Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients

2022 ◽  
pp. 000313482110697
Author(s):  
Bethany R. Shoulders ◽  
Sarah Elsabagh ◽  
Douglas J. Tam ◽  
Amanda M. Frantz ◽  
Kaitlin M. Alexander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Negative Impact ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Trauma Patients ◽  
Icu Patients ◽  
Tertiary Referral Center ◽  
Surgical Icu ◽  
The Impact

Background Delirium occurs frequently in critically ill and injured patients and is associated with significant morbidity and mortality. Limited data exists on the risk factors for developing delirium in critically ill trauma patients and the effect of antipsychotic (AP) medications on delirium progression. Objective The objective of this study is to determine the incidence of delirium in critically ill trauma versus non-trauma surgical patients and determine if the presence of trauma was associated with intensive care unit (ICU) delirium. Secondary outcomes included identifying risk factors for delirium and determining the impact of AP medication use on delirium progression in critically ill trauma patients. Methods This retrospective review studies adult trauma/surgical ICU patients admitted between May 2017-July 2018 to a level I trauma and tertiary referral center. Regression modeling was used to determine the impact of AP use on delirium-free days. Results Delirium was more common in critically ill trauma patients versus non-trauma surgical ICU patients [54/157 (34.4%) vs 42/270 (15.6%), P < .001]. Of the 54 trauma patients with delirium, 28 (52%) received an AP medication for delirium treatment and in the multiple linear regression analysis, AP use was significantly associated with fewer delirium-free days ( P = .02). Discussion Higher admission sequential organ failure assessment scores and increased length of stay were significantly associated with delirium onset in critically ill trauma patients. Use of AP medications for delirium treatment in this population had a negative impact on delirium-free days.

scholarly journals Model Kinerja Finansial Pemerintah Daerah Melalui Aset dan Pendapatan Asli Daerah

2021 ◽  
Vol 18 (1) ◽  
pp. 36
Author(s):  
Kun Ismawati
Keyword(s):  
Financial Performance ◽  
Negative Impact ◽  
Positive Impact ◽  
Capital Expenditure ◽  
Linear Regression Analysis ◽  
Financial Statements ◽  
Multiple Linear Regression Analysis ◽  
Regional Government ◽  
Significant Negative Impact ◽  
The Impact

ABSTRACT  The research aimed to explore financial performance’s model of the Karanganyar Regency Regional Government. This research tested the impact of size, richness, leverage, and capital expenditure on the financial performance of the Karanganyar Regency Regional Government. Research data were 8 (eight) periods of financial statements. Hypotheses analyzed with multiple linear regression. Analysis results showed that size and richness have a significant positive impact on the financial performance of Karanganyar Regency Regional Government; while leverage and capital expenditure have a significant negative impact on the financial performance of the Karanganyar Regional Government. Those results illustrates that greater size and richness will increase the financial performance; on the contrary, the greater leverage and capital expenditure will decrease the financial performance. The model explored is Y = -75.79 + 109.039X1 + 3.754X2 – 0.582X3 – 0.231X4. Keywords                    : size; richness; leverage; capital expenditure; regional government                                      financial performanceCorrespondence to        : [email protected] ABSTRAK Penelitian ini bertujuan menggali model kinerja finansial Pemerintah Daerah Kabupaten Karanganyar. Penelitian ini menguji pengaruh ukuran, kekayaan, leverage, dan belanja modal pada kinerja finansial Pemerintah Daerah Kabupaten Karanganyar. Data penelitian ini adalah 8 (delapan) periode laporan keuangan. Hipotesis dianalisis dengan regresi linear berganda. Hasil analisis menunjukkan bahwa ukuran dan kekayaan memiliki dampak positif signifikan pada kinerja finansial Pemerintah Daerah Kabupaten Karanganyar; sedangkan leverage dan belanja modal memiliki dampak negatif signifikan terhadap kinerja finansial pada Pemerintah Daerah Kabupaten Karanganyar. Hasil-hasil tersebut menggambarkan bahwa makin besar ukuran dan kekayaan akan meningkatkan kinerja finansial; sebaliknya, makin besar leverage dan belanja modal akan menurunkan kinerja finansial. Model yang tergali adalah: Y = -75.79 + 109.039X1 + 3.754X2 – 0.582X3 – 0.231X4. Kata kunci                  : ukuran; kekayaan; leverage; belanja modal; kinerja finansial                                      pemerintah daerah

The Impact of IV Electrolyte Replacement on the Fluid Balance of Critically Ill Surgical Patients

2019 ◽  
Vol 85 (10) ◽  
pp. 1171-1174 ◽  
Author(s):  
Andrew S. Wang ◽  
Navpreet K. Dhillon ◽  
Nikhil T. Linaval ◽  
Nicholas Rottler ◽  
Audrey R. Yang ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Fluid Administration ◽  
Surgical Patients ◽  
Icu Patients ◽  
Surgical Icu ◽  
The Impact ◽  
To Receive ◽  
Electrolyte Replacement ◽  
Critically Ill Surgical Patients

Avoiding excess fluid administration is necessary when managing critically ill surgical patients. The aim of this study was to delineate the current practices of IVelectrolyte (IVE) replacement in a surgical ICU and quantify their contribution to the fluid balance (FB) status. Patients admitted to the surgical ICU over a six-month period were reviewed. Patients undergoing dialysis and those with ICU stay <72 hours were excluded. A total of 248 patients were included. The median age was 60 years, and 57 per cent were male. Overall, 1131 patient ICU days were analyzed. The median daily FB was 672 mL. IVEs were administered in 62 per cent of ICU days. In days that IVEs were used, negative FB was significantly less likely to be achieved (62% vs 69%, P = 0.02). The most commonly administered IVE was calcium (32% of ICU days); however, the largest volume of IVE was administered in the form of phosphorus (median 225 mL). Diuretics were administered in 17 per cent of ICU days. Patients who received diuretics were significantly more likely to receive IVE (70% vs 61%, P = 0.02). Administration of IVE may contribute to the daily positive FB of surgical ICU patients. Implementation of practices that can ameliorate this effect is encouraged.

701: RISK FACTORS FOR MRSA PNEUMONIA IN CRITICALLY ILL TRAUMA/SURGICAL ICU PATIENTS

2016 ◽  
Vol 44 (12) ◽  
pp. 251-251
Author(s):  
Spencer Laehn ◽  
Angie Huang ◽  
Thomas Carver ◽  
William Peppard
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Icu Patients ◽  
Surgical Icu

scholarly journals Cerebral White Matter Hyperintensity as a Healthcare Quotient

2019 ◽  
Vol 8 (11) ◽  
pp. 1823 ◽  
Author(s):  
Kaechang Park ◽  
Kiyotaka Nemoto ◽  
Yoshinori Yamakawa ◽  
Fumio Yamashita ◽  
Keitaro Yoshida ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Linear Regression Analysis ◽  
Large Population ◽  
Multiple Linear Regression Analysis ◽  
White Matter Hyperintensity ◽  
Cerebral White Matter ◽  
Vascular Risk ◽  
Abnormal Lipid Metabolism ◽  
The Impact

To better understand the risk factors and optimal therapeutic strategies of cerebral white matter hyperintensity (WMH), we examined a large population of adults with and without various vascular risk factors (VRFs) or vascular risk conditions (VRCs), such as hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DLP), including the comorbidities. We assessed two participant groups having no medical history of stroke or dementia that underwent brain checkup using magnetic resonance imaging (MRI): 5541 participants (2760 men, 2781 women) without VRCs and 1969 participants (1169 men, 800 women) who had received drug treatments for VRCs and the combination of comorbidities. For data analysis, we constructed WMH-brain healthcare quotient (WMH-BHQ) based on the percentile rank of WMH volume. This metric has an inverse relation to WMH. Multiple linear regression analysis of 5541 participants without VRCs revealed that age, systolic blood pressure (SBP), Brinkman index (BI), and female sex were significant factors lowering WMH-BHQ, whereas body mass index (BMI), male sex, fasting blood sugar, and triglyceride levels were increasing factors. The Kruskal–Wallis test and Dunn tests showed that WMH-BHQs significantly increased or decreased with BMI or SBP and with BI classification, respectively. Regarding the impact of impaired fasting glucose and abnormal lipid metabolism, there were almost no significant relationships. For 1969 participants who had HT, DM, and DLP, as well as their comorbidities, we found that DLP played a substantial role in increasing WMH-BHQ for some comorbidities, whereas the presence of HT and DM alone tended to decrease it. Cerebral WMH can be used as a healthcare quotient for quantitatively evaluating VRFs and VRCs and their comorbidities.

Frequency and risk factors of acute kidney injury in ICU patients of Omdurman teaching hospital

2021 ◽  
Author(s):  
Abdel Mumin SidAhmed ◽  
Nusaiba Hassan Mohamed Eltahir
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Impairment ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Kidney Injury ◽  
Icu Patients ◽  
Long Term Outcome ◽  
Severe Hypotension ◽  
The Impact

Abstract Background: acute kidney injury is a common complication in critically ill patients and it is commonly associated with high mortality and morbidity with adverse short and long term outcome. bjectives: The main objective of this study was to determine the frequency of acute kidney injury in ICU patients in Omdurman teaching hospital. And to assess the risk factors associated with the development of acute kidney injury (AKI) in a critically ill patient. We also intended to correlate acute kidney injury with the primary disease required admitting to ICU and find out the impact of acute kidney injury in ICU outcomes. Methods: In this descriptive prospective, cohort hospital-based study, 211 patients were studied and followed up during admission in ICU using standardized questionnaire to collect clinical data and investigation Results: a total of 61 patients has been included in the study developed renal impairment during their stay in ICU 39 (64%) patients were males and 22 ( 36%) were female mean age was 41 ± 5 renal impairment developed after mean of 5 days of admission and the most common cause was decreased level of consciousness and severe hypotension. sepsis accounting for 40% of the admission. The outcome in ICU showed that the mortality rate was high up to 41% in kidney injury patients Sepsis account for over 96 % (24 patients) who have passed away. Conclusions: development of AKI in ICU is an important risk factor for poor outcomes in critically setting. Prevention is the best method for avoiding AKI, with the early identification and recognition of high-risk patients.

scholarly journals Early Childhood Educators’ Wellbeing During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Patricia Eadie ◽  
Penny Levickis ◽  
Lisa Murray ◽  
Jane Page ◽  
Catriona Elek ◽  
...  
Keyword(s):  
Early Childhood ◽  
Lower Risk ◽  
Online Survey ◽  
Negative Impact ◽  
Linear Regression Analysis ◽  
Organizational Structures ◽  
Research Network ◽  
Student Teacher Relationship ◽  
Learning At Home ◽  
The Impact

AbstractThe importance of Early Childhood (EC) educators’ wellbeing has been brought into sharp focus during the COVID-19 pandemic, as educators have navigated numerous additional stressors while providing education and care services for some children and ongoing support for many others learning at home. This study aimed to explore the impact of the pandemic on EC educators’ wellbeing and educator-child relationships, as growing evidence shows the influence of these factors on children’s developmental outcomes.In July 2020, members of a Research Network of EC Professionals—who previously identified educator wellbeing as a priority issue—were invited to participate in an online survey. The survey included two published, validated scales: the Early Childhood Professional Wellbeing scale (ECPW) and the Student–Teacher Relationship Scale (modified). Survey items about educators’ experiences during the pandemic were also included. Two hundred and thirty-two EC educators from across Australia completed the survey, mostly from Victoria where lockdowns were most severe. Linear regression analysis demonstrated stronger professional wellbeing was associated with less conflict in educator-child relationships and lower risk of staff turnover. This was more likely to be experienced by senior or more experienced staff. Although a negative impact of COVID-19 was reported, ECPW scores were relatively high, and organizational structures supporting professional wellbeing were most strongly associated with lower risk of turnover (r = 0.63, p < 0.001). Findings highlight that supporting EC educators’ wellbeing is essential for workforce retention, and for promoting quality educator-child relationships which are central to young children’s learning and development.

scholarly journals The Impact of Intervention-Related Risk Factors on the Risk of Ventilator-Associated Pneumonia Is High in a Neurosurgical Intensive Care Unit

2020 ◽  
Vol 41 (S1) ◽  
pp. s407-s409
Author(s):  
Ksenia Ershova ◽  
Oleg Khomenko ◽  
Olga Ershova ◽  
Ivan Savin ◽  
Natalia Kurdumova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Negative Slope ◽  
Infection Prevention And Control ◽  
Ventilator Associated Pneumonia ◽  
Related Factors ◽  
Icu Patients ◽  
The Impact ◽  
Adf Test ◽  
Over Time

Background: Ventilator-associated pneumonia (VAP) represents the highest burden among all healthcare-associated infections (HAIs), with a particularly high rate in patients in neurosurgical ICUs. Numerous VAP risk factors have been identified to provide a basis for preventive measures. However, the impact of individual factors on the risk of VAP is unclear. The goal of this study was to evaluate the dynamics of various VAP risk factors given the continuously declining prevalence of VAP in our neurosurgical ICU. Methods: This prospective cohort unit-based study included neurosurgical patients who stayed in the ICU >48 consecutive hours in 2011 through 2018. The infection prevention and control (IPC) program was implemented in 2010 and underwent changes to adopt best practices over time. We used a 2008 CDC definition for VAP. The dynamics of VAP risk factors was considered a time series and was checked for stationarity using theAugmented Dickey-Fuller test (ADF) test. The data were censored when a risk factor was present during and after VAP episodes. Results: In total, 2,957 ICU patients were included in the study, 476 of whom had VAP. Average annual prevalence of VAP decreased from 15.8 per 100 ICU patients in 2011 to 9.5 per 100 ICU patients in 2018 (Welch t test P value = 7.7e-16). The fitted linear model showed negative slope (Fig. 1). During a study period we observed substantial changes in some risk factors and no changes in others. Namely, we detected a decrease in the use of anxiolytics and antibiotics, decreased days on mechanical ventilation, and a lower rate of intestinal dysfunction, all of which were nonstationary processes with a declining trend (ADF testP > .05) (Fig. 2). However, there were no changes over time in such factors as average age, comorbidity index, level of consciousness, gender, and proportion of patients with brain trauma (Fig. 2). Conclusions: Our evidence-based IPC program was effective in lowering the prevalence of VAP and demonstrated which individual measures contributed to this improvement. By following the dynamics of known VAP risk factors over time, we found that their association with declining VAP prevalence varies significantly. Intervention-related factors (ie, use of antibiotics, anxiolytics and mechanical ventilation, and a rate of intestinal dysfunction) demonstrated significant reduction, and patient-related factors (ie, age, sex, comorbidity, etc) remained unchanged. Thus, according to the discriminative model, the intervention-related factors contributed more to the overall risk of VAP than did patient-related factors, and their reduction was associated with a decrease in VAP prevalence in our neurosurgical ICU.Funding: NoneDisclosures: None

Study time, glasses utilization and age affect quality of life among senior first-year Chinese myopia students

2021 ◽  
pp. 112067212098252
Author(s):  
Ziqian Zhu ◽  
Yan He ◽  
Jiezheng Yang ◽  
Qiaoli Li ◽  
HuanHuan Cheng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Regression Analysis ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Study Time ◽  
First Year ◽  
Normal Vision ◽  
First Year Students

Purpose: To compare the quality of life of senior first-year students with normal vision and myopia, and to explore the risk factors related to quality of life in students with myopia. Methods: In this study, 1103 senior first-year students were enrolled in ten high schools. These students were divided according to the diopter degree, with 916 myopia students and 187 normal vision students. Visual function indexes, such as naked eye vision, were measured and recorded, and social demographic indexes and the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was used. The differences in quality of life between the two groups were compared. Multiple linear regression analysis was used to explore the possible risk factors for quality of life in myopia students. Results: In the NEI VFQ-25, the total quality of life scores of myopia students (77.06 ± 15.66) were lower than those of normal vision students (85.49 ± 12.37). The difference was statistically significant ( p = 0.007). In the correlation analysis, the total scores of quality of life in myopia students were positively correlated with wearing glasses ( p = 0.049), and were negatively correlated with study time ( p = 0.029). Multiple linear regression analysis showed that study time, wearing glasses and age were risk factors affecting quality of life in myopia students. Conclusion: Our results show that senior first-year myopia students have lower quality of life scores than students with normal vision. Study time, wearing glasses and age are risk factors for quality of life in senior first-year myopia students.

scholarly journals The impact of viremia on organ failure, biomarkers and mortality in a Swedish cohort of critically ill COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Josef D. Järhult ◽  
Michael Hultström ◽  
Anders Bergqvist ◽  
Robert Frithiof ◽  
Miklos Lipcsey
Keyword(s):  
Organ Failure ◽  
Critically Ill ◽  
Independent Predictor ◽  
Corticosteroid Treatment ◽  
Blood Stream ◽  
Common Finding ◽  
Icu Patients ◽  
Extra Pulmonary ◽  
The Impact ◽  
Swedish Cohort

AbstractThe spread of virus via the blood stream has been suggested to contribute to extra-pulmonary organ failure in Coronavirus disease 2019 (COVID-19). We assessed SARS-CoV-2 RNAemia (RNAemia) and the association between RNAemia and inflammation, organ failure and mortality in critically ill COVID-19 patients. We included all patients with PCR verified COVID-19 and consent admitted to ICU. SARS-CoV-2 RNA copies above 1000/ml measured by PCR in plasma was defined as RNAemia and used as surrogate for viremia. In this cohort of 92 patients 59 (64%) were invasively ventilated. RNAemia was found in 31 patients (34%). Hypertension and corticosteroid treatment was more common in patients with RNAemia. Extra-pulmonary organ failure biomarkers and the extent of organ failure were similar in patients with and without RNAemia, but the former group had more renal replacement therapy and higher mortality (26 vs 16%; 35 vs 16%, respectively, p = 0.04). RNAemia was not an independent predictor of death at 30 days after adjustment for age. SARS-CoV2 RNA copies in plasma is a common finding in ICU patients with COVID-19. Although viremia was not associated with extra pulmonary organ failure it was more common in patients who did not survive to 30 days after ICU admission.Trial registration: ClinicalTrials NCT04316884.

The Impact of Financial Distress, Corporate Governance, and Auditor Switching on Audit Delay

2021 ◽  
Vol 6 (2) ◽  
pp. 108-117
Author(s):  
Sylvi Angelia ◽  
Rizal Mawardi
Keyword(s):  
Corporate Governance ◽  
Financial Services ◽  
Financial Distress ◽  
Audit Committee ◽  
Stock Exchange ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Auditor Switching ◽  
Analysis Technique ◽  
The Impact

Objective – The purpose of this study is to examine the effect between financial distress, corporate governance, auditor switching and audit delay. This research sample using data on a manufacturing company on the Indonesia Stock Exchange. Methodology – The analysis technique used is multiple linear regression analysis technique. Findings– The research finding show that financial distress and the size of the audit committee have a significant effect on audit delay, while the concentration of ownership, managerial ownership, change of directors, and auditor switching has no significant effect on audit delay. Second finding explain that consideration for companies listed on the Indonesia Stock Exchange to pay attention to the timeliness of submitting financial reports and independent auditor reports so as not to get sanctions from the Financial Services Authority. Novelty – Our novelty research using the relationship of Financial Distress, Corporate Governance and Auditor Switching on new research model to Audit Delay. Type of Paper: Empirical JEL Classification: M41, M42 Keywords: Financial Distress, Corporate Governance, Auditor Switching, Audit Delay

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