scholarly journals Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

2021 ◽  
Vol 12 (1) ◽  
pp. 8-16
Author(s):  
Talita Leite dos Santos Moraes ◽  
Joana Monteiro Fraga de Farias ◽  
Brunielly Santana Rezende ◽  
Fernanda Oliveira de Carvalho ◽  
Michael Silveira Santiago ◽  
...  

Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
The COMEPA group

Coronavirus disease 2019 (COVID-19) has dramatically changed our lives. In the past months, hospitals were saturated of patients; therefore, it is still important to have simple and standardized prognostic factors and to evaluate the efficacy and safety of medications commonly used for COVID-19. We aimed to collect data of the patients hospitalized in Internal Medicine and Geriatrics Wards at the University Hospital (Policlinico) ‘P. Giaccone’ in Palermo, Italy (COMEPA, COVID-19 Medicina Policlinico Palermo), with the main purpose of finding prognostic tools that can be easily used in clinical practice in order to identify patients hospitalized for/with COVID-19 at higher risk of negative outcomes, such as mortality, transfer to Intensive Care Unit (ICU) and institutionalization, as well as evaluating the efficacy/safety of medications commonly used for COVID-19. For reaching these aims, the medical records of approximately 600 patients will be recorded, having data on several parameters and including as outcomes mortality, ICU placement, institutionalization. With the COMEPA study, we therefore plan to update current literature, giving new data on prognostic factors and on the efficacy/safety of some medications used for COVID-19.


2021 ◽  
Vol 9 ◽  
pp. 205031212110011
Author(s):  
Thabit Alotaibi ◽  
Abdulrhman Abuhaimed ◽  
Mohammed Alshahrani ◽  
Ahmed Albdelhady ◽  
Yousef Almubarak ◽  
...  

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.


2019 ◽  
Vol 09 (01) ◽  
pp. 42-50
Author(s):  
Camara Youssouf ◽  
Ba Hamidou Oumar ◽  
Sangare Ibrahima ◽  
Toure Karamba ◽  
Coulibaly Souleymane ◽  
...  

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho

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.


2019 ◽  
Vol 109 (4) ◽  
pp. 336-342 ◽  
Author(s):  
S. A. Saku ◽  
R. Linko ◽  
R. Madanat

Background and Aims: Emergency Response Teams have been employed by hospitals to evaluate and manage patients whose condition is rapidly deteriorating. In this study, we aimed to assess the outcomes of triggering the Emergency Response Teams at a high-volume arthroplasty center, determine which factors trigger the Emergency Response Teams, and investigate the main reasons for an unplanned intensive care unit admission following Emergency Response Team intervention. Material and Methods: We gathered data by evaluating all Emergency Response Team forms filled out during a 4-year period (2014–2017), and by assessing the medical records. The collected data included age, gender, time of and reason for the Emergency Response Teams call, and interventions performed during the Emergency Response Teams intervention. The results are reported as percentages, mean ± standard deviation, or median (interquartile range), where appropriate. All patients were monitored for 30 days to identify possible intensive care unit admissions, surgeries, and death. Results: The mean patient age was 72 (46–92) years and 40 patients (62%) were female. The Emergency Response Teams was triggered a total of 65 times (61 patients). The most common Emergency Response Team call criteria were low oxygen saturation, loss or reduction of consciousness, and hypotension. Following the Emergency Response Team call, 36 patients (55%) could be treated in the ward, and 29 patients (45%) were transferred to the intensive care unit. The emergency that triggered the Emergency Response Teams was most commonly caused by drug-related side effects (12%), pneumonia (8%), pulmonary embolism (8%), and sepsis (6%). Seven patients (11%) died during the first 30 days after the Emergency Response Teams call. Conclusion: Although all 65 patients met the Emergency Response Teams call criteria, potentially having severe emergencies, half of the patients could be treated in the arthroplasty ward. Emergency Response Team intervention appears useful in addressing concerns that can potentially lead to unplanned intensive care unit admission, and the Emergency Response Teams trigger threshold seems appropriate as only 3% of the Emergency Response Teams calls required no intervention.


1996 ◽  
Vol 5 (4) ◽  
pp. 500-510 ◽  
Author(s):  
Nancy S. Jecker

Mr. Bernard was a homeless man, aged 58. His medical history revealed alcohol abuse, seizure disorder, and two suicide attempts. Brought to the emergency room at a local hospital after being found “semi-comatose,” his respiratory distress led to his being intubated and placed on a ventilator. The healthcare team suspected the patient ingested antifreeze. Transferred from that hospital to the intensive care unit (ICU) of the university hospital, his diagnosis was “high osmolar gap with high-anion gap metabolic acidosis, most likely secondary to ethylene glycol ingestion and renal insufficiency.”


2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Jéssica Araújo Olímpio ◽  
Jéssica Naiara de Medeiros Araújo ◽  
Vanessa Pinheiro Barreto ◽  
Raianny Alves Costa Medeiros ◽  
Mércio Gabriel de Araújo ◽  
...  

Aim: characterize the sociodemographic and clinical profile of patients with the diagnosis of dry eye risk nursing in intensive care unit. Methods: this is a cross-sectional study carried out at the intensive care unit of a university hospital located in the northeastern region of Brazil between January and July 2016. Results: it was observed that 51% of the patients were male, the mean age was 59.5 years, and 65.6% had a partner. Regarding the reasons for hospitalization, 53.1% were in the postoperative period and 46.9% were clinical patients; 49% were on invasive mechanical ventilation. Conclusion: to know the characteristics of patients with the diagnosis of dry-eye risk nursing in an intensive care unit becomes important in order to direct care for the prevention and early detection of the problem in order to reduce ocular complications


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