scholarly journals ICU mortality rates in patients with sepsis before and after the Surviving Sepsis Campaign

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P15 ◽  
Author(s):  
J Melville ◽  
S Ranjan ◽  
P Morgan
Keyword(s):  
Mortality Rates ◽  
Surviving Sepsis Campaign ◽  
Icu Mortality ◽  
Before And After

scholarly journals Analysis of mortality from diarrheic diseases in under-five children in Brazilian cities with more than 150,000 inhabitants

2009 ◽  
Vol 25 (5) ◽  
pp. 1093-1102 ◽  
Author(s):  
Juraci Vieira Sergio ◽  
Antônio Carlos Ponce de Leon
Keyword(s):  
Mortality Rate ◽  
Time Trends ◽  
Sharp Decrease ◽  
Mortality Rates ◽  
The North ◽  
Indicator Variables ◽  
Before And After ◽  
Geographic Regions ◽  
Annual Mortality ◽  
Children Under 5

This study analyzes mortality from infectious diarrheic diseases in children under 5 years of age in Brazilian municipalities with more than 150,000 inhabitants, excluding State capitals. The annual mortality rates by municipality from 1990 to 2000 were analyzed using a multilevel model, with years as first level units nested in municipalities as second level units. The dependent variable was the yearly mortality rate by municipality, on the log scale. Polynomial time trends and indicator variables to account for differences in geographic regions were used in the modeling. Time trends were centered on 1995, so they could be modeled differently before and after 1995. From 1990 to 1995 there was a sharp decrease in mortality rates by diarrheic diseases in most Brazilian municipalities, while from 1995 to 2000 the decrease was more heterogeneous. In 1995 the North and Northeast of Brazil had higher mortality rates than the Southeast, and the differences were statistically significant. Most importantly, the study concludes that there was an important difference in the pattern of mortality rate decreases over time, comparing the country's five geographic regions.

scholarly journals Impact of Permissive Hypoxia and Hyperoxia Avoidance on Clinical Outcomes in Septic Patients Receiving Mechanical Ventilation: A Retrospective Single-Center Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Kota Nishimoto ◽  
Takeshi Umegaki ◽  
Sayaka Ohira ◽  
Takehiro Soeda ◽  
Natsuki Anada ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
University Hospital ◽  
Icu Mortality ◽  
Respiratory Dysfunction ◽  
Mechanically Ventilated ◽  
Icu Stay ◽  
Ventilation Duration ◽  
Mechanical Ventilation Duration ◽  
Before And After ◽  
Clinical Records

Background. Septic patients often require mechanical ventilation due to respiratory dysfunction, and effective ventilatory strategies can improve survival. The effects of the combination of permissive hypoxia and hyperoxia avoidance for managing mechanically ventilated patients are unknown. This study examines these effects on outcomes in mechanically ventilated septic patients. Methods. In a retrospective before-and-after study, we examined adult septic patients (aged ≥18 years) requiring mechanical ventilation at a university hospital. On April 1, 2017, our mechanical ventilation policy changed from a conventional oxygenation target (SpO2: ≥96%) to more conservative targets with permissive hypoxia (SpO2: 88-92% or PaO2: 60 mmHg) and hyperoxia avoidance (reduced oxygenation for Pa O 2 > 110   mmHg ). Patients were divided into a prechange group (April 2015 to March 2017; n = 83 ) and a postchange group (April 2017 to March 2019; n = 130 ). Data were extracted from clinical records and insurance claims. Using a multiple logistic regression model, we examined the association of the postchange group (permissive hypoxia and hyperoxia avoidance) with intensive care unit (ICU) mortality after adjusting for variables such as Sequential Organ Failure Assessment (SOFA) score and PaO2/FiO2 ratios. Results. The postchange group did not have significantly lower adjusted ICU mortality (0.67, 0.33-1.43; P = 0.31 ) relative to the prechange group. However, there were significant intergroup differences in mechanical ventilation duration (prechange: 11.0 days, postchange: 7.0 days; P = 0.01 ) and ICU stay (prechange: 11.0 days, postchange: 9.0 days; P = 0.02 ). Conclusions. Permissive hypoxia and hyperoxia avoidance had no significant association with reduced ICU mortality in mechanically ventilated septic patients. However, this approach was significantly associated with shorter mechanical ventilation duration and ICU stay, which can improve patient turnover and ventilator access.

scholarly journals Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022737 ◽  
Author(s):  
Ai Tashiro ◽  
Kayako Sakisaka ◽  
Etsuji Okamoto ◽  
Honami Yoshida
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Child Mortality ◽  
Coastal Zone ◽  
Ecological Study ◽  
Mortality Rates ◽  
Population Based ◽  
North Eastern ◽  
Infant And Child Mortality ◽  
Before And After

ObjectivesTo examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011.DesignA population-based ecological study using publicly available data.SettingTwenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008–2010) and after GEJET (2012–2014).ResultsBetween 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=−189.9, p=0.02) and public health nurses (β=−1.7, p=0.01) was negatively associated with mortality rate per person in 2011.ConclusionsIn 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.

scholarly journals 1013. If Blood Cultures Were Not Done Before Starting Antibiotics, Is It of Any Value to Obtain Them Later?

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S301-S302 ◽  
Author(s):  
Kenneth Rand ◽  
Stacy Beal ◽  
Brandon Allen ◽  
Thomas Payton ◽  
Gloria Lipori ◽  
...  
Keyword(s):  
Blood Cultures ◽  
Time Stamp ◽  
Surviving Sepsis Campaign ◽  
Coagulase Negative Staphylococci ◽  
Gram Negative ◽  
Hourly Rate ◽  
Before And After ◽  
Patient Groups ◽  
The Relationship ◽  
Antibiotic Dose

Abstract Background Obtaining blood cultures before starting antibiotics is one of the pillars of the Surviving Sepsis Campaign (SSC), and delay in obtaining blood cultures (BC) after starting antibiotics is associated with increased mortality (Levy M 2015, Pruinelli L 2018), but we were unable to find data on the relationship between such a delay and a reduction in percentage of positive cultures. Methods All adult patients (>18) admitted from the UFHealth Shands Emergency Department (ED) between August 2012 and December 2016 were included in the study (N = 30,743), excluding hospital-hospital transfers. BC were done with BacTec aerobic, anaerobic, and pediatric resin bottles, incubated for 5 days. We calculated the hourly rate of positive BC obtained before and after the start of IV antibiotics by subtracting the time stamp in the electronic medical record (Epic) between the first BC collection time and the start of the first IV antibiotic dose. We considered S. aureus, all Gram-negative rods, β-hemolytic Streptococci and Enterococci as significant pathogens and coagulase negative Staphylococci, S. viridans, Propionibacterium sp., Micrococcus sp. and Bacillus sp. as contaminants hospital ransfers. Results The percentage of BC with significant growth was unchanged during the first hour after starting IV antibiotics, but declined significantly in the period 1–12 hours after IV antibiotics were started. The overall positivity rate before starting IV antibiotics was 1,646/20,867 (7.9%) of patients and declined to 112/3,490 (3.2%), P < 0.0001, in the 1–12 hour period afterwards, but did not decline to 0. Septic patients averaged 1,143/4,923 (23.2%) positive and declined to 65/728 (8.9%), P < 0.0001, while nonseptic patients averaged 503/15,944 (3.15%) positive before antibiotics and declined to 47/2,762 (1.7%) P < 0.0001, 1–12 hours after. It should be pointed out that these are group averages from different patient groups at each hourly time, rather than individual patients with blood cultures drawn serially. Conclusion We conclude that IV antibiotics dramatically reduce the likelihood of getting a positive blood culture, but not during the first hour of administration; however, the residual positivity rate remains high enough that blood cultures are still clinically worthwhile. Disclosures All authors: No reported disclosures.

ANALYZING SURGICAL ICU MORTALITY RATES

1998 ◽  
Vol 89 (Supplement) ◽  
pp. 466A
Author(s):  
Charles Weissman ◽  
Charles L Sprung
Keyword(s):  
Mortality Rates ◽  
Icu Mortality ◽  
Surgical Icu

scholarly journals Sepsis at ICU Admission Increases the ICU Mortality Rates Among Very Long ICU Stay Patients: A Secondary Analysis

2020 ◽  
Vol 5 (4) ◽  
pp. 134-140
Author(s):  
Farshid Rahimibashar ◽  
Mahmood Salesi ◽  
Amir Vahedian-Azimi ◽  
Masoum Khosh Fetrat
Keyword(s):  
Secondary Analysis ◽  
Mortality Rates ◽  
Icu Mortality ◽  
Icu Admission ◽  
Icu Stay

scholarly journals Failure of the New Kidney Allocation System in a Specific Ethnic Group

2020 ◽  
Author(s):  
Texell Longoria-Dubocq ◽  
Yaritza Pizarro-Gonzalez ◽  
Isabel Mayorga-Perez ◽  
Mariel Javier-Gonzalez ◽  
Pedro Hernandez-Rivera
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Wait Time ◽  
Mortality Rates ◽  
Kidney Allocation ◽  
Allocation System ◽  
Transplant Center ◽  
Kidney Allocation System ◽  
Before And After ◽  
Moderate Volume

ABSTRACTIntroductionThe Kidney Allocation System (KAS) implemented on December 4, 2014, was expected to improve kidney transplant list wait-time and allocate more kidney to high cPRA patients. This study aims to demonstrate outcomes after the implementation of the KAS in a Hispanic transplant center.MethodsRetrospective study from a prospectively maintained database from a single-transplant center. Included all DDKT from July 2013 to June 2016. Compare and analyze DDKT selection and outcomes before and after KAS implementation.ResultsThe overall number of kidney transplants performed during this period was 220. All of the patients were Hispanic. Included 50.5% Pre-KAS and 49.5% Post-KAS. Pre-KAS group had a significantly shorter waiting-time list than the post-KAS group, 900.05 vs 1126.75 respectively. EPTS less than 20% significantly improved in the Post-KAS group compared to the Pre-KAS group, 41.3% vs 20.9% respectively. No differences observed in KDPI, 1-year graft failure, or 1-year mortality rates.ConclusionThis might be the first Hispanic only cohort evaluating the effects of KAS on a moderate volume kidney transplant center. The new system increased the wait-time list by approximately 25%, and it did not improve graft quality, graft failure, or mortality rates.

scholarly journals MO863COMPARISON OF ALL-CAUSE-MORTALITY BEFORE AND AFTER COVID-19 PANDEMIC IN A HEMODIALYSIS CENTER: A SUCCESSFUL PREVENTIVE PROTOCOL

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Vahideh Yavari
Keyword(s):  
Excess Mortality ◽  
Preventive Measures ◽  
Mortality Rates ◽  
Early Referral ◽  
Education Of Patients ◽  
Personnel Screening ◽  
All Cause Mortality ◽  
Before And After ◽  
Spss Software ◽  
Time Frames

Abstract Background and Aims COVID-19 has exerted a lot of pressure and concern on Hemodialysis ward managers. Being successful in patient education and, simultaneously, protecting the personnel and patients with in-time provision of sanitation and prevention protocols are mandatory to survive the pandemic. The aim of this study was to assess the success of our preventive measures in the dialysis center after application of our self-developed protocols. Method Crude and age-adjusted mortality rates of two time frames, i.e. 4th January to 5th December 2019 and the same period in 2020 (before and after the start of pandemic) were compared. The data were processed with SPSS software version 26. Results During 4th January to 5th December 2019, the crude all-cause-morality rate of our hemodialysis center was 20.23% (51 out of 252 patients). Likewise, between 4th January 2020 to 5th December 2020, the crude all-cause-morality rate was 18.25% (46 out of 252 patients). Same result was yielded after age adjustment of the morality rates. Conclusion Tailoring effective and timely preventive measures along with tireless education of patients can control all-cause-mortality and possibly COVID-19 excess mortality rates in dialysis centers. It seems that our preventive protocols which included strict patient and personnel screening, early referral to infectious specialist, clear isolation-sanitation protocols of COVID-19 positive cases and repeated patient and personnel education have been successful in surviving the pandemic till present.

scholarly journals Mortality Rates of Severe Dengue Viral Infection Before and After Implementation of a Revised Guideline for Severe Dengue

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kamolwish Laoprasopwattana ◽  
Puttichart Khantee ◽  
Kantara Saelim ◽  
Alan Geater
Keyword(s):  
Viral Infection ◽  
Mortality Rates ◽  
Severe Dengue ◽  
Before And After
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