International Journal of Critical Illness and Injury Science最新文献

{"title":"Incorporation of plasma Vitamin C levels to modified nutritional risk in critically ill score as the novel Vitamin C nutritional risk in critically ill score in sepsis subjects as an early predictor of multidrug-resistant bacteria: A prospective observational study.","authors":"Shwethapriya Rao,&nbsp;Ravindra Maradi,&nbsp;Nitin Gupta,&nbsp;Arjun Asok,&nbsp;Souvik Chaudhuri,&nbsp;Margiben Tusharbhai Bhatt,&nbsp;Sagar Shanmukhappa Maddani","doi":"10.4103/ijciis.ijciis_54_22","DOIUrl":"10.4103/ijciis.ijciis_54_22","url":null,"abstract":"<p><strong>Background: </strong>On intensive care unit (ICU) admission, it is difficult to predict which patient may harbor multidrug-resistant (MDR) bacteria. MDR is the nonsusceptibility of bacteria to at least one antibiotic in three or more antimicrobial categories. Vitamin C inhibits bacterial biofilms, and its incorporation into the modified nutritional risk in critically ill (mNUTRIC) scores may help predict MDR bacterial sepsis early.</p><p><strong>Methods: </strong>A prospective observational study was conducted on adult subjects with sepsis. Plasma Vitamin C level was estimated within 24 h of ICU admission, and it was incorporated into the mNUTRIC score (designated as Vitamin C nutritional risk in critically ill [vNUTRIC]). Multivariable logistic regression was performed to determine if vNUTRIC was an independent predictor of MDR bacterial culture in sepsis subjects. The receiver operating characteristic curve was plotted to determine the vNUTRIC cutoff score for predicting MDR bacterial culture.</p><p><strong>Results: </strong>A total of 103 patients were recruited. The bacterial culture-positive sepsis subjects were 58/103, with 49/58 culture-positive subjects having MDR. The vNUTRIC score on ICU admission in the MDR bacteria group was 6.71 ± 1.92 versus 5.42 ± 2.2 in the non-MDR bacteria group (<i>P</i> = 0.003, Independent Student's <i>t</i>-test). High vNUTRIC score ≥6 on admission is associated with MDR bacteria (<i>P</i> = 0.042 Chi-Square test), and is a predictor of MDR bacteria (<i>P</i> = 0.003, AUC 0.671, 95% confidence interval [0.568-0.775], sensitivity 71%, specificity 48%). Logistic regression showed that the vNUTRIC score is an independent predictor of MDR bacteria.</p><p><strong>Conclusion: </strong>High vNUTRIC score (≥6) on ICU admission in sepsis subjects is associated with MDR bacteria.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9461400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Early Warning Score 2 is superior to quick Sequential Organ Failure Assessment in predicting mortality in sepsis patients presenting to the emergency department in India: A prospective observational study.","authors":"Ankur Verma,&nbsp;Aasiya Farooq,&nbsp;Sanjay Jaiswal,&nbsp;Meghna Haldar,&nbsp;Wasil Rasool Sheikh,&nbsp;Palak Khanna,&nbsp;Amit Vishen,&nbsp;Rinkey Ahuja,&nbsp;Abbas Ali Khatai,&nbsp;Nilesh Prasad","doi":"10.4103/ijciis.ijciis_41_22","DOIUrl":"10.4103/ijciis.ijciis_41_22","url":null,"abstract":"<p><strong>Background: </strong>High in-hospital mortality in sepsis patients remains challenging for clinicians worldwide. Early recognition, prognostication, and aggressive management are essential for treating septic patients. Many scores have been formulated to guide clinicians to predict the early deterioration of such patients. Our objective was to compare predictive values of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2) with respect to in-hospital mortality.</p><p><strong>Methods: </strong>This prospective observational study was conducted in a tertiary care center in India. Adults with suspected infection with at least two Systemic Inflammatory Response Syndrome criteria presenting to the emergency department (ED) were enrolled. NEWS2 and qSOFA scores were calculated, and patients were followed until their primary outcome of mortality or hospital discharge. The diagnostic accuracy of qSOFA and NEWS2 for predicting mortality was analyzed.</p><p><strong>Results: </strong>Three hundred and seventy-three patients were enrolled. Overall mortality was 35.12%. A majority of patients had LOS between 2 and 6 days (43.70%). NEWS2 had higher area under curve at 0.781 (95% confidence interval [CI] (0.59, 0.97)) than qSOFA at 0.729 (95% CI [0.51, 0.94]), with <i>P</i> < 0.001. Sensitivity, specificity, and diagnostic efficiency to predict mortality by NEWS2 were 83.21% (95% CI [83.17%, 83.24%]); 57.44% (95% CI [57.39%, 57.49%]); and 66.48% (95% CI [66.43%, 66.53%]), respectively. qSOFA score had sensitivity, specificity, and diagnostic efficiency to predict mortality of 77.10% (95% CI [77.06%, 77.14%]); 42.98% (95% CI [42.92%, 43.03%]); and 54.95% (95% CI [54.90%, 55.00%]), respectively.</p><p><strong>Conclusion: </strong>NEWS2 is superior to qSOFA in predicting in-hospital mortality for sepsis patients presenting to the ED in India.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9468066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute physiology and chronic health evaluation score and mortality of patients admitted to intermediate care units of a hospital in a low- and middle-income country: A cross-sectional study from Pakistan","authors":"Aysha Almas, SherMuhammad Sethi, AmberSabeen Ahmed, Madiha Iqbal, Mehmood Riaz, MuhammadZain Mushtaq","doi":"10.4103/ijciis.ijciis_83_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_83_22","url":null,"abstract":"Background: Intermediate care units (IMCUs) serve as a bridge between general wards and intensive care units by providing close monitoring and rapid response to medical emergencies. We aim to identify the common acute medical conditions in patients admitted to IMCU and compare the predicted mortality of these conditions by acute physiology and chronic health evaluation-II (APACHE-II) score with actual mortality. Methods: A cross-sectional study was conducted at a tertiary care hospital from 2017 to 2019. All adult internal medicine patients admitted to IMCUs were included. Acute conditions were defined as those of short duration (<3 weeks) that require hospitalization. The APACHE-II score was used to determine the severity of these patients’ illnesses. Results: Mean (standard deviation [SD]) age was 62 (16.5) years, and 493 (49.2%) patients were male. The top three acute medical conditions were acute and chronic kidney disease in 399 (39.8%), pneumonia in 303 (30.2%), and urinary tract infections (UTIs) in 211 (21.1%). The mean (SD) APACHE-II score of these patients was 12.5 (5.4). The highest mean APACHE-II (SD) score was for acute kidney injury (14.7 ± 4.8), followed by sepsis/septic shock (13.6 ± 5.1) and UTI (13.4 ± 5.1). Sepsis/septic shock was associated with the greatest mortality (odds ratio [OR]: 6.9 [95% CI (confidence interval): 4.5–10.6]), followed by stroke (OR: 3.9 [95% CI: 1.9–8.3]) and pneumonia (OR: 3.0 [95% CI: 2.0–4.5]). Conclusions: Sepsis/septic shock, stroke, and pneumonia are the leading causes of death in our IMCUs. The APACHE-II score predicted mortality for most acute medical conditions but underestimated the risk for sepsis and stroke.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of intermediate syndrome in a COVID-19 patient with severe organophosphate toxicity","authors":"MarwaMohammed Fouad, NerminHamdy Zawilla, DoaaAtef Moubarez","doi":"10.4103/ijciis.ijciis_84_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_84_22","url":null,"abstract":"Organophosphate (OP) poisoning is one of the most common causes of poisoning in the world, due to its easy availability, low cost, and wide occupational exposure. It has a significant death and morbidity rate. Cholinergic syndrome, intermediate syndrome (IMS), and syndrome of delayed polyneuropathy are the three primary syndromes that define OP poisoning. We report the case of a 44-year-old male patient who had a history of OP poisoning by inhalation and later developed altered mental status (AMS). The patient transiently improved and regained consciousness following treatment with atropine and obidoxime. He deteriorated the following day with AMS and generalized muscle weakness consistent with IMS and was intubated for airway protection. Despite further complication by Klebsiella and COVID-19 infections, he recovered to hospital discharge on day 14.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135594297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An assessment of serum magnesium levels in critically ill patients: A prospective observational study","authors":"DeepakS Laddhad, Vinayak Hingane, TusharRamrao Patil, DhruvDeepak Laddhad, AishwaryaDhruv Laddhad, ShantanuDeepak Laddhad","doi":"10.4103/ijciis.ijciis_11_23","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_11_23","url":null,"abstract":"Background: A specific magnesium level is essential to be maintained to ensure appropriate neuromuscular excitability and cardiac function; an increase or decrease in its levels usually leads to critical abnormality. Hypomagnesemia in critically ill patients has many potential ramifications and is found to be an important factor in hindering their recovery. Thus, the study aimed to assess the serum magnesium levels in critically ill participants and explore its effect on their condition. Methods: A prospective observational study was conducted for 21 months, from February 2019 to October 2020, among all critically ill participants admitted to the medical intensive care unit (ICU) of a tertiary care hospital. The Acute Physiology and Chronic Health Evaluation II score questionnaire was used to determine the severity of their condition and blood samples were collected within 24 h of their ICU admission for analysis. Results: One hundred participants were enrolled, of which 40% were between the age group of 46 and 65 years and 71% were males. Among all participants with hypomagnesemia, 52% were diabetic, 19% had a history of alcohol use disorder, and 27% had normal calcium and potassium levels. Hypomagnesemia significantly correlated with a longer duration of ICU stay among participants. Conclusion: A significant correlation was observed between hypomagnesemia and increased ICU length of stay and mortality but not the duration of mechanical ventilation. Monitoring and appropriate supplementation of serum magnesium is recommended to limit further comorbidity and mortality in the critical care setting.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The optimal time for endotracheal intubation in subjects with coronavirus disease 2019 pneumonia: A retrospective observational study","authors":"Rashid Nadeem, Nadia Nadeem, RawanMohamad Albwidani, FatimaHakim Falih, HatimRiyaz Husain, AhmadZouhir Krrak, ManojPazhampallil Mathews, KarimSaid Hammouda Hussein, Fatema Abdulkarim, Farooq Dar","doi":"10.4103/ijciis.ijciis_79_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_79_22","url":null,"abstract":"Background: The optimal timing of intubation has been debated among healthcare professionals, current studies do not show any differences between early and late intubation. most studies failed to show any significant difference in clinical outcomes between early or late intubation. Methods: The study was conducted as a retrospective review of subjects with confirmed coronavirus disease 2019 admitted to the Dubai Hospital intensive care unit (ICU). Study variables included time to intubation, duration of supplemental oxygen requirement >15 L/min, and cumulative duration of tachypnea and tachycardia while on the aforementioned oxygen requirement on this oxygen usage level. Each time duration was assessed for correlation with clinical variables including mortality and length of stay in ICU and hospital. Results: Subjects who require endotracheal intubation within 4 h after the start of oxygen >15 L/min have lower survival (P = 0.03). Subjects who have tachypnea on the aforementioned oxygen requirement for 6–19.5 h (P = 0.01) before they require intubation have better survival. No duration of tachycardia has any significant effect on survival. Only the duration of invasive mechanical ventilation (MV) correlated with the hospital length of stay. Conclusions: Subjects who require endotracheal intubation within 4 h after the start of oxygen >15 L/min have lower survival. The optimal time for intubation is after tachypnea of 6 h but before 19.5 h. No duration of tachycardia has any significant effect on survival. Only the duration of invasive MV correlated with the hospital length of stay.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of metoclopramide for prevention of gastric regurgitation during endotracheal intubation in the emergency department: A randomized controlled trial","authors":"Upendra Hansda, IjasMuhammed Shaji, ChittaRanjan Mohanty, Nitish Topno, JithinJacob Varghese, Sangeeta Sahoo, Satyabrata Guru","doi":"10.4103/ijciis.ijciis_80_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_80_22","url":null,"abstract":"Background: Gastric content regurgitation and aspiration are the dreaded complications of securing the airway. Cricoid pressure hinders intubation and causes lower esophageal sphincter (LES) relaxation. A recent study suggests no added benefit of cricoid pressure in preventing pulmonary aspiration of gastric contents. Metoclopramide increases LES tone, prevents gastroesophageal reflux, and increases antral contractions. Hence, we wanted to study the efficacy of metoclopramide for preventing gastric regurgitation during endotracheal intubation (ETI) in patients presenting to the emergency department (ED). Methods: This study was a randomized controlled trial in patients requiring ETI in the ED. The study participants were randomized to receive either metoclopramide (intervention) 10 mg/2 ml intravenous (IV) bolus or a placebo of normal saline (placebo) 2 ml IV bolus 5 min before rapid sequence induction and intubation. The outcome of the study was the visualization of gastric regurgitation at the glottic opening during direct laryngoscopy at the time of intubation. Results: Seventy-four study participants were randomized and allocated to the metoclopramide group (n = 37) or placebo group (n = 37). Gastric regurgitation at the glottis was noted in three study participants (8%) in the metoclopramide group, and six (16%) in the placebo group (odds ratio [OR] - 0.456; 95% confidence interval [CI] of 0.105–1.981; P = 0.295). The study participants who were intubated in the first attempt had less gastric regurgitation compared to ≥2 attempts (OR 0.031; 95% CI of 0.002–0.511; P = 0.015). Conclusion: There was no decrease in regurgitation with metoclopramide as compared to placebo during ETI in study participants presenting to the ED.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of adjuvant therapy with midazolam, paracetamol, tramadol, or magnesium sulfate during intravenous regional anesthesia with ropivacaine: A randomized clinical trial.","authors":"Hesameddin Modir,&nbsp;Esmail Moshiri,&nbsp;Mohsen Parsi Khamene,&nbsp;Davood Komijani","doi":"10.4103/ijciis.ijciis_39_22","DOIUrl":"10.4103/ijciis.ijciis_39_22","url":null,"abstract":"<p><strong>Background: </strong>Intravenous (IV) regional anesthesia is an easy, safe, reliable, and efficient option for inducing anesthesia during surgeries but with tourniquet-related pain. This study aimed to evaluate midazolam, paracetamol, tramadol, and magnesium sulfate administration as adjuvants with ropivacaine on pain relief and hemodynamic changes in IV regional anesthesia.</p><p><strong>Methods: </strong>A randomized, double-blind, placebo-controlled trial was conducted in subjects undergoing forearm surgery with IV regional anesthesia. The block randomization method was used to assign eligible participants to each of five study groups. Hemodynamic parameters were assessed before applying the tourniquet, at prespecified time points (5, 10, 15, and 20 min), then and every subsequent 10 min until surgery completion. A Visual Analog Scale was used to assess pain severity at baseline followed by every 15 min until completion of the surgery, and after tourniquet deflation every 30 min to 2 h, and at 6, 12, and 24 h postoperative. Data were analyzed using Chi-square and analysis of variance with repeated data testing.</p><p><strong>Results: </strong>The shortest onset and the longest duration of sensory block were observed in the tramadol group and the shortest onset of motor block in the midazolam group (<i>P</i> < 0.001). Pain score was estimated to be significantly lower in the tramadol group at the time of tourniquet application and release, and 15 min to 12 h after tourniquet release (<i>P</i> < 0.05). In addition, the lowest dose of pethidine consumption was observed in the tramadol group (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Tramadol appeared to be able to effectively relieve pain, shorten the onset of sensory block, prolong the duration of sensory block, and achieve the lowest consumption of pethidine.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9461399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of prophylactic antiemetic therapy with palonosetron and dexamethasone as single-agents or in combination in adult patients undergoing laparoscopic surgery: A randomized trial.","authors":"Neha Sadhoo,&nbsp;Jay Prakash,&nbsp;Vishwanath Kumar,&nbsp;Ramesh Kumar Kharwar,&nbsp;Sabih Ahmad,&nbsp;Bijaya Kumar Sethi","doi":"10.4103/ijciis.ijciis_150_20","DOIUrl":"10.4103/ijciis.ijciis_150_20","url":null,"abstract":"<p><strong>Background: </strong>The incidence of postoperative nausea and vomiting (PONV) is quite high after laparoscopic surgeries. This study endeavors to compare the efficacy of the combination of palonosetron and dexamethasone with that of either drug alone in the prevention of PONV in patients undergoing laparoscopic surgeries.</p><p><strong>Methods: </strong>This randomized, parallel-group trial was done on ninety adults of American Society of Anesthesiologists Grade I and II patients aged 18-60 years undergoing laparoscopic surgeries under general anesthesia. The patients were randomly divided into three groups of thirty patients each. Group P (<i>n</i> = 30) received palonosetron 0.075 mg intravenously (iv), Group D (<i>n</i> = 30) received dexamethasone 8 mg iv and Group P + D (<i>n</i> = 30) received palonosetron 0.075 mg and dexamethasone 8 mg iv. The primary outcome was incidence of PONV in 24 h, and the secondary outcome was a number of rescue antiemetics required. To compare the proportions in the groups, unpaired <i>t</i>-test, Mann-Whitney <i>U</i>-test, Chi-square test, or Fisher's exact test was applied.</p><p><strong>Results: </strong>We found that the overall incidence of PONV was 46.7% in Group P, 50% in Group D, and 43.3% in Group P + D during the first 24 h. Rescue antiemetic was required in 27% of the patients in Group P and Group D compared to 23% of the patients in Group P + D and twice in 3% of the patients in Group P, 7% of the patients in Group D, and none in Group P + D which were not significant.</p><p><strong>Conclusions: </strong>The combination therapy of palonosetron plus dexamethasone did not significantly reduce the incidence of PONV when compared with either drug alone.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"4-10"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9468063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S100B as a predictor of delirium in critically ill obstetric patients: A nested case–control study","authors":"Rekha Sachan, Radhey Shyam, Monam Solanki, MunnaLal Patel, Wahid Ali","doi":"10.4103/ijciis.ijciis_19_23","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_19_23","url":null,"abstract":"Background: Delirium is a neuropsychiatric illness that lasts for a short period of time. The incidence of delirium in the intensive care unit (ICU) varies from 20% to 80%. Methods: A nested case–control study was carried out in the obstetric ICU. Individuals were divided into three groups: critically ill obstetric women who had delirium on admission (Group A), women who developed delirium within follow-up of 7 days (Group B), and women who did not develop delirium after follow-up of 7 days (Group C). The APACHE II score was used to assess critical illness severity. The Richmond Agitation-Sedation Scale was used to assess the alertness or sedation level of patients, and the Confusion Assessment Method (ICU scale) was used to assess the presence of delirium. S100B was measured by human S100B calcium-binding protein B ELISA kit (Elabscience Biotechnology, Houston, USA). Results: Severe preeclampsia and antepartum eclampsia were significantly associated with delirium. S100B levels in Group B were found to be significantly higher than those in Group C. S100B levels were higher in patients with >2 morbidities in comparison to patients with two morbidities. At a cutoff value of >169.25 pg/ml, S100B had a sensitivity of 74% and a specificity of 87.2% to discriminate cases of delirium from nondelirium. Conclusion: The rise in S100B levels was approximately three times greater in those who developed delirium as compared to those who did not. It is a more specific predictor of delirium.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}