Critical care medicine
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Critical care medicine · Feb 2017
Multicenter StudyHealthcare Resource Use and Costs in Long-Term Survivors of Acute Respiratory Distress Syndrome: A 5-Year Longitudinal Cohort Study.
To evaluate the time-varying relationship of annual physical, psychiatric, and quality of life status with subsequent inpatient healthcare resource use and estimated costs. ⋯ In a multisite cohort of long-term acute respiratory distress syndrome survivors, better annual physical and quality of life status, but not psychiatric status, were associated with fewer hospitalizations and lower healthcare costs.
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Critical care medicine · Feb 2017
Multicenter Study Observational StudyGreater Protein and Energy Intake May Be Associated With Improved Mortality in Higher Risk Critically Ill Patients: A Multicenter, Multinational Observational Study.
Controversy exists about the value of greater nutritional intake in critically ill patients, possibly due to varied patient nutritional risk. The objective of this study was to investigate whether clinical outcomes vary by protein or energy intake in patients with risk evaluated by the NUTrition Risk in the Critically Ill score. ⋯ Greater nutritional intake is associated with lower mortality and faster time to discharge alive in high-risk, longer stay patients but not significantly so in nutritionally low-risk patients.
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Critical care medicine · Feb 2017
Multicenter Study Observational StudyEvaluation of RBC Transfusion Practice in Adult ICUs and the Effect of Restrictive Transfusion Protocols on Routine Care.
Research supports the efficacy and safety of restrictive transfusion protocols to reduce avoidable RBC transfusions, but evidence of their effectiveness in practice is limited. This study assessed whether admission to an ICU with an restrictive transfusion protocol reduces the likelihood of transfusion for adult patients. ⋯ In this sample of ICU patients, transfusions often occurred outside evidence-based guidelines, but admission to an ICU with an restrictive transfusion protocol did reduce the risk of transfusion in moderately anemic patients controlling for patient and ICU factors. This study supports the effectiveness of restrictive transfusion protocols for influencing transfusions in clinical practice.
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Critical care medicine · Feb 2017
Multicenter Study Observational StudyReadmissions to Intensive Care: A Prospective Multicenter Study in Australia and New Zealand.
To determine factors independently associated with readmission to ICU and the independent association of readmission with subsequent mortality. ⋯ In this large prospective study, readmission to ICU was not an independent risk factor for mortality.
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Critical care medicine · Feb 2017
Multicenter StudySubarachnoid Hemorrhage Patients Admitted to Intensive Care in Australia and New Zealand: A Multicenter Cohort Analysis of In-Hospital Mortality Over 15 Years.
The primary aim of this study was to describe in-hospital mortality in subarachnoid hemorrhage patients requiring ICU admission. Secondary aims were to identify clinical characteristics associated with inferior outcomes, to compare subarachnoid hemorrhage mortality with other neurological diagnoses, and to explore the variability in subarachnoid hemorrhage standardized mortality ratios. ⋯ Subarachnoid hemorrhage patients admitted to ICU in Australia and New Zealand have a high mortality rate. Year of admission beyond 2003 did not impact risk-adjusted in-hospital mortality. Significant variability was noted between institutions. This implies an urgent need to systematically evaluate many aspects of the critical care provided to this patient group.