Critical Care Research and Practice最新文献

{"title":"Knowledge Regarding Mechanical Ventilation and Practice of Ventilatory Care among Nurses Working in Intensive Care Units in Selected Governmental Hospitals in Addis Ababa, Ethiopia: A Descriptive Cross-Sectional Study.","authors":"Kedir Abdureman Hassen,&nbsp;Micheal Alemayehu Nemera,&nbsp;Andualem Wubetie Aniley,&nbsp;Ararso Baru Olani,&nbsp;Sofoniyas Getaneh Bedane","doi":"10.1155/2023/4977612","DOIUrl":"https://doi.org/10.1155/2023/4977612","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical ventilation (MV) is a backbone and major supportive modality in intensive care units (ICUs) even though it has side effects and complications. Knowledge of nurses about mechanical ventilators and good practice of nursing care for the ventilated patient plays a crucial role in improving the effectiveness of mechanical ventilation, preventing harm, and optimizing the patient outcome. This study intended to assess the knowledge regarding MV and the practice of ventilator care among nurses working in the ICU.</p><p><strong>Method: </strong>A descriptive cross-sectional study design was conducted. All nurses working in the intensive care unit of selected governmental hospitals were included in the study. The data were collected from March 1 to 30, 2021 with structured and pretested self-administered questionnaires. The collected data were evaluated with SPSS version 26 software. The variables, which have an independent association with poor outcomes, were identified based on OR, with 95% CI and a <i>p</i> value less than 0.05.</p><p><strong>Results: </strong>Of 146 nurses who participated in the study, 51.4% were males. About 71.4% had a BSc in nursing and 57.5% of them had training related to MV. More than half (51.4%) of nurses had poor knowledge regarding MV and the majority (58.9%) of them had poor practice in ventilatory care. The educational level (AOR, 5.1; 95% CI, 1.190-22.002) was positively associated with knowledge. Likewise, the educational level (AOR 5.0 (1.011-24.971)) and work experience (AOR 4.543 (1.430-14.435)) were positively associated with the practice of nurses.</p><p><strong>Conclusions: </strong>Knowledge regarding mechanical ventilators and the practice of ventilatory care among nurses in the selected public hospitals was poor. The educational levels were found statistically associated with both the knowledge and practice of nurses. To improve nursing care offered for MV patients, upgrading the educational level of intensive care nurses plays a vital role.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2023 ","pages":"4977612"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10823060","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 Systematic Review and Meta-Analysis of Randomized Controlled Trials on Supine vs. Nonsupine Endotracheal Intubation.","authors":"Chriselyn F Palma,&nbsp;Radwan Mashina,&nbsp;Claire Chen,&nbsp;Tareq Arar,&nbsp;Marwan Mashina,&nbsp;Yussef Al Ghoul,&nbsp;Banreet Dhindsa,&nbsp;Rajany Dy","doi":"10.1155/2023/5496368","DOIUrl":"https://doi.org/10.1155/2023/5496368","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to compare the safety and efficacy of supine vs. nonsupine positions during intubation.</p><p><strong>Methods: </strong>Based on the literature from inception to October 2020, 13 studies with nonemergent intubation in supine and nonsupine positions were chosen using PRISMA and MOOSE protocols. Pooled estimates were calculated using random-effects models with 95% confidence interval (CI). The primary outcome was a successful intubation, attempt, and duration of intubation. The secondary outcome was adverse events (trauma and hypoxia). Bias was evaluated qualitatively, by visual analysis, and quantitatively through the Egger test.</p><p><strong>Results: </strong>The final analysis included 13 clinical trials with 1,916 patients. The pooled success rates in the supine vs. lateral positions were 99.21% and 98.82%. The supine vs. semierect positions were 99.21% and 98.82%. The 1st attempt success rate in the supine vs. lateral position was 85.35% and 88.56% compared to 91.38% and 90.76% for the supine vs. semierect position. The rate of total adverse events in the supine position was 3.73% vs. 6.74% in the lateral position, and the rate of total adverse events in the supine position was 0.44% vs. 0.93% in semierect position. Low to substantial heterogeneity was noted in our analysis. <i>Discussion</i>. There is no significant difference between total successful intubations and success from 1st intubation attempt between supine and nonsupine positions. However, there are slightly higher rates of adverse events in nonsupine position. Addition of more recent studies on supine vs. nonsupine intubations would improve this study. Given these findings, it is important to develop more studies regarding different intubation positions and techniques with the aim of improving efficacy and decreasing adverse outcomes. <i>Other</i>. This review is not registered in a public database. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2023 ","pages":"5496368"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826912","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":"Critical Care Nurses' Adherence to Ethical Codes and Its Association with Spiritual Well-Being and Moral Sensitivity.","authors":"Marzieh Momennasab,&nbsp;Zohreh Homayoon,&nbsp;Camellia Torabizadeh","doi":"10.1155/2023/8248948","DOIUrl":"https://doi.org/10.1155/2023/8248948","url":null,"abstract":"<p><strong>Background: </strong>Adherence to ethical codes is a major pillar of nursing care that is affected by various factors. Identifying these factors can lead to better ethical performance. The present study was conducted to determine critical care nurses' adherence to ethical codes and its association with spiritual well-being (SWB) and moral sensitivity (MS).</p><p><strong>Methods: </strong>In this descriptive-correlational study, data were collected using the moral sensitivity questionnaire (MSQ) by Lützén et al., Paloutzian and Ellison's spiritual well-being scale (SWBS), and the adherence to ethical codes questionnaire. The study was conducted on 298 nurses working in critical care units of hospitals affiliated with Shiraz University of Medical Sciences in southern Iran in 2019. This study was examined and approved by the Ethics Committee of Shiraz University of Medical Sciences.</p><p><strong>Results: </strong>The majority of the participants were female (76.2%) and single (60.1%), with a mean age of 30.69 ± 5.74 years. The mean scores of adherence to ethical codes, SWB, and MS were 64.06 (good), 91.94 (moderate), and 134.08 (moderate), respectively. Adherence to ethical codes had a positive correlation with the total score of SWB (<i>P</i> < 0.001, <i>r</i> = 0.25) and MS (<i>P</i> < 0.001, <i>r</i> = 0.27). A positive correlation was also observed between MS and SWB (<i>P</i> < 0.001, <i>r</i> = 0.41). Meanwhile, MS (<i>β</i> = 0.21) had a greater effect than SWB (<i>β</i> = 0.157) on adherence to ethical codes.</p><p><strong>Conclusion: </strong>Critical care nurses showed a good adherence to ethical codes. MS and SWB also positively affected their adherence to ethical codes. Nursing managers can use these findings to devise plans for the promotion of MS and SWB in nurses and thus help improve their ethical performance.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2023 ","pages":"8248948"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541335","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":"Investigating the Utility of the SOFA Score and Creating a Modified SOFA Score for Predicting Mortality in the Intensive Care Units in a Tertiary Hospital in Jordan.","authors":"Anas H A Abu-Humaidan,&nbsp;Fatima M Ahmad,&nbsp;Laith S Theeb,&nbsp;Abdelrahman J Sulieman,&nbsp;Abdelkader Battah,&nbsp;Amjad Bani Hani,&nbsp;Mahmoud Abu Abeeleh","doi":"10.1155/2023/3775670","DOIUrl":"https://doi.org/10.1155/2023/3775670","url":null,"abstract":"<p><strong>Background: </strong>The utility of the Sequential Organ Failure Assessment (SOFA) score in predicting mortality in the intensive care unit (ICU) has been demonstrated before, but serial testing in various settings is required to validate and improve the score. This study examined the utility of the SOFA score in predicting mortality in Jordanian ICU patients and aimed to find a modified score that required fewer laboratory tests.</p><p><strong>Methods: </strong>A prospective observational study was conducted at Jordan University Hospital (JUH). All adult patients admitted to JUH ICUs between June and December 2020 were included in the study. SOFA scores were measured daily during the whole ICU stay. A modified SOFA score (mSOFA) was constructed from the available laboratory, clinical, and demographic data. The performance of the SOFA, mSOFA, qSOFA, and SIRS in predicting ICU mortality was assessed using the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>194 patients were followed up. SOFA score (mean ± SD) at admission was significantly higher in non-survivors (7.5 ± 3.9) compared to survivors (2.4 ± 2.2) and performed the best in predicting ICU mortality (AUROC = 0.8756, 95% CI: 0.8117-0.9395) compared to qSOFA (AUROC = 0.746, 95% CI: 0.655-0.836) and SIRS (AUROC = 0.533, 95% CI: 0.425-0.641). The constructed mSOFA included points for the hepatic and CNS SOFA scores, in addition to one point each for the presence of chronic kidney disease or the use of breathing support; it performed as well as the SOFA score in this cohort or better than the SOFA score in a subgroup of patients with heart disease.</p><p><strong>Conclusion: </strong>SOFA score was a good predictor of mortality in a Jordanian ICU population and better than qSOFA, while SIRS could not predict mortality. Furthermore, the proposed mSOFA score which employed fewer laboratory tests could be used after validation from larger studies.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2023 ","pages":"3775670"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10068864","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":"Examination of Impact of After-Hours Admissions on Hospital Resource Use, Patient Outcomes, and Costs.","authors":"Charlenn Skead,&nbsp;Laura H Thompson,&nbsp;Hanna Kuk,&nbsp;Ariel Hendin,&nbsp;Moosa Yasir Hamood Al Abri,&nbsp;Yasmeen Choudhri,&nbsp;Tim Ramsay,&nbsp;Brent Herritt,&nbsp;Kwadwo Kyeremanteng","doi":"10.1155/2022/4815734","DOIUrl":"https://doi.org/10.1155/2022/4815734","url":null,"abstract":"<p><strong>Background: </strong>Nighttime and weekends in hospital and intensive care unit (ICU) contexts are thought to present a greater risk for adverse events than daytime admissions. Although some studies exist comparing admission time with patient outcomes, the results are contradictory. No studies currently exist comparing costs with the time of admission. We investigated the differences in-hospital mortality, ICU length of stay, ICU mortality, and cost between daytime and nighttime admissions.</p><p><strong>Methods: </strong>All adult patients (≥18 years of age) admitted to a large academic medical-surgical ICU between 2011 and 2015 were included. Admission cohorts were defined as daytime (8:00-16:59) or nighttime (17:00-07:59). Student's <i>t</i>-tests and chi-squared tests were used to test for associations between days spent in the ICU, days on mechanical ventilation, comorbidities, diagnoses, and cohort membership. Regression analysis was used to test for associations between patient and hospitalization characteristics and in-hospital mortality and total ICU costs.</p><p><strong>Results: </strong>The majority of admissions occurred during nighttime hours (69.5%) with no difference in the overall Elixhauser comorbidity score between groups (<i>p</i>=0.22). Overall ICU length of stay was 7.96 days for daytime admissions compared to 7.07 days (<i>p</i>=0.001) for patients admitted during nighttime hours. Overall mortality was significantly higher in daytime admissions (22.5% vs 20.6, <i>p</i>=0.012); however, ICU mortality was not different. The average MODS was 2.9 with those admitted during the daytime having a significantly higher MODS (3.0, <i>p</i>=0.046). Total ICU cost was significantly higher for daytime admissions (<i>p</i>=0.003). Adjusted ICU mortality was similar in both groups despite an increased rate of adverse events for nighttime admissions. Daytime admissions were associated with increased cost. There was no difference in all hospital total cost or all hospital direct cost between groups. These findings are likely due to the higher severity of illness in daytime admissions.</p><p><strong>Conclusion: </strong>Daytime admissions were associated with a higher severity of illness, mortality rate, and ICU cost. To further account for the effect of staffing differences during off-hours, it may be beneficial to compare weekday and weeknight admission times with associated mortality rates.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"4815734"},"PeriodicalIF":1.7,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9711991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35208496","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":"The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction.","authors":"Michael L Savage,&nbsp;Karen Hay,&nbsp;Bonita Anderson,&nbsp;Gregory Scalia,&nbsp;Darryl Burstow,&nbsp;Dale Murdoch,&nbsp;Isuru Ranasinghe,&nbsp;Owen Christopher Raffel","doi":"10.1155/2022/8343785","DOIUrl":"https://doi.org/10.1155/2022/8343785","url":null,"abstract":"<p><strong>Background: </strong>When compared to left ventricular ejection fraction (LVEF), previous studies have suggested the superiority of wall motion score index (WMSI) in predicting cardiac events in patients who have suffered acute myocardial infarction. However, there are limited studies assessing WMSI and mortality in ST-segment elevation myocardial infarction (STEMI). We aimed to compare the prognostic value of WMSI in a cohort of STEMI patients treated with primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>A comparison of WMSI, LVEF, and all-cause mortality in STEMI patients treated with primary PCI between January 2008 and December 2020 was performed. The prognostic value of WMSI, LVEF, and traditional risk scores (TIMI, GRACE) were compared using multivariable logistic regression modelling.</p><p><strong>Results: </strong>Among 1181 patients, 27 died within 30-days (2.3%) and 49 died within 12 months (4.2%). WMSI ≥1.8 was associated with poorer survival at 12-months (9.2% vs 1.5%; <i>p</i> < 0.001). When used as the only classifier for predicting 12-month mortality, the discriminatory ability of WMSI (area under the curve (AUC): 0.77; 95% CI: 0.68-0.84) was significantly better than LVEF (AUC: 0.71; 95% CI: 0.61-0.79; <i>p</i>=0.034). After multivariable modelling, the AUC was comparable between models with either WMSI (AUC: 0.89; 95% CI: 0.85-0.94) or LVEF (AUC: 0.87; 95% CI: 0.83-0.92; <i>p</i> < 0.08) yet performed significantly better than TIMI (AUC: 0.71; 95% CI: 0.62-0.79; <i>p</i> < 0.001), or GRACE (AUC: 0.63; 95% CI: 0.54-0.71; <i>p</i> < 0.001) risk scores.</p><p><strong>Conclusions: </strong>When examined individually, WMSI is a superior predictor of 12-month mortality over LVEF in STEMI patients treated with primary PCI. When examined in multivariable predictive models, WMSI and LVEF perform very well at predicting 12-month mortality, especially when compared to existing STEMI risk scores.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"8343785"},"PeriodicalIF":1.7,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9671736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40502466","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":"Age as the Impact on Mortality Rate in Trauma Patients.","authors":"Onchuda Wongweerakit,&nbsp;Osaree Akaraborworn,&nbsp;Burapat Sangthong,&nbsp;Komet Thongkhao","doi":"10.1155/2022/2860888","DOIUrl":"https://doi.org/10.1155/2022/2860888","url":null,"abstract":"<p><strong>Background: </strong>Globally, the fastest-growing population is that of older adults. Geriatric trauma patients pose a unique challenge to trauma teams because the aging process reduces their physiologic reserve. To date, no agreed-upon definition exists for the geriatric trauma patients, and the appropriate age cut point to consider patients at increased risk of mortality is unclear.</p><p><strong>Objectives: </strong>To determine the age cut point at which age impacts the mortality rate in trauma patients in Thailand.</p><p><strong>Materials and methods: </strong>This was a retrospective cohort and prognostic analysis study conducted in trauma patients ≥40 years. Patient data were retrieved from the trauma registry database and hospital information system in Songklanagarind Hospital. The estimated sample size of 1,509 patients was calculated based on the trauma registry data. The age with the maximum mortality rate was used as the cut point to define the elderly population. Hospital cost, intensive care unit (ICU) length of stay, gender, precomorbidity, mechanism of injury, injury severity score (ISS), and trauma and injury severity score were analyzed for any correlation with mortality, and whether or not they were associated with elderly trauma patients.</p><p><strong>Results: </strong>A total of 1,523 trauma patients ≥40 years were included in the study. The median age in both the survival and death groups was 61 years, with gender in both groups being similar (<i>p</i> value = 0.259). In the multivariate logistic regression analyses, the adjusted odds ratio (OR) showed that increasing age was significantly associated with mortality (OR = 1.05; 95% CI, 1.02-1.07; <i>p</i> value <0.001). In the age group of 70 to 79 years and >80 years, the odds of mortality were significantly increased (OR 3.29, 95% CI, 1.24-8.68; <i>p</i> value = 0.016 and OR 3.29, 95% CI, 1.27-12.24; <i>p</i> value = 0.018, respectively).</p><p><strong>Conclusion: </strong>Age is a significant risk factor for mortality in trauma patients. The mortality significantly increased at the age of 70 and higher.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"2860888"},"PeriodicalIF":1.7,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40456225","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 Prospective Evaluation of Grip Strength Comparing a Low-Tech Method to Dynanometry in Preoperative Surgical Patients and Weak Intensive Care Patients.","authors":"Mark J Shea,&nbsp;Anika Weightman,&nbsp;Bradley Wibrow,&nbsp;Matthew H Anstey","doi":"10.1155/2022/3428851","DOIUrl":"https://doi.org/10.1155/2022/3428851","url":null,"abstract":"<p><strong>Objective: </strong>Grip strength testing offers a mechanism to identify patients in whom frailty might be present, discriminate between robust elderly and vulnerable younger patients, and can be used as a tool to track changes in muscle bulk over the course of an inpatient stay. We compared gold-standard quantitative grip strength measurement to a low-tech alternative, a manual bedside sphygmomanometer.</p><p><strong>Design: </strong>Under supervision, subjects performed hand-grip strength testing with each instrument. A mean score is calculated from three measurements on the dominant and nondominant hand. <i>Setting</i>. Testing was performed in a tertiary centre in Perth, Western Australia, in both outpatient clinics and intensive care units. <i>Participants</i>. 51 adult pre-operative surgical outpatients were assessed, alongside 20 intensive care inpatients identified as being weak. <i>Main outcome measures</i>. A statistical correlation between the two measures was evaluated. Feasibility, safety, and convenience were also assessed in outpatient and bedside settings.</p><p><strong>Results: </strong>Highly correlated results in both tertiary surgical outpatients (<i>r</i> _s = 0.895, <i>p</i> ≤ 0.001, <i>N</i> = 102; <i>r</i> (100) = 0.899, <i>p</i> ≤ 0.001) and weak intensive care patients (<i>r</i> _s = 0.933, <i>p</i> ≤ 0.001, <i>N</i> = 39 r (37) = 0.935, <i>p</i> ≤ 0.001).</p><p><strong>Conclusions: </strong>Modifying a manual bedside sphygmomanometer to measure grip strength is feasible and correlates well with a formal dynamometer in preadmission surgical patients and weak patients in the intensive care unit. The use of an existing, safe, and available device removes barriers to the measurement of weakness in patients and may encourage uptake of objective measurement in multiple settings.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"3428851"},"PeriodicalIF":1.7,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40656904","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":"The Prognostic Accuracy Evaluation of mNUTRIC, APACHE II, SOFA, and SAPS 2 Scores for Mortality Prediction in Patients with Sepsis.","authors":"Pham Dang Hai,&nbsp;Le Thi Viet Hoa","doi":"10.1155/2022/4666594","DOIUrl":"https://doi.org/10.1155/2022/4666594","url":null,"abstract":"<p><strong>Background: </strong>The modified Nutrition Risk in the Critically Ill (mNUTRIC) score is a helpful tool to evaluate nutritional risk in critically ill patients. However, there is a lack of data on the relationship between mNUTRIC score and septic patients' outcomes. So, this study aims to validate the prognostic role of the mNUTRIC score and to compare the performances of mNUTRIC, APACHE II, SOFA, and SAPS 2 scores for mortality prediction in patients with sepsis.</p><p><strong>Methods: </strong>This prospective observational study was performed on 194 septic patients admitted to the Intensive Care Unit (ICU) of 108 Military Central Hospital. Sepsis was defined based on the sepsis-3 definition. The mNUTRIC score was used to evaluate the nutritional status within 24 h of ICU admission. Baseline characteristics and clinical information were collected to calculate the mNUTRIC, APACHE II, SOFA, and SAPS 2 scores. The outcome was in-hospital mortality from all causes.</p><p><strong>Results: </strong>Nonsurvivors patients had a significantly higher median mNUTRIC score (6 vs. 4, <i>P</i> < 0.001). The mortality rate in the group with a NUTRIC score ≥5 was significantly higher than in the group with a NUTRIC score <5 (56.0% vs 10.2%; <i>P</i> < 0.001). The area under the ROC curves (AUC) for predicting the mortality of mNUTRIC was 0.79 (sensitivity 67.1% and specificity 81.0% (<i>P</i> < 0.001)). Compared with other severity scores in mortality prediction, AUC was 0.78 for APACHE II (sensitivity 84.9% and specificity 67.7%), 0.77 for SOFA score (sensitivity 76.7% and specificity 65.3%), and 0.73 for SAPS 2 (sensitivity 66.1%, specificity 77.7%). In the multivariate analysis, mNUTRIC score was associated with in-hospital mortality (HR, 2.00; 95% CI, 1.54 to 2.58; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Our study showed that the mNUTRIC score was similar to severity scores (APACHE II, SOFA, SAPS 2) in mortality prediction and was the independent mortality predictor in patients with sepsis.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"4666594"},"PeriodicalIF":1.7,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663806","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":"Incidence, Associated Factors, and Outcome of Delirium among Patients Admitted to ICUs in Oman.","authors":"Rasha Khamis Al-Hoodar,&nbsp;Eilean Rathinasamy Lazarus,&nbsp;Omar Al Omari,&nbsp;Omar Al Zaabi","doi":"10.1155/2022/4692483","DOIUrl":"https://doi.org/10.1155/2022/4692483","url":null,"abstract":"<p><strong>Background: </strong>The incidence of delirium is high up to 46.3% among patients admitted to ICU. Delirium is linked to negative patient outcomes like increased duration of mechanical ventilation use, prolonged ICU stay, increased mortality rate, and healthcare costs. Despite the importance of delirium and its consequences that are significant, there is a scarcity of studies which explored delirium in Oman.</p><p><strong>Objectives: </strong>This study was conducted to assess the incidence of delirium, the association between the selected predisposing factors and precipitating factors with delirium, determine the predicators of delirium, and evaluate its impacts on ICU mortality and ICU length of stay among ICU patients in Oman.</p><p><strong>Methods: </strong>A multicenter prospective observational design was used. A total of 153 patients were assessed two-times a day by bedside ICU nurses through the Intensive Care Delirium Screening Checklist (ICDSC).</p><p><strong>Results: </strong>The results revealed that the delirium incidence was 26.1%. Regression analysis showed that sepsis, metabolic acidosis, nasogastric tube use, and APACHE II score were independent predictors for delirium among ICU patients in Oman and delirium had significant impacts on ICU length of stay and mortality rate.</p><p><strong>Conclusion: </strong>Delirium is common among ICU patients and it is associated with negative consequences. Multidisciplinary prevention strategies should be implemented to identify and treat the modifiable risk factors.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":"4692483"},"PeriodicalIF":1.7,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33513366","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}