Journal of Intensive Care Medicine最新文献

{"title":"Cardiogenic Shock and Utilization of Mechanical Circulatory Support in Pregnancy.","authors":"Anna C O'Kelly, Amy Sarma, Emily Naoum, Sarah Rae Easter, Katherine Economy, Jonathan Ludmir","doi":"10.1177/08850666231225606","DOIUrl":"10.1177/08850666231225606","url":null,"abstract":"<p><p>Maternal mortality rates are rising in the United States, a trend which is in contrast to that seen in other high-income nations. Cardiovascular disease and hypertensive disorders of pregnancy are consistently the leading causes of maternal mortality both in the United States and globally, accounting for about one-quarter to one-third of maternal and peripartum deaths. A large proportion of cardiovascular morbidity and mortality stems from acquired disease in the context of cardiovascular risk factors, which include obesity, pre-existing diabetes and hypertension, and inequities in care from maternal care deserts and structural racism. Patients may also become pregnant with preexisting structural heart disease, or acquire disease throughout pregnancy (ex: spontaneous coronary artery dissection, peripartum cardiomyopathy), and be at higher risk of pregnancy-related cardiovascular complications. While risk-stratification tools including the modified World Health Organization (mWHO) classification, Cardiac Disease in Pregnancy (CARPREG II) and Zwangerschap bij Aangeboren HARtAfwijking/Pregnancy in Women with Congenital Heart Disease (ZAHARA) have been designed to help physicians identify patients at increased risk for adverse pregnancy outcomes and who may therefore benefit from referral to a tertiary care center, the limitation of these scores is their predominant focus on patients with known preexisting heart disease. As such, identifying patients at risk for pregnancy complications presents a significant challenge, and it is often patients with high-risk cardiovascular substrates prior to or during pregnancy who are at a highest risk for adverse pregnancy outcomes including cardiogenic shock.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"467-475"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Rapid Response Team Activation Impact in Patients with Cirrhosis with Acute Decompensation.","authors":"Joelle N Friesen, Mackenzie Maberry, Jody C Olson, Alice Gallo de Moraes","doi":"10.1177/08850666241302024","DOIUrl":"10.1177/08850666241302024","url":null,"abstract":"<p><p>Background: Cirrhosis is associated with significant healthcare utilization, yet data about in-hospital decompensations remain sparse. Additionally, the impact of liver transplant candidacy status on resuscitation and outcomes is largely unknown. Aims:We aimed to evaluate the characteristics of resuscitation events for patients with cirrhosis with acute decompensation, analyzing liver transplant candidacy and intensive care unit (ICU) transfer parameters. Methods: Retrospective single-center review of adult patients with liver cirrhosis who had a rapid response team (RRT) activation during hospitalization and no prior liver transplantation. Results: Patients with cirrhosis who were liver transplant candidates were more likely to be younger (<i>p</i> = .003), have a higher serum total bilirubin (<i>p</i> = .015), higher INR (<i>p</i> < .001), and higher MELD 3.0 (<i>p</i> = .006). There was no significant difference in ICU transfer (<i>p</i> = .170) after RRT activation. Liver transplant candidates had a lower 30- and 60-day mortality (<i>p</i> = .008, <i>p</i> = .014) and were less likely to have a code status discussion after decompensation (<i>p</i> = .001). Lower serum albumin was associated with ICU transfer (<i>p</i> = .001). Patients who transferred to the ICU were more likely to have a code status discussion within 24 h after RRT (<i>p</i> = .011) without significant difference in 30- or 60-day mortality (<i>p</i> = .059, <i>p</i> = .277). Conclusions: Liver transplant candidacy in patients with cirrhosis with acute decompensation is not clearly correlated with ICU transfer. Liver transplant candidates are more likely to be younger, have higher MELD 3.0 scores, less likely to have code status discussed after RRT, and have lower 30- and 60-day mortality rates. Patients who transfer to the ICU are more likely to have a code status discussion without any significant difference in 30- or 60-day mortality.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"528-535"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors of Hospital Mortality After Near Hanging: A Retrospective two-Center French Study.","authors":"Yanis Gueddoum, Antoine Goury, Vincent Legros, Thierry Floch, Bruno Mourvillier, Guillaume Thery","doi":"10.1177/08850666241303881","DOIUrl":"10.1177/08850666241303881","url":null,"abstract":"<p><p>Introduction: suicide is a global public health issue, with over 800 000 people taking their own lives every year. However, most suicide attempts do not result in death. Hanging is the most common method used in France, often leading to post-hanging coma (PHC). The prognosis for patients admitted in intensive care unit (ICU) following PHC is poor, yet predictive criteria of mortality have been poorly evaluated. Methods: we retrospectively collected prehospital and in-hospital data from 65 patients hospitalized in 2 French ICU for PHC, between first March 2010 and first August 2023, and compared characteristics between patients alive and dead. Results: hospital mortality was 52%. Among baseline characteristics, SAPSII and pre-hospital cardiac arrest were associated with mortality, respectively 47 versus 62 (<i>P</i> = .005) and 32% versus 85% (<i>P</i> = .001). Concerning neuroprognostication, abnormal pupillary light reflex (PLR) was more frequent in patients who died (14% vs 56%, <i>P</i> = .002), as abnormal EEG (0% vs 32%, <i>P</i> = .002) and abnormal transcranial doppler (10% vs 35%, <i>P</i> = .031). Conclusion: we identified several poor prognostic factors associated with hospital mortality after PHC. Further larger-scale studies are needed to supplement these findings.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"503-508"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valproic Acid for Hyperactive Delirium and Agitation in Critically Ill Patients.","authors":"Olivia Nuti, Cristian Merchan, Tania Ahuja, Serena Arnouk, John Papadopoulos, Alyson Katz","doi":"10.1177/08850666241302760","DOIUrl":"10.1177/08850666241302760","url":null,"abstract":"<p><p>Background: Delirium and agitation are common syndromes in critically ill patients. Valproic acid (VPA) has shown benefit in intensive care unit (ICU)-associated delirium and agitation, but further evaluation is needed. Objective: The purpose of this study was to evaluate the effectiveness and safety of VPA for hyperactive delirium and agitation in critically ill adult patients. Methods: A retrospective cohort study at NYU Langone Health was conducted in critically ill patients treated with VPA for hyperactive delirium or agitation from October 1, 2017 to October 1, 2022. The primary outcome was effectiveness of VPA, defined as a reduction in the total number of any concomitant psychoactive medication by day 3 of VPA treatment. Secondary outcomes included the effect of VPA on the doses of concomitant medications and adverse events. Results: A total of 87 patients were included in the final analysis. By day 3 of VPA treatment, a 33% reduction (<i>P</i> < .001) in the total number of concomitant psychoactive medications was observed. VPA decreased the need for sedatives, as assessed by midazolam equivalents, but no significant changes were seen with dexmedetomidine alone, opioids, or antipsychotics. A 10 mg/kg loading dose was utilized in 36% of the cohort and its use decreased the risk for initiating additional psychoactive medications by day 3 of therapy (OR 2.8, 95% CI 1.0-7.8, <i>P</i> = .047), with benefits noted as early as 48 h after initiation. Adverse events were low in the total cohort (10.3%). Conclusion and Relevance:The addition of VPA to a complex pharmacologic regimen for hyperactive delirium and agitation is safe and can assist in the prevention of polypharmacy and overall workload in critically ill patients admitted primarily for cardiogenic shock and respiratory failure requiring mechanical ventilation.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"519-527"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Chest Compression Pauses During Pediatric ECPR.","authors":"Elena M Insley, Andrew S Geneslaw, Tarif A Choudhury, Anita I Sen","doi":"10.1177/08850666241301023","DOIUrl":"10.1177/08850666241301023","url":null,"abstract":"<p><p><b>Objective:</b> To quantify chest compression (CC) pauses during pediatric ECPR (CPR incorporating ECMO) and implement sustainable quality improvement (QI) initiatives to reduce CC pauses during ECMO cannulation. <b>Methods:</b> We retrospectively identified baseline CC pause characteristics during pediatric ECPR events (pre-intervention), deployed QI interventions to reduce CC pause length, and then prospectively quantified CC pause metrics post-QI interventions (post-intervention). Data were gathered from a single center review of CC-pause characteristics in children less than 18 years old with a PICU ECPR arrest. QI Interventions included: (1) sharing baseline CC data with ECPR stakeholders, (2) establishing consensus among providers regarding areas for improvement, and (3) creating a communication aid to encourage counting CC pauses out loud. Multidisciplinary ECPR simulations allowed for practice of these skills. Using telemetry data, CC pause metrics were analyzed in the medical (CPR before cannulation) and surgical (CPR during ECMO cannulation, demarcated by the sterile draping of the patient) phases of ECPR, pre- and post-intervention. <b>Results:</b> Pre-intervention, 11 ECPR events (5 central cannulation, 6 peripheral cannulation) met inclusion criteria compared with 14 ECPR events (2 central, 12 peripheral) post-intervention. Pre-intervention analysis identified longer CC pauses and lower chest compression fraction (CCF) during the surgical versus medical phase of ECPR. Compared to pre-intervention data, CCF during the surgical phase of ECPR improved from 66% to 81% (73-85%) post-intervention (<i>P</i> = .02). Median CC pause length was significantly reduced from 20 s pre-intervention to 10.5 (9-13) seconds post-intervention (<i>P</i> = .01). There was no change in the surgical phase of ECPR duration (44 min pre- vs 41 min post-intervention, <i>P</i> = .8) or survival to hospital discharge (45% vs 21%, <i>P</i> = .4). <b>Conclusion:</b> Simple and feasible communication interventions during ECPR can minimize CC pauses, increase CCF and improve CPR quality without prolonging the time needed for ECMO cannulation.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"495-502"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxygen Targets for Mechanically Ventilated Adults with Sepsis: Secondary Analysis of the PILOT Trial.","authors":"Jack C Shapiro, Jonathan D Casey, Edward T Qian, Kevin P Seitz, Li Wang, Bradley D Lloyd, Joanna L Stollings, Robert E Freundlich, Wesley H Self, Todd W Rice, Jonathan P Wanderer, Matthew W Semler","doi":"10.1177/08850666241299378","DOIUrl":"10.1177/08850666241299378","url":null,"abstract":"<p><p>Background: Patients with sepsis frequently require invasive mechanical ventilation. How oxygenation during mechanical ventilation affects clinical outcomes for patients with sepsis remains uncertain. Research Question: To evaluate the effects of different oxygen saturation targets on clinical outcomes for patients with sepsis receiving mechanical ventilation. Study Design and Methods: We performed a secondary analysis of the <u>P</u>ragmatic <u>I</u>nvestigation of optima<u>L</u> <u>O</u>xygen <u>T</u>argets (PILOT) trial dataset among patients who met criteria for sepsis by the Sepsis-3 definition at the time of enrollment. We compared patients randomized to a lower oxygen saturation target (90%; range, 88-92%), an intermediate target (94%; range, 92-96%), and a higher target (98%; range, 96-100%) with regard to the outcomes of 28-day in-hospital mortality and ventilator-free days to study day 28. Results: Of 2541 patients in the PILOT dataset, 805 patients with sepsis were included in the current analysis. In-hospital mortality by day 28 did not differ significantly between the lower target group (48%; 95% confidence interval [CI], 42% to 54%), the intermediate target group (50%; 95% CI, 43% to 56%), and the higher target group (51%; 95% CI, 45% to 56%) (P = 0.83). The number of ventilator-free days to day 28 did not significantly differ between the trial groups, with a mean of 9.9 (standard deviation [SD], 11.8) in the lower oxygen saturation target group, 9.5 (SD, 11.2) in the intermediate group, and 9.4 (SD, 11.4) in the higher group (P = 0.65). Interpretation: Among mechanically ventilated patients with sepsis in a large, randomized trial, the incidence of 28-day in-hospital mortality was not statistically significantly different between the use of a lower, intermediate, or higher oxygen target. However, the confidence intervals included treatment effects that would be clinically meaningfully and further randomized trials of oxygen targets in sepsis are required. Referenced trial name Pragmatic Investigation of optimaL Oxygen Targets Trial (PILOT) ClinicalTrials.gov number NCT03537937URL: https://clinicaltrials.gov/study/NCT03537937.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"486-494"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Immunomodulatory Effects of Nutritional Supplements in Traumatic Brain Injury.","authors":"Christian Zanza, Yaroslava Longhitano, Raymond Planinsic, Antonio Voza, Manfredi Tesauro, Giorgia Caputo, Francesca Rubulotta, Luigi La Via","doi":"10.1177/08850666251337378","DOIUrl":"https://doi.org/10.1177/08850666251337378","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) remains a leading cause of mortality and disability worldwide, characterized by complex pathophysiological processes that extend beyond the initial trauma. The inflammatory response following TBI plays a crucial role in patient outcomes, presenting both protective and potentially detrimental effects. This narrative review examines the current evidence regarding the role of nutritional supplements in modulating the inflammatory response after TBI. Recent research has demonstrated that various nutritional interventions, including probiotics, immunonutrition formulas, vitamin D, and taurine supplementation, can significantly influence inflammatory markers and clinical outcomes. Probiotics have shown particular promise in reducing inflammatory mediators and infection rates, while also decreasing hospital and ICU length of stay. Immunonutrition, especially through vitamin D supplementation, demonstrates significant effects on consciousness levels and ventilation requirements. The timing of nutritional intervention emerges as critical, with the early post-injury period (24-72 h) representing a crucial window for therapeutic intervention. The gut-brain axis appears central to these effects, with nutritional supplements potentially modulating both central and systemic inflammatory responses. While these interventions show promising results in reducing inflammatory markers and improving short-term outcomes, their impact on mortality rates remains limited. Future research should focus on optimizing nutritional protocols, understanding individual patient factors, and investigating long-term functional outcomes. This review supports a paradigm shift in approaching nutritional support in TBI, transitioning from viewing it as merely supportive care to recognizing it as an active therapeutic intervention that can significantly influence patient outcomes.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251337378"},"PeriodicalIF":3.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Race, Ethnicity, and Outcomes Following Pediatric Firearm Injury: A United States Population Study.","authors":"Austin L Du, Alvaro A Macias, Brittany N Burton, Rodney A Gabriel","doi":"10.1177/08850666251337399","DOIUrl":"https://doi.org/10.1177/08850666251337399","url":null,"abstract":"<p><p>PurposeAs of 2019, firearm injury is the leading cause of death among children and adolescents. This study aims to investigate the association of race and ethnicity on the outcomes of pediatric firearm injury patients.MethodsFirearm injuries among patients ages 0-17 years in 2016 and 2019 were identified using the Kids' Inpatient Database, the largest database for the United States inpatient pediatric population representing 70-80% of all pediatric hospitalizations nationwide. Race and ethnicity were the primary independent variables, and the primary outcome was a composite variable of in-hospital morbidities, including outcomes such as postoperative infection, iatrogenic hypotension, and postoperative aspiration pneumonia. All outcomes except for length of stay were analyzed using multivariable logistic regression. Fine-Gray competing risks regression was used to analyze hospital length of stay. Subgroup analyses of patients under 15 years old, ZIP codes below median household income, urban counties, high severity injury, and each injury intent were used to identify effect modification.ResultsAmong the 6173 firearm injury patients, no association was found between race and ethnicity and composite morbidity. Compared to non-Hispanic White patients, Black patients had decreased odds of inpatient mortality overall (OR 0.53 [95% CI 0.35-0.8], p = 0.003), although this association was not found in subgroups specific to assault, self-harm, populations >250,000, or age under 15 years. Overall, non-routine disposition and length of stay were not associated with race and ethnicity.ConclusionsRace and ethnicity are not associated with morbidity following firearm injury in younger pediatric patients. Intent of injury, young age, and urban environment may act as effect modifiers for firearm mortality. Policy interventions can limit disparities in outcomes by targeting suicide and assault in specific racial and ethnic groups.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251337399"},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BRAIN-SIM: Leveraging Simulation for Neurocritical Care Education with an Innovative Multidisciplinary Approach.","authors":"Brett DerGarabedian, Lauren Lacovara, Justin Delic, Swarna Rajagopalan","doi":"10.1177/08850666251327156","DOIUrl":"https://doi.org/10.1177/08850666251327156","url":null,"abstract":"<p><p>Background and ObjectivesEarly recognition and response are paramount in the treatment of neurologic emergencies. Due to its complexity, neurocritical care continues to provoke unease for practitioners and trainees. Simulation provides a realistic opportunity for learners to detect an acutely deteriorating neurologic patient and make rapid-fire treatment decisions. A multidisciplinary simulation-based learning environment may improve trainee confidence when caring for the neurocritical care patient population.MethodsNine simulation lab sessions were performed with a multidisciplinary team including medical students, residents, critical care medicine fellows, advanced practice providers (APP), critical care pharmacy residents, and neuroscience unit nurses. High fidelity manikins capable of reproducing acute neurologic and physiologic emergencies were used. After the simulation, participants completed a survey utilizing Likert scale responses regarding simulation logistics, faculty competence, and pre- and post-simulation confidence levels managing specific acute neurologic emergencies and performing neurocritical care procedural skills.ResultsNine simulation lab sessions were conducted, and thirty-eight surveys were completed. Mean learner confidence levels in managing patients improved from pre- to post-simulation in patients with coma [3.18 ± 0.51 versus 4.32 ± 0.25 (<i>P </i>< .001)], status epilepticus [3.23 ± 0.55 versus 4.36 ± 0.29 (<i>P </i>< .001)], acute ischemic stroke [3.75 ± 0.59 versus 4.63 ± 0.43 (<i>P </i>< .001)], intracerebral hemorrhage [3.25 ± 0.74 versus 4.63 ± 0.43 (<i>P </i>< .001)], intracranial hypertension [3.25 ± 0.74 versus 4.63 ± 0.43 (<i>P </i>< .001)], respiratory failure [3.5 ± 0.77 versus 4.63 ± 0.43 (<i>P </i>= .0016)], and procedures such as central lines [2.2 ± 0.56 versus 3.8 ± 0.56 (<i>P </i>= .003)], intubations [2.25 ± 0.39 versus 3.63 ± 0.62 (<i>P </i>< .001)], and bronchoscopies [2 ± 0 versus 3.2 ± 0.56 (<i>P </i>= .004). Consistently, learners strongly agreed that faculty were knowledgeable, well-informed, and thorough. Learners commented that the simulation experiences were realistic and allowed them to identify areas for improvement.DiscussionSimulation training can be an effective method to improve neurocritical care education by increasing clinician confidence in managing neurologic emergencies and procedures while providing opportunities for multidisciplinary collaboration. Further evaluation of the effectiveness of simulation education in this patient care setting is warranted.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251327156"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Statistics Utilized in Primary Articles in the <i>Journal of Intensive Care Medicine</i>: A Prelude to Practical Pedagogy in Biostatistics.","authors":"Asahi Murata, Emma Kar, Chase Irwin, Eric vanSonnenberg","doi":"10.1177/08850666251318683","DOIUrl":"https://doi.org/10.1177/08850666251318683","url":null,"abstract":"<p><p>BackgroundBiostatistics is an increasing focus in current medical school curricula. This study evaluated the statistical methods utilized in a high-impact factor medical Journal to develop a guide to those statistics that can be applied to facilitate the interpretation of data for practicing physicians, fellows, residents, and medical students.MethodsIn Part 1 of our tandem manuscripts, the 100 most recent primary articles from February 2021 to December 2021 were analyzed from the <i>Journal of Intensive Care Medicine</i>. The evaluation consisted of study temporality, study design, types of descriptor variables, and types of statistical tests.ResultsRetrospective studies were most common (75/100, 75%), followed by prospective studies (23/100, 23%). The most popular designs were cohort (82/100, 82%), followed by case series (9/100, 9%), randomized control trials (4/100, 4%), and case-control (3/100, 3%). The most commonly utilized descriptor variables were frequency and proportion (100/100, 100%), followed by median (74/100, 74%) and mean (71/100, 71%). The chi-square test was the most frequently used statistical test (59/100, 59%), while logistic regression (48/100, 48%), Mann-Whitney-U (46/100, 46%), and two-sample independent t-test (40/100, 40%) also were popular.ConclusionThis review revealed that retrospective and cohort studies were utilized most frequently. The chi-square test was used in the majority of studies, while logistic regression was also popular. This information can help determine areas in which supplemental training will be most beneficial to improve the understanding of statistical methods in medical journals by practicing physicians, fellows, residents, and medical students. As an outgrowth of this study, we have developed a practical guide to relevant statistical methods, serving as Part 2 of these tandem manuscripts.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251318683"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}