Critical care medicine
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Critical care medicine · Nov 2020
National Trends and Variation of Functional Status Deterioration in the Medically Critically Ill.
Physical and psychologic deficits after an ICU admission are associated with lower quality of life, higher mortality, and resource utilization. This study aimed to examine the prevalence and secular changes of functional status deterioration during hospitalization among nonsurgical critical illness survivors over the past decade. ⋯ Following nonsurgical critical illness, the prevalence of functional status deterioration and magnitude increased in a nationally representative cohort, despite efforts to reduce ICU dysfunction over the past decade. Identifying the prevalence of functional status deterioration and primary etiologies associated with functional status deterioration will elucidate vital areas for further research and targeted interventions. Reducing ICU debilitation for key disease processes may improve ICU survivor mortality, enhance quality of life, and decrease healthcare utilization.
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Critical care medicine · Nov 2020
Multicenter StudyGraph Convolutional Networks-Based Noisy Data Imputation in Electronic Health Record.
A deep learning-based early warning system is proposed to predict sepsis prior to its onset. ⋯ Using Physionet Challenge 2019, the proposed method can accurately and early predict the onset of sepsis. The proposed method can be a practical early warning system in the environment of real hospitals.
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Critical care medicine · Nov 2020
International Survey to Establish Prioritized Outcomes for Trials in People With Coronavirus Disease 2019.
There are over 4,000 trials conducted in people with coronavirus disease 2019. However, the variability of outcomes and the omission of patient-centered outcomes may diminish the impact of these trials on decision-making. The aim of this study was to generate a consensus-based, prioritized list of outcomes for coronavirus disease 2019 trials. ⋯ Life-threatening respiratory and other organ outcomes were consistently highly prioritized by all stakeholder groups. Patients/family members gave higher priority to many patient-reported outcomes compared with health professionals.
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Critical care medicine · Nov 2020
Observational StudyTemperature Trajectory Subphenotypes Correlate With Immune Responses in Patients With Sepsis.
We recently found that distinct body temperature trajectories of infected patients correlated with survival. Understanding the relationship between the temperature trajectories and the host immune response to infection could allow us to immunophenotype patients at the bedside using temperature. The objective was to identify whether temperature trajectories have consistent associations with specific cytokine responses in two distinct cohorts of infected patients. ⋯ Temperature trajectory subphenotypes are associated with consistent cytokine profiles in two distinct cohorts of infected patients. These subphenotypes could play a role in the bedside identification of cytokine profiles in patients with sepsis.
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Critical care medicine · Nov 2020
Clinician Accuracy in Identifying and Predicting Organ Dysfunction in Critically Ill Children.
To determine clinician accuracy in the identification and prediction of multiple organ dysfunction syndrome. ⋯ PICU clinicians correctly identified multiple organ dysfunction syndrome and predicted new or progressive multiple organ dysfunction syndrome with 80% accuracy. However, only 8% of patients developed new or progressive multiple organ dysfunction syndrome, so accuracy was largely due to true negative predictions. The positive predictive value for new or progressive multiple organ dysfunction syndrome prediction was just 22%. Accuracy did not differ by clinician type, but was correlated with self-rated confidence and was higher for negative predictions.