Epidemiology of critically ill patients in intensive care units: a population-based observational study

Garland, Allan; Olafson, Kendiss; Ramsey, Clare D.; Yogendran, Marina; Fransoo, Randy

doi:10.1186/cc13026

Cited by 95 publications

(69 citation statements)

References 34 publications

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“…This observation is in line with reports from other studies [5]- [7]. The mean age of the total population was 58.92+13.89 years covering a age ranges from 14 to 102 years while results from different studies revealed lower mean age [5], [8] as well as higher mean age [6], [8], [9]. Table 1 shows that almost fifty three percent of the total population were aged between 40-60 years, 49.61% aged 60years and above and 13.44% between the age group of 20-40 years.…”

Section: Resultssupporting

confidence: 91%

“…The length of stay of admitted cases in ICUs was evaluated from the day admitted to ICUs to the discharge day from ICUs (Figure 1) and it was found that majority (54.43%) of patient admitted to JMCH stayed for a duration of 10-15 days while 66.13 per cent of patients from private hospital (JCMC) stayed 6-10 days being a mean of 8.34+2.5 days for the whole population. The mean LOS for individuals ICUs episodes in different studies reveals comparatively lower mean Los range of 4to 67 days [9], [11] [7]. There were no significant relation between the disease diagnosed and length of stay(p=0.05).…”

Section: Resultsmentioning

confidence: 99%

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Demography and Feeding Practices of ICU Patient of Government and Private Hospitals of Jorhat District, Assam

Pl¹,

Ms²,

Gogoi³

2017

IJPHS

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The aim of the present study was to analyze the characteristics and feeding practices of patient admitted to medicine ICUs. All relevant clinical and dietary information were collected for patients admitted to ICUs of selected Government and private hospitals of Jorhat district, Assam. This information was abstracted with the help of pre-structured schedule from the Medical Record Department and Intensive Care Unit team and analysed. A total of 1034 patients were admitted during the study period. Majority of the patients (49.61%) were from the age group of 60years and above. Majority incidence of diseases is a reason of admission in ICUs of both the hospitals was non-communicable diseases and patients were admitted via emergency OPD. Highest length of stay of 10-15 days was observed among the majority of patient from government hospital while it was shorter (6-10 days) for private hospital. The daily feeding pattern of each of the patients was recorded. Patients dependent on homemade blenderized foods for nutritional support were more in Government hospital while compare to the patient using both the commercial formulae as well as homemade food till the last day of stay in private hospitals. Increased cost of hospitalization and better outcome of patient in terms of short stay at hospitals and better nutritional status of the patient admitted to private hospitals were not feasible for low income groups patients admitted in Government hospital. The results of the present study will help the need of formulation and development of patient specific homemade foods with its ingredients used and nutritional requirement in it are taken account for both oral and enteral feedings in the hospitals with higher standard values with all demonstration on the development of protocols for clean techniques in the preparation, safe handling and storage of handmade enteral feeds.

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Section: Resultssupporting

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Demography and Feeding Practices of ICU Patient of Government and Private Hospitals of Jorhat District, Assam

Pl¹,

Ms²,

Gogoi³

2017

IJPHS

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“…[1] Approximately 10% of patients discharged from the ICU require readmission during the same hospital stay. [2] Readmission exposes patients to increased risks, as transfers between healthcare professionals have been linked to an increased rate of adverse events, higher mortality, and longer hospital stays.…”

Section: Introductionmentioning

confidence: 99%

Association of severity of illness and intensive care unit readmission: A systematic review

et al. 2016

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Objectives To determine whether ICU readmission is associated with higher severity of illness scores in adult patients. Background Readmissions to the intensive care unit (ICU) are associated with increased costs, morbidity, and mortality. Methods We performed searches of MEDLINE, EMBASE, and grey literature databases. We selected studies reporting data from adults who were hospitalized in an ICU, received severity of illness scores, and were discharged from the ICU. Characteristics of readmitted and non-readmitted patients were examined. Results We screened 4766 publications and included 31 studies in our analysis. In most studies, severity of illness scores were higher in patients readmitted to the ICU. Readmission was also associated with higher mortality and longer ICU and hospital stays. Excessive heterogeneity precluded the reporting of results in the form of a meta-analysis. Conclusions ICU readmission is associated with higher severity of illness scores during the same hospitalization in adult patients.

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“…5,6 Studi epidemiologi pasien sakit kritis yang berbasis populasi yang dilakukan di Canada menyebutkan bahwa angka kejadian sakit kritis lebih banyak terjadi pada laki laki daripada perempuan tetapi penolakan terhadap perawatan di ICU dan tata laksanan agresif lebih banyak terjadi pada perempuan. 7 Angka mortalitas pada studi ini adalah 68,6%, dengan faktor risiko penyakit terbanyak adalah sepsis berat (78,9%). Angka mortalitas pada studi ini sesuai dengan beberapa studi mortalitas kandidiasis invasif, dimana angka mortalitas berkisar antara 30 -70%.…”

Section: Diskusiunclassified

Faktor-Faktor yang Berhubungan dengan Mortalitas 30 Hari pada Pasien Sakit Kritis dengan Kandidiasis Invasif yang Dirawat di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM)

Ardian¹,

Pitoyo²,

Adhitianingsih³

et al. 2017

JPDI

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Pendahuluan. Tingkat mortalitas kandidiasis invasif mencapai 30-70%. Setiap studi menunjukkan tingkat mortalitas yang berbeda pada studi dan sampel yang berbeda. Belum ada data mengenai profil dan analisis faktor mortalitas kandidiasis invasif pada pasien sakit kritis. Studi ini bertujuan untuk memberikan informasi profil kandidiasis invasif pada pasien sakit kritis beserta faktor faktor yang berpengaruh terhadap mortalitas sebagai upaya untuk meningkatkan kualitas tata laksana pasien sakit kritis dengan kandidiasis invasif.Metode. Desain penelitian adalah potong lintang, mengumpulkan data dari rekam medis pada seratus dua pasien sakit kritis dengan kandidiasis invasif. Pasien kandidiasis invasif adalah pasien dengan hasil kultur darah dan atau kultur cairan tubuh normal steril positif jamur spesies Candida. Data yang dikumpulkan meliputi data usia, spesies jamur candida penyebab, faktor risiko kandidiasis invasif, serta data faktor yang berpengaruh terhadap mortalitas yang meliputi ada tidaknya kondisi sepsis, nilai APACHE, ada tidaknya kondisi gagal napas,ada tidaknya gagal ginjal, waktu pemberian terapi antijamur,Charlson Index, dan tempat perawatan (ICU atau Non ICU). Uji analisis bivariat dengan uji chi square dilakukan terhadap masing masing faktor, yang dilanjutkan dengan uji multivariat regresi logistik untuk menilai faktor yang paling berhubungan terhadap mortalitas 30 hari.Hasil. Dari 102 sampel penelitian didapatkan laki laki 52,9% dan perempuan 47,1%. Median usia 53 tahun dengan angka mortalitas 68,6%. Spesies candida penyebab terbanyak adalah Candida tropicalis (34,3%) dan Candida parapsilosis (29,4%), tiga faktor risiko kandidiasis invasif terkait penyakit dasar adalah sepsis (78,9%), keganasan (42,15%), diabetes melitus ( 29,4%) sedangkan yang terkait terapi atau tata laksana adalah penggunaan antibiotik spektrum luas (99%), kateter vena sentral (77,5%), serta pemberian nutrisi parenteral (70,6%). Pada analisis multivariat regresi logistik, faktor yang paling berpengaruh terhadap mortalitas adalah sepsis berat ( p 0,001, OR 7,7, IK95% 2,4 – 24,7), Charlson Index ≥ 3 ( p 0,022, OR 3,5, IK95% 1,2 – 10,2), dan gagal napas (p 0,066, OR 2,733 IK95% 0,9 – 8,0).Simpulan. Pada pasien sakit kritis dengan kandidiasis invasif yang dirawat di RSCM, laki laki lebih banyak dari pada perempuan, dengan median usia 53 tahun, dan angka mortalitas 68,6%. Spesies candida terbanyak penyebab infeksi adalah Candida tropicalis dan Candida parapsilosis. Faktor risiko kandidiasis invasif terbanyak terkait penyakit dasar adalah sepsis sedangkan terkait terapi atau tata laksana adalah penggunaan antibiotik spektrum luas. Faktor faktor yang berhubungan dengan mortalitas 30 hari adalah kondisi sepsis berat dan Charlson index ≥3.Kata Kunci: faktor mortalitas, kandidiasis invasif, sakit kritis Factors Related to 30 day Mortality in Critically Ill Patients with Invasive Candidiasis in Cipto Mangunkusumo HospitalIntroduction. Mortality rate of invasive candidiasis is still high, approximately 30-70%. Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with invasive candidiasis. Methods. The Study design was cross sectional. We studied 102 hospitalized critically ill patients with invasive candidiasis. The demographic, clinical and laboratory data, the risk factors for invasive candidiasis and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher’s test was carried out to analyse some factors such as age > 60 years old, severe sepsis, APACHE score > 20, respiratory failure, renal failure, delayed antifungal treatment > 72 hours after positive culture, Charlson index score, and ICU or non ICU patients. The logistic regression of multivariate analysis was carried out to identify the most influence of all mortality factors. Results. Among 102 identified sample, the majority was male (52.9%), the median age was 53 years old and the mortality rate was 68,6%. Laboratory candida findings came from blood sample (candidemia) (98.03%), liquor cerebrospinal (1.5%) and retina exudate (1.5%). The most common candida species were candida non albicans especially Candida tropicalis (34.3%) and Candida parapsilosis (34.3%). The risk factors for invasive candidiasis from this study related to underlying disease were sepsis (78.9%), malignancy (42.15%), diabetes mellitus (29.4%) and related to therapy or treatment were the usage of broad spectrum antibiotic (99%), central vein catheter (77.5%), and parenteral nutrition (70.6%). The result from multivariate analysis, severe sepsis (p 0.001, OR 7.7, IK95% 2.4 – 24.7), Ch arlson Index ≥3 (p 0.022, OR 3.5, IK95% 1.2–10.2), and respiratory failure (p 0.066, OR 2.7 IK95% 0.9 – 8.0) were independently associated with mortality. Conclusions. In Cipto Mangunkusumo hospital, most critically ill patients with invasive candidiasis was male, median age was 53 years old, and mortality rate was 68,6%. The most species candida caused infection were Candida tropicalis and Candida parapsilosis. The most risk factors of invasive candidiasis from underlying disease was sepsis and from the treatment was the usage of broad spectrum antibiotic. Severe sepsis, and Charlson index ≥3 were associated with a 30 day mortality in critically ill patients with invasive candidiasis.

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Epidemiology of critically ill patients in intensive care units: a population-based observational study

Cited by 95 publications

References 34 publications

Demography and Feeding Practices of ICU Patient of Government and Private Hospitals of Jorhat District, Assam

Demography and Feeding Practices of ICU Patient of Government and Private Hospitals of Jorhat District, Assam

Association of severity of illness and intensive care unit readmission: A systematic review

Faktor-Faktor yang Berhubungan dengan Mortalitas 30 Hari pada Pasien Sakit Kritis dengan Kandidiasis Invasif yang Dirawat di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM)

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