scholarly journals Risk Factors Associated with Vancomycin-ResistantEnterococcusin Intensive Care Unit Settings in Saudi Arabia

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mahmoud Shorman ◽  
Jaffar A. Al-Tawfiq
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Multiorgan Failure ◽  
Tertiary Hospital ◽  
Oral Contrast ◽  
Factors Associated ◽  
Icu Admission

Background. Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens worldwide. There is one report about the epidemiology of VRE in Saudi Arabia.Objective. To determine the risk factors associated with VRE infection or colonization in intensive care unit (ICU) settings.Design. This is a descriptive, epidemiologic hospital-based case-control study of patients with VRE from February 2006 to March 2010 in ICU in a tertiary hospital in Saudi Arabia.Methods. Data were collected from hospital records of patients with VRE. The main outcome measure was the adjusted odds ratio estimates of potential risk factors for VRE.Results. Factors associated with VRE included ICU admission for multiorgan failure, chronic renal failure, prior use of antimicrobial agents in the past three months and before ICU admission, gastrointestinal oral contrast procedure, and hemodialysis. Being located in a high risk room (roommate of patients colonized or infected with VRE) was found to be protective.Conclusions. Factors associated with VRE acquisition are often complex and may be confounded by local variables.

Risk Factors Associated With Resistance to Ciprofloxacin in Clinical Bacterial Isolates From Intensive Care Unit Patients

2007 ◽  
Vol 28 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Phillip D. Levin ◽  
Robert A. Fowler ◽  
Cameron Guest ◽  
William J. Sibbald ◽  
Alex Kiss ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prior Treatment ◽  
Bacterial Isolates ◽  
Icu Patients ◽  
Gram Negative ◽  
Factors Associated ◽  
Icu Admission ◽  
Ciprofloxacin Resistance

Objective.To determine risk factors and outcomes associated with ciprofloxacin resistance in clinical bacterial isolates from intensive care unit (ICU) patients.Design.Prospective cohort study.Setting.Twenty-bed medical-surgical ICU in a Canadian tertiary care teaching hospital.Patients.All patients admitted to the ICU with a stay of at least 72 hours between January 1 and December 31, 2003.Methods.Prospective surveillance to determine patient comorbidities, use of medical devices, nosocomial infections, use of antimicrobials, and outcomes. Characteristics of patients with a ciprofloxacin-resistant gram-negative bacterial organism were compared with characteristics of patients without these pathogens.Results.Ciprofloxacin-resistant organisms were recovered from 20 (6%) of 338 ICU patients, representing 38 (21%) of 178 nonduplicate isolates of gram-negative bacilli. Forty-nine percent ofPseudomonas aeruginosaisolates and 29% ofEscherichia coliisolates were resistant to ciprofloxacin. In a multivariate analysis, independent risk factors associated with the recovery of a ciprofloxacin-resistant organism included duration of prior treatment with ciprofloxacin (relative risk [RR], 1.15 per day [95% confidence interval {CI}, 1.08-1.23];P< .001), duration of prior treatment with levofloxacin (RR, 1.39 per day [95% CI, 1.01-1.91];P= .04), and length of hospital stay prior to ICU admission (RR, 1.02 per day [95% CI, 1.01-1.03];P= .005). Neither ICU mortality (15% of patients with a ciprofloxacin-resistant isolate vs 23% of patients with a ciprofloxacin-susceptible isolate;P= .58 ) nor in-hospital mortality (30% vs 34%;P= .81 ) were statistically significantly associated with ciprofloxacin resistance.Conclusions.ICU patients are at risk of developing infections due to ciprofloxacin-resistant organisms. Variables associated with ciprofloxacin resistance include prior use of fluoroquinolones and duration of hospitalization prior to ICU admission. Recognition of these risk factors may influence antibiotic treatment decisions.

scholarly journals Risk Factors for Sepsis in the Neonatal Intensive Care Unit of a Tertiary Hospital in Mexico

2021 ◽  
Vol 2 (12) ◽  
pp. 1183-1186
Author(s):  
Ilse Lizeth Villegas-Velasquez ◽  
Luz Irene Pascual-Mathey ◽  
Olga Lidia Valenzuela-Limon ◽  
Patricia Elisa Molina-Prior ◽  
Jose Locia-Espinoza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Tertiary Hospital ◽  
Factors Associated ◽  
Newborn Weight

Neonatal Sepsis (NS) is a systemic infection caused by bacteria, fungi, or viruses during the first month of life. Although various studies have identified the factors associated with NS, it is a public health problem due to its high morbidity and mortality. The study aimed to identify the risk factors associated with neonatal sepsis in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital in Mexico. A case-control study was carried out using records of neonates (with sepsis 39 and without sepsis 39) from January to December 2017. The risk factors studied were the sociodemographic and clinical characteristics of the mother and clinics of the neonate. The data were analyzed using the Chi2 test, Fisher's exact test, Student's t-test, and the Odds Ratio (OR). The risk factors associated with NS were gestational age (OR 0.77, CI 95% = 0.64-0.91, p = 0.004), newborn weight (OR 0.45, CI95% = 0.23-0.86, p = 0.017) and days of hospital stay (OR 1.06, CI95% = 1.02-1.10, p = 0.0014). The mother's sociodemographic and clinical factors were not associated with NS. Risk factors associated with NS were gestational age, newborn weight, and days of hospital stay.

scholarly journals Predictors of Mortality in COPD Exacerbation Cases Presenting to the Respiratory Intensive Care Unit

2020 ◽  
Author(s):  
Yang Cao ◽  
Zhenzhen Xing ◽  
Huangyu Long ◽  
Yilin Huang ◽  
Yanfei Guo
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Multiple Logistic Regression Analysis ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Hospital ◽  
Chronic Obstructive ◽  
Record System ◽  
Factors Associated

Abstract Background: Studies report high in-hospital mortality of chronic obstructive pulmonary disease (COPD) exacerbations especially for those who requiring intensive care unit (ICU) admission. Recognizing factors associated with mortality in those patients could reduce healthcare costs and improve end-of-life care. Methods: This retrospective cohort study included 384 patients with AECOPD admitted to the respiratory ICU (RICU) of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristic, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. Results: We finally enrolled 384 AECOPD patients, 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (CHD, 115 (29.9%)) and chronic heart failure (CHF, (76 (19.8%)). Multiple logistic regression analysis revealed the independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia combined with CHF and the requirement for invasive mechanical ventilation (IMV).Conclusions: The in-hospital mortality of patients with COPD exacerbation requiring RICU admission is high. Lymphocytes<0.8×109/L, leukopenia, requirement for IMV, combined with CHF could be identified as risk factors associated with increased mortality rates.

scholarly journals Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET)

2020 ◽  
Author(s):  
Lindsay Kim ◽  
Shikha Garg ◽  
Alissa O’Halloran ◽  
Michael Whitaker ◽  
Huong Pham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Invasive Mechanical Ventilation ◽  
The United States ◽  
Surveillance Network ◽  
Factors Associated ◽  
Icu Admission ◽  
Male Sex

Abstract Background Currently, the United States has the largest number of reported coronavirus disease 2019 (COVID-19) cases and deaths globally. Using a geographically diverse surveillance network, we describe risk factors for severe outcomes among adults hospitalized with COVID-19. Methods We analyzed data from 2491 adults hospitalized with laboratory-confirmed COVID-19 between 1 March–2 May 2020, as identified through the Coronavirus Disease 2019–Associated Hospitalization Surveillance Network, which comprises 154 acute-care hospitals in 74 counties in 13 states. We used multivariable analyses to assess associations between age, sex, race and ethnicity, and underlying conditions with intensive care unit (ICU) admission and in-hospital mortality. Results The data show that 92% of patients had ≥1 underlying condition; 32% required ICU admission; 19% required invasive mechanical ventilation; and 17% died. Independent factors associated with ICU admission included ages 50–64, 65–74, 75–84, and ≥85 years versus 18–39 years (adjusted risk ratios [aRRs], 1.53, 1.65, 1.84, and 1.43, respectively); male sex (aRR, 1.34); obesity (aRR, 1.31); immunosuppression (aRR, 1.29); and diabetes (aRR, 1.13). Independent factors associated with in-hospital mortality included ages 50–64, 65–74, 75–84, and ≥ 85 years versus 18–39 years (aRRs, 3.11, 5.77, 7.67, and 10.98, respectively); male sex (aRR, 1.30); immunosuppression (aRR, 1.39); renal disease (aRR, 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR, 1.28); neurologic disorders (aRR, 1.25); and diabetes (aRR, 1.19). Conclusions In-hospital mortality increased markedly with increasing age. Aggressive implementation of prevention strategies, including social distancing and rigorous hand hygiene, may benefit the population as a whole, as well as those at highest risk for COVID-19–related complications.

scholarly journals A ten-year review of indications and outcomes of obstetric admissions to an intensive care unit in a low-resource country

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261974
Author(s):  
Betty Anane-Fenin ◽  
Evans Kofi Agbeno ◽  
Joseph Osarfo ◽  
Douglas Aninng Opoku Anning ◽  
Abigail Serwaa Boateng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Hospital ◽  
Icu Mortality ◽  
Icu Admission ◽  
Review Period ◽  
Participant Characteristics ◽  
Low Resource Country

Introduction Obstetric intensive care unit admission (ICU) suggests severe morbidity. However, there is no available data on the subject in Ghana. This retrospective review was conducted to determine the indications for obstetric ICU admission, their outcomes and factors influencing these outcomes to aid continuous quality improvement in obstetric care. Methods This was a retrospective review conducted in a tertiary hospital in Ghana. Data on participant characteristics including age and whether participant was intubated were collected from patient records for all obstetric ICU admissions from 1st January 2010 to 31st December 2019. Descriptive statistics were presented as frequencies, proportions and charts. Hazard ratios were generated for relations between obstetric ICU admission outcome and participant characteristics. A p-value <0.05 was deemed statistically significant. Results There were 443 obstetric ICU admissions over the review period making up 25.7% of all ICU admissions. The commonest indications for obstetric ICU admissions were hypertensive disorders of pregnancy (70.4%, n = 312/443), hemorrhage (14.4%, n = 64/443) and sepsis (9.3%, n = 41/443). The case fatality rates for hypertension, hemorrhage, and sepsis were 17.6%, 37.5%, and 63.4% respectively. The obstetric ICU mortality rate was 26% (115/443) over the review period. Age ≥25 years and a need for mechanical ventilation carried increased mortality risks following ICU admission while surgery in the index pregnancy was associated with a reduced risk of death. Conclusion Hypertension, haemorrhage and sepsis are the leading indications for obstetric ICU admissions. Thus, preeclampsia screening and prevention, as well as intensifying antenatal education on the danger signs of pregnancy can minimize obstetric complications. The establishment of an obstetric HDU in CCTH and the strengthening of communication between specialists and the healthcare providers in the lower facilities, are also essential for improved pregnancy outcomes. Further studies are needed to better appreciate the wider issues underlying obstetric ICU admission outcomes. Plain language summary This was a review of the reasons for admitting severely-ill pregnant women and women who had delivered within the past 42 days to the intensive care unit (ICU), the admission outcomes and risk factors associated with ICU mortality in a tertiary hospital in a low-resource country. High blood pressure and its complications, bleeding and severe infections were observed as the three most significant reasons for ICU admissions in decreasing order of significance. Pre-existing medical conditions and those arising as a result of, or aggravated by pregnancy; obstructed labour and post-operative monitoring were the other reasons for ICU admission over the study period. Overall, 26% of the admitted patients died at the ICU and maternal age of at least 25 years and the need for intubation were identified as risk factors for ICU deaths. Attention must be paid to high blood pressure during pregnancy.

Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Records ◽  
Injury Severity ◽  
University Hospital ◽  
Factors Associated ◽  
Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

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