In [98]:
from IPython.core.display import display, HTML
from tqdm import tqdm
import pandas as pd
import re
pd.set_option('display.max_rows', 100)
In [2]:
from horacy import HoracyModel
model = HoracyModel('model_all/').load()
load done in 12.05 seconds
In [150]:
def score_text(text, criteria):
total = 0
value = 1
for c in criteria:
if type(c) in (int,float):
value = c
else:
c = c.replace('_',r'\b')
total += value if re.findall(c,text,re.I) else 0
return total
def score_results(i_d_lists, criteria):
results = []
for i,d in zip(*i_d_lists):
doc = model.get_doc(i)
text = model.doc_to_text(doc).replace('\n',' ').replace('\r',' ')
s = score_text(text, criteria)
text = highlight(text, criteria)
rec = s,d,i,text,doc
results += [rec]
results.sort(key=lambda x:(-x[0],x[1]))
return results
def highlight(text, criteria, before='<b>', after='</b>'):
for c in criteria:
if type(c) in (int,float):
continue
else:
c = '('+c.replace('_',r'\b')+'\w*)'
text = re.sub(c, before+r'\1'+after, text, flags=re.I)
return text
def agg_scores(results):
scores = [x[0] for x in results]
scores.sort(reverse=True)
return max(scores),sum(scores),sum([x*x for x in scores])/len(scores),min(scores)
In [157]:
criteria = [5,'mechanical','ventilat',2,'_age','years','_old',1,'\d+ patients','adjust','surviv','discharge','extubate','died','dead','death','mortality','duration','_day','probability','Kaplan-Meier','curve','figure','table']
criteria = [5,'mechanical','ventilat',2,'adjust','_age','years','_old',1,'\d+ patients','surviv','discharge','extubate','died','dead','death','mortality','duration','_day','figure','table']
for query in [
'results after mechnical ventilation discharged dead died',
'results after mechnical ventilation discharged dead died survived survivors adjusted age years old',
'results after mechnical ventilation discharged died survived survivors extubated adjusted',
'results after mechnical ventilation discharged dead died survived survivors adjusted age years old',
'results after mechnical ventilation discharged died survived extubated adjusted',
'results after mechnical ventilation discharged died survived extubated adjusted age',
'outcomes after mechnical ventilation discharged died survived extubated adjusted',
'results outcomes after mechnical ventilation discharged died survived extubated adjusted age',
'results outcomes after mechnical ventilation discharged died survived extubated adjusted',
]:
q = model.text_to_dense(query)
i_d = model.dense_ann_query(q,50)
results = score_results(i_d, criteria)
scores = agg_scores(results)
print(scores)
(21, 625, 169.26, 2)
(10, 266, 31.88, 2)
(21, 673, 201.18, 1)
(10, 266, 31.88, 2)
(21, 683, 198.06, 6)
(21, 483, 120.7, 1)
(21, 674, 204.48, 1)
(21, 580, 163.56, 2)
(21, 690, 212.76, 1)
In [158]:
q = model.text_to_dense('results after mechnical ventilation discharged dead died')
q = model.text_to_dense('results after mechnical ventilation discharged survived died')
q = model.text_to_dense('results after mechnical ventilation discharged dead died survived survivors')
q = model.text_to_dense('results after mechnical ventilation discharged dead died survived survivors adjusted age years old')
q = model.text_to_dense('results after mechnical ventilation discharged died survived survivors extubated adjusted')
q = model.text_to_dense('results outcomes after mechnical ventilation discharged died survived extubated adjusted age')
i_d_lists = model.dense_ann_query(q,50)
results = score_results(i_d_lists, criteria)
print(agg_scores(results))
for s,d,i,text,doc in results:
display(HTML(f"{s} :: {d} :: {i}<br>{text}"))
(21, 580, 163.56, 2)
21 :: 0.2231106162071228 :: 1817665
In the analysis of adult population, a total of 262 patients were admitted to ICUs and received mechanical ventilation during the study period. The mean age of those patients was 57 (SD 21) years, and the majority were male (64%). Of 262 patients, 98 patients died after receiving mechanical ventilation. Thus, the overall mortality for patients admitted to ICUs and receiving mechanical ventilation during the study period was 37%, with a median survival time in the ICU of 11 days (IQR 6-20 days). Because the average duration of mechanical ventilation was 11 days, the analysis was restricted to within 30 days of receiving mechanical ventilation. The mortality rate was 27.3 per 1000-person years (95% CI 22.4 to 33.2). The Kaplan-Meier survival curves for 30-day ICU mortality is shown in Figure 2. At the end of 30 days after receiving the mechanical ventilation, the overall survival rate was 82% after the fifth day and 75% after the tenth day of receiving the mechanical ventilation. Results Figure 2: Kaplan-Meier curves of the probability of survival over time for adult mechanical ventilated patients (N=262) admitted to the intensive care unit between 2016-2018.
21 :: 0.22461026906967163 :: 1729272
In the analysis of adult population, a total of 262 patients were admitted to ICUs and received mechanical ventilation during the study period. The mean age of those patients was 57 (SD 21) years, and the majority were male (64%). Of 262 patients, 98 patients died after receiving mechanical ventilation. Thus, the overall mortality for patients admitted to ICUs and receiving mechanical ventilation during the study period was 37%, with a median survival time in the ICU of 11 days (IQR 6-20 days). Because the average duration of mechanical ventilation was 11 days, the analysis was restricted to within 30 days of receiving mechanical ventilation. The mortality rate was 27.3 per 1000-person years (95% CI 22.4 to 33.2). The Kaplan-Meier survival curves for 30-day ICU mortality is shown in Figure 2 . At the end of 30 days after receiving the mechanical ventilation, the overall survival rate was 82% after the fifth day and 75% after the tenth day of receiving the mechanical ventilation. Kaplan-Meier curves of the probability of survival over time for adult mechanical ventilated patients (N=262) admitted to the intensive care unit between 2016-2018.
21 :: 0.25707387924194336 :: 1720937
Among the 30 patients analyzed in the present study, 60% and 73.3% showed positive results of albumin and blood on dipstick tests; 50% of patients showed a random urine ACR or PCR more than 100 mg/g Cr. Moreover, 26.7% of patients showed AKI, and the mean and median durations from symptom onset were 18 and 16 days, respectively. Old age was a predictor of the occurrence of AKI even after adjustment for comorbidities and the application of a mechanical ventilator. Mechanical ventilator, CRRT, and ECMO therapies were applied to 12 (40%), 3 (10%), and 5 (16.7%) patients, respectively. A total of 5 patients died of septic shock progression and multiple organ failure. Diabetes, the occurrence of AKI, and the application of CRRT were risk factors predicting mortality in the univariate analysis. DISCUSSION
21 :: 0.25707387924194336 :: 1772652
Among the 30 patients analyzed in the present study, 60% and 73.3% showed positive results of albumin and blood on dipstick tests; 50% of patients showed a random urine ACR or PCR more than 100 mg/g Cr. Moreover, 26.7% of patients showed AKI, and the mean and median durations from symptom onset were 18 and 16 days, respectively. Old age was a predictor of the occurrence of AKI even after adjustment for comorbidities and the application of a mechanical ventilator. Mechanical ventilator, CRRT, and ECMO therapies were applied to 12 (40%), 3 (10%), and 5 (16.7%) patients, respectively. A total of 5 patients died of septic shock progression and multiple organ failure. Diabetes, the occurrence of AKI, and the application of CRRT were risk factors predicting mortality in the univariate analysis. DISCUSSION
20 :: 0.18770551681518555 :: 330000
The primary outcome, weaning duration, defined from the first day of randomization to the day the patient was successfully weaned, was shorter with trach collar than with pressure support: 15 versus 19 days. Patients were considered weaning successes when they breathed without ventilator assistance for at least 5 days. A Cox proportional hazards model revealed that the rate of successful weaning was 1.43 times faster with trach collar than with pressure support. Mortality was equivalent in the two arms, but, of course, the study was not powered to detect a difference in mortality. Of the entire 500 randomized and non-randomized patients, 54 % were alive at 6 months after enrollment and 45 % were alive at 12 months. This survival rate is surprisingly high. To put the numbers in perspective, 1-year survival in older (66 years) patients ventilated in an ICU was approximately 40 % [64, 65] . That is, the LTACH patients in the study of Jubran et al., who were ventilated for 67 days, had a 1-year mortality comparable to ICU patients who were ventilated for 9 days. Indeed, 72 % of the 260 patients who had been weaned by discharge were alive at 12 months. Conclusion Longterm mortality and quality of life after prolonged mechanical ventilation Survival and quality of life: short-term versus long-term ventilator patients
20 :: 0.20748543739318848 :: 485080
The primary outcome, weaning duration, defined from the first day of randomization to the day the patient was successfully weaned, was shorter with trach collar than with pressure support: 15 versus 19 days. Patients were considered weaning successes when they breathed without ventilator assistance for at least 5 days. A Cox proportional hazards model revealed that the rate of successful weaning was 1.43 times faster with trach collar than with pressure support. Mortality was equivalent in the two arms, but, of course, the study was not powered to detect a difference in mortality. Of the entire 500 randomized and non-randomized patients, 54 % were alive at 6 months after enrollment and 45 % were alive at 12 months. This survival rate is surprisingly high. To put the numbers in perspective, 1-year survival in older (66 years) patients ventilated in an ICU was approximately 40 % [64, 65]. That is, the LTACH patients in the study of Jubran et al., who were ventilated for 67 days, had a 1-year mortality comparable to ICU patients who were ventilated for 9 days. Indeed, 72 % of the 260 patients who had been weaned by discharge were alive at 12 months. Weaning in long-term acute care hospitals in the United States Hospitals (Martin Tobin, Amal Jubran) ::: Conclusion Long-term mortality and quality of life after prolonged mechanical ventilation Survival and quality of life: short-term versus long-term ventilator patients
19 :: 0.17577874660491943 :: 1817668
In this analysis, a total of 175 patients were admitted to ICUs and received mechanical ventilation during the study period. Most of the patients were below 1 month (89% of the whole population) and 59% were boys. A total of 30 (17%) of this study population died after the date of mechanical ventilation with a median survival time of 16 days (IQR 7-37 days). The mortality rate was 9.9 per 1000-person years (95%, CI 6.96 to 14.25). The Kaplan-Meier survival curves for 30-day ICU mortality as shown in Figure 3. The curve shows that by the end of one month, 75% of patients on mechanical ventilation are still alive. The characteristic of the population as demonstrated in Table 3. The main source of the admission of those neonates was labor and delivery by C-section, with the mean gestational week being 32 (SD 5) weeks. Prematurity with respiratory problems (50%) was the main recorded cause of the initiation of mechanical ventilation, followed by respiratory distress syndrome (37%). The majority of admissions to ICUs were premature. Neonates who received mechanical ventilation within the first month of their life and who were born extremely preterm had a high mortality rate after the initiation of mechanical ventilation. A total of 169 (96%) of the neonates were intubated in ICU while only 3% had already been intubated before their ICU admission. Variables related to mechanical ventilation parameters on day one of mechanical ventilation are presented in Table 3. For the results of the univariate analysis of factors associated with mortality among this population, Table 4 shows that neonates who received mechanical ventilation within the first month of life and who were born extremely preterm had a high mortality rate after the initiation of mechanical ventilation. In addition, those neonates who had respiratory distress syndrome as the cause of initiating the mechanical ventilation had a high rate of mortality; however, the univariate analysis showed no significant association. Neonates who had congenital anomalies as the cause of receiving mechanical ventilation were more likely to have a lower survival rate (OR 13, 95% CI 2.68-62.8). Results Table 3: Demographic, clinical characteristics, and initial ventilator modes of the pediatric patients on the inanition of the mechanical ventilation in the ICU between 2016-2018 (N=175). Table 3: Demographic, clinical characteristics, and initial ventilator modes of the pediatric patients on the inanition of the mechanical ventilation in the ICU between 2016-2018 (N=175). Table 4: The univariate analysis of factors associated with mortality among adult patients who admitted to ICU and received mechanical ventilation between 2016-2018. Figure 3: Kaplan-Meier curves of the probability of survival overtime for pediatric mechanical ventilated patients (N=175) admitted to the intensive care unit between 2016-2108.
19 :: 0.186578631401062 :: 1729275
In this analysis, a total of 175 patients were admitted to ICUs and received mechanical ventilation during the study period. Most of the patients were below 1 month (89% of the whole population) and 59% were boys. A total of 30 (17%) of this study population died after the date of mechanical ventilation with a median survival time of 16 days (IQR 7-37 days). The mortality rate was 9.9 per 1000-person years (95%, CI 6.96 to 14.25). The Kaplan-Meier survival curves for 30-day ICU mortality as shown in Figure 3 . The curve shows that by the end of one month, 75% of patients on mechanical ventilation are still alive. The characteristic of the population as demonstrated in Table 3 . The main source of the admission of those neonates was labor and delivery by C-section, with the mean gestational week being 32 (SD 5) weeks. Prematurity with respiratory problems (50%) was the main recorded cause of the initiation of mechanical ventilation, followed by respiratory distress syndrome (37%). The majority of admissions to ICUs were premature. Neonates who received mechanical ventilation within the first month of their life and who were born extremely preterm had a high mortality rate after the initiation of mechanical ventilation. A total of 169 (96%) of the neonates were intubated in ICU while only 3% had already been intubated before their ICU admission. Variables related to mechanical ventilation parameters on day one of mechanical ventilation are presented in Table 3 . For the results of the univariate analysis of factors associated with mortality among this population, Table 4 shows that neonates who received mechanical ventilation within the first month of life and who were born extremely preterm had a high mortality rate after the initiation of mechanical ventilation. In addition, those neonates who had respiratory distress syndrome as the cause of initiating the mechanical ventilation had a high rate of mortality; however, the univariate analysis showed no significant association. Neonates who had congenital anomalies as the cause of receiving mechanical ventilation were more likely to have a lower survival rate (OR 13, 95% CI 2.68-62.8). Demographic Demographic The univariate analysis of factors associated with mortality among adult patients who admitted to ICU and received mechanical ventilation between 2016-2018. Values are presented as numbers and percentage (%). CI -confidence interval mortality, as 72% such patients died in ICUs. Kaplan-Meier curves of the probability of survival overtime for pediatric mechanical ventilated patients (N=175) admitted to the intensive care unit between 2016-2108.
19 :: 0.2375965714454651 :: 1114333
The median time from illness onset (ie, before admission) to discharge was 22·0 days (IQR 18·0-25·0), whereas the median time to death was 18·5 days (15·0-22·0; table 2). 32 patients required invasive mechanical ventilation, of whom 31 (97%) died. The median time from illness onset to invasive mechanical ventilation was 14·5 days (12·0-19·0). Extracorporeal membrane oxygenation was used in three patients, none of whom survived. Sepsis was the most frequently observed complication, followed by respiratory failure, ARDS, heart failure, and septic shock (table 2). Half of non-survivors experienced a secondary infection, and ventilator-associated pneumonia occurred in ten (31%) of 32 patients requiring invasive mechanical ventilation. The frequency of complications were higher in non-survivors than survivors (table 2) . In univariable analysis, odds of in-hospital death was higher in patients with diabetes or coronary heart disease (table 3) . Age, lymphopenia, leucocytosis, and elevated ALT, lactate dehydrogenase, high-sensitivity cardiac troponin I, creatine kinase, d-dimer, serum ferritin, IL-6, prothrombin time, creatinine, and procalcitonin were also associated with death (table 3) . Results Treatments and outcomes Risk factors associated with in-hospital death Risk factors associated with in-hospital death
18 :: 0.25767046213150024 :: 274006
Methods: Retrospectively collected data on patients admitted to the ICU between January 2013 and December 2014 were reviewed. Patients admitted to the ICU, aged > = 18 years, mechanically ventilated for > = 48 hours and with the final diagnosis of ICU-acquired weakness were selected. Predictive factors of ICU-AW were identified using multivariate logistic regression analysis. Results: From the 177 patients included, 20,3% developed ICU-AW. The mean age was 57,3 years and 58,3% were female. The median time of mechanical ventilation was 343,5 hours. 55,6% of patients had solid tumors and 44,4% had hematological malignancies. Glucocorticoids and neuromuscular blocking agents were administered in 88,9% and 38,9% of patients, respectively. Septic shock developed in 72,2% of patients and was found to be a predictive factor for developing ICU-AW (OR 4,15, pvalue 0,018). 66,7% of patients started or continued physical rehabilitation during the hospital length of stay approximately 12 days after admission in the ICU. 44,4% of patients with ICU-AW died 37 days after admission in the ICU. 8 patients (22,2%) with ICU-AW were re-evaluated by physical and rehabilitation medicine 144 days after hospital discharge. Significant improvement was noted in their physical status while in the program of physical therapy. Conclusions: ICU-AW is a relatively frequent problem and septic shock was found to be a predictive factor for the development of this entity. Early mobilization is an important intervention to decrease the weakness and physical deconditioning in the critically ill patients. P412
17 :: 0.21437162160873413 :: 1166756
Results: Fifteen (65,2%) out of 23 pts were male with a median age of 55 years (range: 28-69). Patients' baseline diseases were: multiple myeloma (34,8%), non-Hodgkin´s Lymphoma (26,1%), Hodgkin´s Lymphoma (8,7%), acute lymphoblastic leukemia (8,7%), myelodisplasic syndrome (8,7%), solid tumor (8,7) and acute myeloblastic leukemia (4,3%). Fifteen (65,2%) pts received auto-HSCT, 5 (21,7%) allo-HSCT from unrelated donor, 2 (8,7%) allo-HSCT from identical sibling, and the remainder haploidentical HSCT (1) (4,3%). So, 6,6% of auto-HSCT pts and 8% of allo-HSCT were admitted in the ICU. The median stay in the ICU was 5 days (range: 1-30) and reasons for admission were: respiratory insufficiency (60,8%), septic shock (30,4%), renal insufficiency (4,3%) and multi-organic failure (4,3%). Twenty-one (91.3%) pts required respiratory support with: nasal cannula or oxygen mask (C/M) (19%), non-invasive mechanical ventilation (NIMV) (66,7%) and invasive mechanical ventilation (IMV) (14,3%). Fourteen (60%) pts needed inotropic agents for shock treatment. Finally, 4 (4,5%) pts required substitutive renal therapy with hemodialysis or haemofiltration (HD/HF). Eleven (47,8%) out of 23 pts died, 7 (63,6%) were male with a median age of 55 years (range: 24-64). Ten of them (90,9%) needed IMV and were treated with inotropic agents. All patients who required HD/HF (n=4) died. IMV and treatment with inotropic agents were associated with ICU mortality (OR 6,5; p=0,03, OR 7; p=0,008; respectively). P186
17 :: 0.23494839668273926 :: 1819119
A total of 463 patients were admitted to the MICU during the study period. Among them, 234 patients were admitted to the MICU before its relocation, and the other 229 were admitted afterward. Patients were predominantly male (65%), with a median age of 66 years (IQR, 58 to 74 years) and a median APACHE II score of 28 (IQR, 19 to 36). Among the 463 patients, 108 (23.3%) were diagnosed with sepsis, and 155 (33.5%) were diagnosed with pneumonia. The prevalence of sepsis increased significantly after the MICU relocation (18.8% to 28.0%, P=0.020). The most common underlying comorbidity was hematologic malignancy (21.8%), followed by solid organ malignancy (19.7%), diabetes mellitus (13.4%), heart failure (10.8%), end-stage renal disease (9.7%), liver cirrhosis (6.1%), solid organ transplant (5.6%), and bronchiectasis (3.5%). The proportion of patients who were transferred from other ICUs was 18.8%, which did not differ before and after the relocation (P=0.333). Antacids were administered to 87.7% of patients. Mechanical ventilation was administered to 67.8% of patients for a median of 4 days (IQR, 2 to 9 days), and ventilator dependency (ventilator use ≥21 days) was observed in 43 of 483 patients (8.9%), which did not differ before and after the MICU relocation (5.1% vs. 4.8%, P=0.872). Steroids were administered to 54.2% of patients for a median of 4 days (IQR, 2 to 8 days). These baseline characteristics did not differ between the before and after MICU relocation groups. A total of 530.5 respiratory samples (95% CI, 488.2 to 572.8) were used to perform microbiological analyses per 1,000 patient-days before the relocation, and 513.5 samples (95% CI, 468.6 to 558.5) were used per 1,000 patientdays after the relocation, and that difference was not statistically significant (P=0.558) (Table 1). Baseline Characteristics ::: RESULTS Table 1.: Baseline characteristics of 463 patients admitted to the medical ICU before and after its relocation
16 :: 0.2446158528327942 :: 1035872
Methods A prospective study was done on a 24-bed mixed ICU over a period of 18 months. Eighty-three patients ≥18 years were included in the study. All patients were dependent on mechanical ventilation and met the CCM criteria for sepsis upon admission to the ICU. APACHE II score, SOFA score, weight, BMI and nutritional status were calculated. Patients were initiated for enteral feeding based on the established feeding protocol within 48 hours of admission. The feeding status of the patient was recorded on the start day (D0), day 3 (D3) and day 7 (D7). Factors aff ecting the feeding process and its progression were also recorded Results The patient mean age was 71.4 ± 12.2. LOS in the ICU was 9 to 21 days. Based on BMI, 18% of the patients were malnourished upon admission. APACHE II was 26 ± 7.8 and SOFA was 9.2 ± 4.6. The mortality rate was 42.5%. Enteral nutrition started early in 64 (77.1%) of the patients (D0), on day 3 (D3) 29 (45.31%) patients met their caloric goals and on day 7 (D7) only 18 (28.1%) patients achieved their caloric goals. Discontinuation of enteral feeding was mainly due to procedures, whereas late start and/or decreased hourly intake were due to GI complications, GI intolerance, excessive diarrhoea and hemodynamic instability. There was no association between compliance with the feeding protocol and the LOS, nutritional status, severity or disease progression. P423
15 :: 0.178305983543396 :: 1803041
The median age was 3.5 months, (range 0.07–23.96 months), 60% were male, 12% had UMCs and 14% were premature (<37 weeks gestation) (table 1). Of the 375 subjects with UMCs, heart disease was the most common, 146/357 (39%). Nearly 90% of the children’s parents self-identified as Jordanian, and 7% reported Palestinian as their nationality. Primary and secondary education was the highest attainment in 41% and 44% of the mothers, respectively. The median birth weight was 3.0 kg, and 28% were born by caesarean section. The median number of siblings was 2, 1.6% attended daycare and 77% were exposed to smoke (73% and 18% to cigarette and hookah, respectively). Demographics and clinical characteristics ::: Results Table 1: Univariate and multivariable analysis of factors associated with length of stay (LOS), risk of death, oxygen therapy, intensive care unit (ICU) admission and mechanical ventilation
15 :: 0.24389612674713135 :: 1729262
تهوية يتلقون الذين واألطفال البالغني املرضى بقاء تقدير األهداف: بها. املرتبطة اخلطر عوامل وحتديد ميكانيكية املركزة العناية وحدة في رجعي بأثر األتراب دراسة أجريت الطريقة: امللك ومستشفى )KAMC( الطبية العزيز عبد امللك مدينة في )ICU( العربية اململكة الرياض، ،)KACSH( لألطفال التخصصي الله عبد املرضى جلميع الطبية السجالت من بيانات التحليل يتضمن السعودية. ميكانيكية تهوية تلقوا الذين املركزة العناية وحدات في قبولهم مت الذين اخلطر عوامل جمع مت مريض، لكل 8102م. 6102م- الفترة خالل اإلقامة أثناء الوفيات هي الدراسة لهذه الرئيسية النتيجة وكانت احملتملة. امليكانيكية التهوية تلقي بعد املركزة العناية وحدة في العناية وحدات في األطفال مرضى من و571 البالغني من 262 قبل النتائج: للمرضى بالنسبة الدراسة. فترة خالل ميكانيكية تهوية وتلقوا املركزة البقاء مدة متوسط مع ،37% اإلجماليه الوفيات معدل كان البالغني، كانت ]]IQRأيام). 6-20 الرباعي (املدى يوما 11 من احلياة قيد على الوفيات معدل زيادة مع مستقل بشكل املرتبطة الرئيسية اخلطر عوامل 95% الثقة فاصل ،2.6 األرجحية (نسبة 51-60 بني أعمارهم تتراوح بالنسبة املركزة. العناية وحدة بقبول املتعلقة والعوامل )CI 6.7-1.0 على البقاء مدة متوسط مع ،17% الوفيات معدل كان األطفال، لسكان في مشاكل مع اخلداج كان يوم). IQR 7-37( يوما 16 من احلياة قيد 50%( امليكانيكية التهوية لبدء املسجل الرئيسي السبب التنفسي اجلهاز شهر خالل ميكانيكية تهوية لديهم الذين الوالدة حديثي املرضى). من بعد مرتفع وفيات معدل لديهم كان األوان قبل ولدوا والدتهم من واحد امليكانيكية. التهوية بدء على تؤثر امليكانيكية التهوية بدء وأسباب املريض عمر من كل كان اخلامتة: ميكانيكية. تهوية إلى يحتاجون الذين املرضى بقاء Objectives: To estimate the survival of adult and pediatric patients receiving mechanical ventilation and determine the associated risk factors Methods: A retrospective cohort study was carried out in the intensive care unit (ICU) at King Abdulaziz Medical City (KAMC) and King Abdullah Children's Specialist Hospital (KACSH), Riyadh, Saudi Arabia. The analysis includes data from medical records of all patients admitted to ICUs who received mechanical ventilation between 2016-2018. For each patient, potential risk factors were collected. The main outcome of this study was the mortality during the stay in ICU after receiving mechanical ventilation Results: A total of 262 adults and 175 pediatric patients were admitted to ICUs and received mechanical ventilation during the study period. For adult patients, the overall mortality was 37%, with a median survival time of 11 days (interquartile range [IQR] 6-20 days). The main risk factors independently associated with the increased mortality rate were being aged 51-60 (odds ratio [OR] 2.6, 95% confidence interval [CI] 6.7-1.0) and factors related to ICU admission. For the pediatric population, the mortality rate was 17%, with a median survival time of 16 days (IQR 7-37 days) Abstract
14 :: 0.2540227174758911 :: 976680
Results: Of the 65 case subjects, the median age was 41 (interquartile range [IQR], 28-57) years, 60.0% were men, and 55.4% had at least one underlying medical condition. Sixty-two patients started oseltamivir therapy within a median of 5 (IQR, 4-6) days from the onset of illness, and 31 received IV corticosteroids. ARDS developed in 33 patients, and 24 were treated initially with noninvasive positive pressure ventilation (NPPV). In this group, NPPV was successful in 13 patients (54.2%). Nine patients died at a median of 16 (IQR, 10-24) days after onset of illness. Multivariate Cox regression identifi ed two independent risk factors for death: progressive dyspnea after resolution of fever (relative risk, 5.852; 95% CI, 1.395-24.541; P 5 .016) and a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score on presentation (relative risk for each point, 1.312; 95% CI, 1.140-1.511; P , .001). At 3-month follow-up of survivors with A(H1N1), ground-glass opacities were still present, although diminished, in 85.7%, and diffusing capacity for carbon monoxide was mildly reduced in 61.5%. Abstract
13 :: 0.22876375913619995 :: 1166892
Results: 20 allograft patients were included. 14 were male, with a median age 47 years (range 23-68 years). 6 were female, with median age 61 years (range 51-67 years). Diagnosis N (%) includes ALL 3 (15%), AML 7 (35%), aCML 1 (5%), CMML 3 (15%), HL 1 (5%), MDS 2 (10%), MDS/MPN 1 (5%), FL 1 (5%), SCD 1 (5%). Sixteen (80%) patients received their first transplant, 4 (20%) received second transplant. Eight (40%) patients had sibling donor, 12 patients (60%) had unrelated donor. Sixteen (80%) patients had 10/10 matched donor, 2 (10%) patients had 9/ 10 matched donor, 2 (10%) patients had 8/10 matched donor. Nineteen (95%) received Reduced Intensity Conditioning (RIC), one (5%) received Myeloablative (MA) conditioning. Majority of RIC allo-HSCT patients were conditioned with Fludarabine, Mephalan, Campath (FMC). A small number were conditioned with busulfan, fludarabine and ATG. The MA allo-HSCT patient was conditioned with TBI, cyclophosphamide. GvHD prophylaxis was ciclosporin alone starting on day -1 with a target level of 150-250 ug/L for all RIC and ciclosporin and methotrexate for the MA patients. Two (10%) allograft patients were admitted to ICU on three occasions. Both patients were male, 58 and 68 years old. One had MMUD allograft for MDS/MPN. The other had 2 nd MUD allograft for relapsed AML. The reasons for ICU admission include sepsis, cardiac arrest and respiratory failure. The median duration of ICU admission was 5 days (range 2-9). There were 2 deaths within 100 days of transplant. One patient died on day +11 during his second ICU admission with multi organ failure (MOF). One patient died after ICU discharge on day +23 with relapsed disease, bronchopneumonia with disseminated fungal infection. ICU mortality rate was 50%, and 100-day mortality rate was 10%. P211
13 :: 0.23613786697387695 :: 1817669
The results of this study showed that the mortality rate of adult patients who required mechanical ventilation was 37% and that of the pediatric population was 17%. Elderly patients and those with circulatory system disease and infection as admission cause to ICU have higher mortality rate after the initiation of mechanical ventilation. Similarly, the gestational age and cause of intubation were associated with a higher mortality rate among neonates. Discussion
13 :: 0.24545884132385254 :: 1618049
At 28 days after ICU admission 34 patients (63%; 95% CI 49.6–74.6) were alive and not mechanically ventilated. Six patients were alive but still ventilated (11.3%; 95% CI 5.3–22.6) and 14 had died (25.9%; CI 16.1–38.9). The median length of ICU stay was 8.5 days (IQR 5–22.3). Results
13 :: 0.24719953536987305 :: 1800705
At baseline, 79 (82%) of participants required oxygen, 56 (58%) were in the ICU, and 41 (43%) were on mechanical ventilation. Adults had a median APACHE II score of 13, reflecting an anticipated 15% mortality,[7] whereas children had a median PRISM III score of 3 reflecting an anticipated 2% mortality.[8] The participants randomized to receive standard care had slightly more severe illness at baseline compared to those randomized to plasma (oxygen requirement in 43 participants (88%) vs. 36 (77%) and mechanical ventilation in 24 participants (49%) vs. 17 (36%)). Thirty five (57%) participants had multi-lobar infiltrates on chest X-ray and was similar in both arms, and 31 (51%) had pleural effusions which were more common in the standard care arm (59% (19) vs 41% (12)). The protocol did not mandate any evaluation of the pleural effusions, though no empyema’s were reported. Loss to follow up for completion of the study (Day 28) was higher in the participants that received standard care (22% (N=10) vs. 10% (4)), though follow up through the primary endpoint (or Day 28 if not reaching endpoint, or death) was similar (82% (37) vs. 86% (36)). Results APACHE II: a severity of disease classification system PRISM III: an updated Pediatric Risk of Mortality score
13 :: 0.255926251411438 :: 352178
The results for a total of five consecutive patients with severe ARDS with confirmed HAdV-55 infection were included. All five patients were immunocompetent young men with a median age of 32 years. The mean time from onset to dyspnea was 5 days. Arterial blood gas analysis at ICU admission revealed profound hypoxia. Mean partial oxygen pressure/fraction of inspired oxygen was 58.1. Mean durations from onset to a single-lobe consolidation shown on chest X-rays (CXRs) and, from the first positive CXR to bilateral multilobar lung infiltrates, were 2 days and 4.8 days, respectively. The viral load was higher than 1 × 10 8 copies in three patients and was 1 × 10 4 in one patient. It was negative in the only patient who survived. The mean duration for noninvasive positive pressure ventilation (NPPV) failure and IMV failure were 30.8 hours and 6.2 days, respectively. Four patients received venovenous ECMO. Four (80%) of the five patients died despite receiving appropriate respiratory support. Abstract
12 :: 0.25253963470458984 :: 545877
Results: We included 50 patients (34 male) with a median age of 52. The majority (27) were immunosuppressed: 21 patients had human immunodeficiency virus (HIV) infection with CD4 count less than 350/mm3, 3 had hematological neoplasia under chemotherapy, 2 were under immunosuppressant drugs, and 2 had solid neoplasia under chemotherapy. The median APACHE II score was 19 and SAPSII score was 43. Eight patients had a “do not intubate” status due to their comorbidities. The most frequent reason to perform NIV was bacterial pneumonia (44 %) followed by pneumocystosis (30 %), ARDS (16 %), flu (6 %) and tuberculosis (2 %). Median time of NIV was 3,5 days. We had a NIV success rate of 60 % (14 patients were intubated, 5 did not have intubation indication and 1 patient died from another cause). The mortality rate was 28 %. We found statistically significant association between the severity scores SAPSII and APACHE and the NIV result and death (higher scores were associated with failure of NIV and death). We also found that patients with hematological neoplasia under chemotherapy had higher rates of failure of NIV and death. HIV infection was associated with death but not with NIV failure. Centro Hospitalar São João, Porto, Portugal ::: A. Silva-Pinto, A. Sarmento, L. Santos ::: P235 Use of non-invasive ventilation in infectious diseases besides classical indications
11 :: 0.23609811067581177 :: 1729263
. Prematurity with respiratory problems was the main recorded cause of initiation of mechanical ventilation (50% of patients). Neonates who had mechanical ventilation within one month of their birth and were born extremely preterm had a high mortality rate after the initiation of mechanical ventilation. Abstract
11 :: 0.25325894355773926 :: 154809
A total of 306 SARI patients were admitted and enrolled by the two surveillance sites between week 40, 2010 and week 39, 2014; 48 did not meet the case definition and were excluded from further analyses leaving a total of 258 patients included in this analysis. Median age at admission was 63 years (range, 19-97 years) and 121 (47%) were women. One hundred thirty-one (51%) were white, non-Hispanic and 101 (39%) were Hispanic. The median time from symptom onset to hospital admission was four days (interquartile range (IQR); 2-6 days), the median duration of hospital stay was five days (IQR, 3-9 days); 96 (37%) patients were admitted to the ICU (Table 1) . Results Characteristics of all SARI patients, and by status (alive/dead) Three patients were co-infected; one with coronavirus HKU1/rhinovirus, one with coronavirus HKU1/human metapneumovirus and one with coronavirus 229E/rhinovirus deaths occurring outside the hospital; when limited to persons ≥ 65 years the increase was 47%. Age ≥ 65 years and admission to the ICU were significantly associated with mortality.
11 :: 0.2607012391090393 :: 692471
One thousand fifty-one patients had the get-upand-go test done, and 441 patients (41.9%) failed. Six hundred seventy-six patients had the mini-mental status examination done, and 311 patients (46%) failed. Table 2 compares selected features of those who survived pneumonia vs those who died. There are a number of instructive observations. Not unexpectedly, there were major differences in mean age, mean pneumonia severity risk score, and mean length of stay between the two groups. Also, the effect of functional status at the time of admission on subsequent mortality was striking. Thus, 4.0%, 11.6%, 20.1%, and 25.2% of those who were walking, walking with assistance, wheelchair, and bedridden, respectively, died. The mean ages for patients in each of these groups were 63.8, 80.0, 73.3, and 74.4 years, respectively. The mean pneumonia severity risk scores for patients in the four functional status categories were 90.6, 117.3, 113.7, and 117.6, respectively. Ten of the 610 patients (1.6%) who passed the get-up-and-go test died, compared with 62 of the 441 patients (14.0%) who failed this test. The group that passed this test was younger (77.3 years vs 81.6 years), had a lower mean risk score (102.2 vs 121.8), and a lower percentage of patients in risk classes IV and V (73% vs 86%). There were major differences in mortality according to the site of hospitalization, with mortality rates ranging from 5.9 to 13.3%. As shown in the multivariate analysis, site of care remained a significant predictor for mortality after simultaneously adjusting for other factors. Results Characteristics of Patients by Mortality Status*
10 :: 0.24844753742218018 :: 1583505
For the entire period of recorded human history, the world has never been globally as aged as today. It is therefore not surprising that the proportion of elderly patients admitted to the ICU is increasing, even in circulatory shock. The usefulness of ICU admission in the aged population is a hot topic worldwide. Mortality rates are known to increase with age, but the impact of age on outcomes after circulatory shock has not been well defined. Biston et al. [7] explored this topic, performing a secondary analysis of data from a large randomized trial that compared the effects of dopamine and norepinephrine on outcome in the ICU. Mortality rates were higher in elderly (75–84 years) and very elderly (≥85 years) patients at 28 days, at hospital discharge and after 6 and 12 months of follow-up. Most very elderly patients were dead at 6 (92 %) and 12 months (97 %). Mortality rates increased with age in all types of shock. Using multivariable analysis, the risk of death was higher in very elderly patients as compared to patients aged <75 years. In this analysis, ageing is independently associated with higher mortality rates in patients with circulatory failure, whatever the etiology. By 1 year after admission, most patients aged >85 years had died. Cardiac dysfunction in the intensive care unit Outcome of elderly patients with circulatory failure
10 :: 0.24846374988555908 :: 1484761
For the entire period of recorded human history, the world has never been globally as aged as today. It is therefore not surprising that the proportion of elderly patients admitted to the ICU is increasing, even in circulatory shock. The usefulness of ICU admission in the aged population is a hot topic worldwide. Mortality rates are known to increase with age, but the impact of age on outcomes after circulatory shock has not been well defined. Biston et al. [7] explored this topic, performing a secondary analysis of data from a large randomized trial that compared the effects of dopamine and norepinephrine on outcome in the ICU. Mortality rates were higher in elderly (75-84 years) and very elderly (C85 years) patients at 28 days, at hospital discharge and after 6 and 12 months of follow-up. Most very elderly patients were dead at 6 (92 %) and 12 months (97 %). Mortality rates increased with age in all types of shock. Using multivariable analysis, the risk of death was higher in very elderly patients as compared to patients aged \75 years. In this analysis, ageing is independently associated with higher mortality rates in patients with circulatory failure, whatever the etiology. By 1 year after admission, most patients aged [85 years had died. Cardiac dysfunction in the intensive care unit Outcome of elderly patients with circulatory failure
10 :: 0.25009793043136597 :: 1812065
Two binary logistic regression models showed that males were 5.69 times more likely to exhibit progression to maximum paralysis in ≤2 weeks compared to females, adjusted P=0.017. Older GBS patients with age 8–14 years were 3.9 times more likely to sustain residual paralysis at 60 days compared to younger patients aged 1–7 years, adjusted P=0.034 (Table 4). Factors associated with disease outcomes ::: Results Table 4: Factors associated with level of progression to maximum paralysis and residual paralysis
9 :: 0.2006034255027771 :: 485712
The mean age of the study participants was 60.3 ± 15.3 years and 213 (66.1%) of the participants were male. The reasons for admission were cardiovascular disease (203, 63.0%), lung disease (49, 15.2%), malignancy (35, 10.9%) and others (35, 10.9%). One hundred and thirty seven (42.5%) patients had received cardiopulmonary resuscitation within 24 h prior to ECMO initiation. After the median (IQR) 2 (0–10) days of admission, the patients received ECMO insertion because of cardiotomy (31, 9.6%), non-operative cardiovascular causes (185, 57.5%), adult respiratory distress syndrome (ARDS) (43, 13.4%), non-ARDS lung causes (44, 13.7%) and other causes (19, 5.9%). Two hundred and thirty (71.4%) and 92 (28.6%) patients received VA and VV ECMO support, respectively. One hundred and six (32.9%) patients were undergoing IABP on the date of ECMO insertion. The median (IQR) duration from ECMO initiation to death or discharge was 21 (8–40) days. The incidence of AKI comprising all KDIGO grades was 82.3%. In-hospital mortality was 51.6%. The median (IQR) durations for AKI and in-hospital mortality were 2 (1–7) days and 9 (4–23) days, respectively. Results
9 :: 0.22521042823791504 :: 440392
A total of 126 sepsis patients were consecutively enrolled: 71 survivors and 55 non-survivors (43.7%) who died within 6.6 ± 5.7 days after MICU admission. Mean age of each group was over 70 years. Male was predominant in the non-survivor group and as risk factor for mortality. Sepsis diagnosis at MICU admission showed no correlation with mortality. APACHE II score was significantly higher among non-survivors. Principal suspected infection source was the respiratory tract, followed by urogenital tract, most infection caused by gram negative bacteria. Six patients with intra-abdominal infection all died within twenty-eight days after admission (Table 2). 3.1. Characteristics of Study Subjects ::: 3. Results Table 2: Demographic and clinical characteristics of septic patients.
9 :: 0.22651243209838867 :: 568037
For all-cause mortality, 30/258 (12%, 95% CI 8–15%) patients died within 30 days of hospital admission [23/30 died in-hospital (77%)]. Among patients ≥ 65 years, 22/135 (16%, 95% CI 11–24%) died within 30 days of hospital admission [15/22 died in-hospital (68%)]. Among those who died, the median age at admission was 72 years (range: 35–88 years), the median duration of hospital stay was 6 days (range: 0–28 days), and the median time from symptom onset to death was 12 days (range: 4–32 days). Twenty-two of thirty (73%, 95% CI 58–89%) patients that died were admitted to the ICU [20/22 died in-hospital (90%)] and 27/30 (90%) patients had at least one underlying disease. An influenza virus was detected among 4/30 (13%) patients who died. All-cause mortality by influenza season was similar, with 5/36 deaths (14%) in the 2010–2011 season, 3/23 (13%) in 2011–2012, 6/44 (14%) in 2012–2013 and 16/125 (13%) in 2013–2014. Mortality ::: Results
9 :: 0.2294865846633911 :: 157911
A total of 126 sepsis patients were consecutively enrolled: 71 survivors and 55 nonsurvivors (43.7%) who died within 6.6 ± 5.7 days after MICU admission. Mean age of each group was over 70 years. Male was predominant in the non-survivor group and as risk factor for mortality. Sepsis diagnosis at MICU admission showed no correlation with mortality. APACHE II score was significantly higher among non-survivors. Principal suspected infection source was the respiratory tract, followed by urogenital tract, most infection caused by gram negative bacteria. Six patients with intra-abdominal infection all died within twenty-eight days after admission ( Table 2) . Characteristics of Study Subjects. Demographic and clinical characteristics of septic patients.
9 :: 0.24025958776474 :: 273907
In the period of the study, 1789 patients were admitted to the ICU and 13 PGWH patients were included. There were 10 male patients (77 %) and 3 female (23 %), with a mean age of 30 years (range 14-64). There were no self-inflicted lesions (all PGWH were results of aggression). Glasgow Coma Scale at admission was 8 or less in 10 patients. On admission, 7 patients were anisocoric, 8 presenting shock, 5 had associated body lesions from another gunshot wound (such as limbs or in the thorax). Mean SAPS 3 was 67 (range 35-94) and mean Apache II, 26 (range 8-37). The CT scan findings were: midline shift in 8 patients, 7 single lobe haemorrhages (such as frontal or parietal lobe), and 6 patients with bleeding in more than one lobe. Six patients had subarachnoid and 3 had intraventricular hemorrhage. Early surgical procedure was made to 10 patients (mainly decompressive craniectomy). The mean hospital length of stay was 21 days (range 2 to 136 days). Six patients had wound infection, and three, infection in other sites. The mortality rate for the entire group was 54 % (7 out 13). 4 patients progressed to brain death. Of the six patients discharged from the hospital, four had good outcome (defined as modified Rankin scores of 0-3), and two, bad outcome (modified Rankin of 4). Results
9 :: 0.2491436004638672 :: 1061936
Methods Six months after ICU discharge, survivors went to a follow-up consultation and the QOL-SP was applied. The QOL-SP comprises 15 items grouped in three subscales, which evaluate Basic Physiologic Activities (BPA), Normal Daily Activities (NDA) and Emotional State (ES), and enables the calculation of a global index (QOL-SP Index). Patients from the sepsis group were compared with those from the control group concerning background variables (age, sex, gender, previous health state), ICU variables (reason for admission, APACHE II score and length of ICU stay) and QOL-SP variables. Patients younger than 18 years old and those with an ICU stay ≤ 1 day were excluded. Patients exhibiting nonsevere sepsis at or after ICU admission, and those with severe sepsis/septic shock after ICU admission were also excluded. Introduction
9 :: 0.26117193698883057 :: 193577
The mean age of the study participants was 60.3 ± 15.3 years and 213 (66.1%) of the participants were male. The reasons for admission were cardiovascular disease (203, 63.0%), lung disease (49, 15.2%), malignancy (35, 10 .9%) and others (35, 10 .9%). One hundred and thirty seven (42.5%) patients had received cardiopulmonary resuscitation within 24 h prior to ECMO initiation. After the median (IQR) 2 (0-10) days of admission, the patients received ECMO insertion because of cardiotomy (31, 9. 6%), non-operative cardiovascular causes (185, 57.5%), adult respiratory distress syndrome (ARDS) (43, 13.4%), non-ARDS lung causes (44, 13.7%) and other causes (19, 5.9%) . Two hundred and thirty (71.4%) and 92 (28.6%) patients received VA and VV ECMO support, respectively. One hundred and six (32.9%) patients were undergoing IABP on the date of ECMO insertion. The median (IQR) duration from ECMO initiation to death or discharge was 21 days. The incidence of AKI comprising all KDIGO grades was 82.3%. In-hospital mortality was 51.6%. The median (IQR) durations for AKI and in-hospital mortality were 2 (1-7) days and 9 (4-23) days, respectively. Results Is anemia at hospital admission associated with in-hospital acute kidney injury occurrence? Nephron Clinical practice Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients Is anemia at hospital admission associated with in-hospital acute kidney injury occurrence? Nephron Clinical practice Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients
8 :: 0.24510252475738525 :: 273783
Of 51 patients treated with TH, 27 patients survived to hospital discharge. Seventeen of the hospital survivors were conscious: 6, 3 and 8 patients with CPC at discharge 1, 2 and 3, respectively. Five of them passed away later. Approximately 78.6 %, 76.9 % and 75 % of awake patients survived at 6 months, 1 and 2 years after discharge, respectively. The majority (3/5) of dead cases died within 6 months with severe functional disability (score 24-26). The patients' disability scores were shown in table. One-third of awake patients with CPC 2 and 3 who still survived at 6 months after discharge finally recovered to normal physical and cognitive function, while most of patients with CPC1 returned to normal function or minimal disability. Results
8 :: 0.2601914405822754 :: 1448192
Results: BHT was performed in the 15 patients (age 56.4±13.7 years; 10 men, 5 women) after resuscitation from cardiac arrest. The average duration of time onset of cardiac arrest to return of heartbeat was 29.3±12.6 minutes. Eleven patients obtained good neurologic outcome (moderate disabilities and good recovery; 73.3%), no patient died during BHT, and 1 patient died on the 12th hospital day. This outcome rate (73.3%) was statistically the same as the previous rate (70.6%) in the prospective study between 1996 and 2000. Patients
7 :: 0.2584715485572815 :: 147888
In conclusion, for the patients confirmed with EVD, the survival rate was 51.23 %. Some surviving patients did not become blood EBOV negative until 4 weeks after admission or later. Most non-surviving patients died within 1 week after admission. Patients under the age of 6 years and those with high viral load had a higher fatality rate. Patients who presented confusion, vomiting, abdominal pain, and conjunctivitis at the time of admission were at higher risk of death. Such patients should be the priority of medical attention and should be put under intensive treatment, particularly during the first week of hospitalization. Conclusions
7 :: 0.2584715485572815 :: 522569
In conclusion, for the patients confirmed with EVD, the survival rate was 51.23 %. Some surviving patients did not become blood EBOV negative until 4 weeks after admission or later. Most non-surviving patients died within 1 week after admission. Patients under the age of 6 years and those with high viral load had a higher fatality rate. Patients who presented confusion, vomiting, abdominal pain, and conjunctivitis at the time of admission were at higher risk of death. Such patients should be the priority of medical attention and should be put under intensive treatment, particularly during the first week of hospitalization. Conclusions
7 :: 0.25954365730285645 :: 1474963
The Kaplan-Meier survival plots are shown in Figure 2 . Survival up to 5 years since ICU admission was 54.9% (95% CI: 50.2%, 60.1%). Survival at 28 days from ICU admission was 67.2% (95% CI: 62.9%, 71.9%); among those surviving to hospital discharge, 84.5% (79.8%, 89.4%) were alive 5 years post-hospital discharge. Median follow-up time from ICU admission was 449 days (IQR: 13, 1138). Most deaths occurred within 28 days of ICU admission with very few additional deaths occurring post-hospital discharge in our follow-up period. Primary outcome 60% when compared to the group not receiving a rescue therapy (median (IQR): 8 days (4, 17) versus 5 days (3, 8); p<.01).
6 :: 0.22774672508239746 :: 1168681
At a median follow-up of 20 months (Range, seven months -four years), eight patients (50%) died at a median of 79 (Range, 24 to 230 days), with a transplantrelated mortality of 25% and relapse-related mortality of 25%. Five patients (31%) relapsed post-UCBT; four died and one had a successful second UCBT (event-free survival was 44%). Immune reconstitution in alive patients was achieved at a median of eight months. P718
6 :: 0.23593151569366455 :: 324201
Sociodemographic as well as disease-and treatmentrelated characteristics of study participants who returned the self-report questionnaire at 1 year after discharge from ICU are displayed in Table 1 . Two-thirds of persons were male. Median age at admission to ICU was 56 years (IQR 47-65). The vast majority had a moderate (46%) or severe form (43%) of ARDS (according to the classification provided by the Berlin definition [16] ). Patient characteristics The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material
5 :: 0.24145781993865967 :: 161765
All patients were male, with a mean age of 74 ± 12 (55-89). 3 patients died. The most common diagnosis was community acquired pneumonia (50 %), and second was acute on chronic cardiac failure (25 %). At admission they were all classified in the very high risk group. Also, the 8 patients had one or more mayor chronic criteria. The most frequent risk factors were hypertension history or hypotension at admission (75 % respectively), age and sepsis (62.5 % respectively). All patients had early elevation of serum creatinine (sCr) of at least 0.1 mg/dl. Average days between admission to the ICU and beginning of CRRT was 3. Results
5 :: 0.24284613132476807 :: 1807743
Although the incidence rate of ED visit increased from 2007 through 2014, the rate of hospitalization declined, from 63.4% in 2007 to 38.2% in 2014. Peculiarly, the hospitalization rate was markedly lower in 2009, at 22.5%. The yearly ICU admission rate declined over the study period, from 1.9% in 2007 to 0.9% in 2014 (Table 2). 1. CAP under 18 years of age during 2007–2014 ::: Results Table 2.: The clinical features of patients with pneumonia who visited Emergency Departments by age group and year in 2007–2014
5 :: 0.25510668754577637 :: 1769951
There were 29 patients (16 boys and 13 girls) who met the criteria for ALTE (Table 1). The median patient age was 39.0 days (range, 3-220 days), with a peak incidence of age younger than 1 month (48.3%) and 69.0% of patients younger than 2 months (Fig. 1). Twelve patients (41.4%) were preterm infants, and 8 (27.6%) were low birth weight infants. Among 12 preterm infants, the median gestational age was 35.5 weeks (range, 27.5-36.3 weeks), and 2 patients were diagnosed as bronchopulmonary dysplasia and 2 patients were diagnosed as apnea of prematurity. Fifteen infants (51.7%) were firstborn. The median maternal age was 31.0 yr (range, 25-42 yr) and no mother presented with a history of smoking. There was no history of SIDS or ALTE in their siblings. Demographic characteristics of the patients ::: RESULTS
5 :: 0.2551475763320923 :: 273697
Results 130 patients were enrolled, 63.8 % were male, the median age -64 ± 16 (19Ð91), median BMI Ð 27.9 ± 5.9 (18.8Ð49), ICU LOS Ð 15.4 ± 6,1 days, mortality rate of 26.9 % (35). 70 % of patients were admitted for medical reasons, 31.5 % had normal weight, and the remaining patients were either overweight or obese. Energy intake in the first 10 days was 12.4 ± 6.6 Kcal/Kg/day (0Ð34.1); excluding the first 3 days it rose to 15.6 ± 7.4Kcal/Kg/day (0Ð34.1). Nutritional support was evaluated over a period of 1,223 days in which 80 % of the days patients received nutritional support, 66 % by enteral route and 14 % by parenteral route. Methods
5 :: 0.2621474266052246 :: 545738
Results: Incidence of AKI between 2009 and 2015 was 2.99 % in 8033 patient episodes. All factors other than gender were noticeably associated with AKI. Rate of AKI was 2.7 % in elective cases compared to 10.5 % in urgent cases. Revision surgery was associated with an increased rate of AKI when compared to primary surgery. AKI increased with age and the rate of AKI in patients over the age of 80 was 9.9 %. Development of AKI progressively increased from 0.88 % in ASA 1 to 13.3 % in ASA 4 patients. Pre-operative anaemia and blood transfusion increased the risk of AKI from 2 % to 4.6 % and 2.2 % to 8.9 % respectively. All patients who developed AKI had post-operative anaemia. AKI affected 6.9 % of those patients who were admitted to the HDU while patients not admitted to HDU demonstrated a rate of AKI of 1.7 %. Patients with AKI had a mean LOS of 28.6 days compared to 9.4 days in those without AKI. Patients with no AKI had a mortality of 1.8 % at one year compared with 5.8 %, 6.5 % and 7.7 % in patients with Stage 1, Stage 2 and Stage 3 AKI respectively. Royal National Orthopaedic Hospital, Middlesex, UK ::: N. Desai, R. Baumber, P. Gunning, A. Sell ::: P211 Identification of risk factors for the development of acute kidney injury after lower limb arthroplasty
4 :: 0.2319011092185974 :: 1448634
Results: The median age of patients was 5 days, median gestational age was 38.5 weeks (range 34 to 41 weeks), and median weight loss since birth was 8%. Overall, 70% of patients were exclusively breast fed; 5% were exclusively formula fed. The median TSB for admission was 20 mg/dL (range 12 to 26 mg/dL); 8% of patients had a TSB of 25 mg/dL or greater. ABO blood group incompatibility was present in 16% of patients, more than half of whom had a positive direct antiglobulin test. Rh incompatibility was noted in 9% of patients; all patients were direct antiglobulin test negative. All patients received phototherapy; 73% of patients received intravenous fluid; 68% of patients received intensive lactation consultation; 15% of patients required inpatient admission for continued medical care beyond 24 hours. Hypernatremia at 150 meq/L or greater was associated with need for inpatient admission (odds ratio 1.8; 95% confidence interval 1.0 to 3.2; P<.001). Age, gestational age, TSB, percentage of weight loss, and feeding method were not associated with need for inpatient admission. The median discharge TSB was 15. Patients and TSB were followed up after discharge. There were no adverse outcomes. Emergency Department Observation Unit: A Novel Alternative to Inpatient Admission
4 :: 0.2559633255004883 :: 874993
At six and 24 months, 44 and 34% of the patients were alive, respectively. The median observation time was 116 months (range 30.5-205). Patients with response on day 7 and 28 had significantly higher OS probability than non-responders with an OS rate after two years of 49 and 58%, respectively. Overall survival and OS according to 68 Survival
2 :: 0.2570793628692627 :: 709719
Overall, the median age of the 2156 children in the analysis cohort was 4 months (IQR, 2-9 months), 59% were boys, and 62% were white. Admission locations were as follows: ICU (16%), step-down unit (3%), ward (76%), and observation unit (5%). RESULTS
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