostic factors, with particular emphasis on case volume. ⋯ Survival of septic shock patients with malignancies markedly increased over the recent years. Furthermore, we identified case volume as a major prognostic factor in this setting.