Critical Care and Resuscitation最新文献

{"title":"Health concerns of intensive care survivors and research participation willingness: A multicentre survey","authors":"Reyas Aboobacker Kaniyamparambil MBBS FCICM ,&nbsp;Charlotte Goldsmith MBBS ,&nbsp;Nicolas Demasi MBBS ,&nbsp;Brad Wibrow MBBS FCICM ,&nbsp;Prakkash ParangiAnanthan MBBS FCICM ,&nbsp;Adrian Regli MBBS PhD ,&nbsp;Matt Anstey MBBS FCICM ,&nbsp;Susan Pellicano RN ,&nbsp;Anne Marie Palermo RN ,&nbsp;Sarah Van Der Laan MBBS ,&nbsp;Edward Litton MBBS PhD","doi":"10.1016/j.ccrj.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.ccrj.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the relative importance of health concerns reported by survivors of critical illness treated in the intensive care unit (ICU), their estimate of time to achieve recovery, and their reported randomised clinical trial participation willingness.</p></div><div><h3>Design</h3><p>A multicentre survey.</p></div><div><h3>Setting</h3><p>Six Australian ICUs.</p></div><div><h3>Participants</h3><p>Adult patients who had received mechanical ventilation, vasopressor support or renal replacement therapy for more than 24 h were likely to be discharged from ICU within 24 h.</p></div><div><h3>Interventions</h3><p>Survey administration was verbal and occurred in the ICU.</p></div><div><h3>Main outcome measures</h3><p>A numeric rating of eight ICU survivor-related health concerns developed with consumer input (disability requiring ongoing care, prolonged hospitalisation, repeated hospitalisation, impaired activity level, pain, low mood, inability to return home, and dying). Zero indicated no concern and ten extreme concern. Respondents were also asked to estimate their expected recovery time and their willingness to participate in a randomised clinical trial.</p></div><div><h3>Results</h3><p>Of 584 eligible participants, 286 (49.0%) respondents had a mean age of 62.3 years (standard deviation (SD) 14.8) and 178 (62.2%) were male. The median ICU length of stay at the time of survey was 4 days (interquartile range (IQR) 3–7). Respondents reported high levels of concern for all health outcomes with the highest median scores being for survival with severe disability and requirement for ongoing care scoring 8 (IQR 3–10), and never being able to return home needing assisted living or a nursing home scoring 8 (IQR 1–10). The median expected recovery time was 23 days (IQR 10–33). Higher concerns were associated with an increased likelihood of trial participation willingness.</p></div><div><h3>Conclusion</h3><p>Survivors reported high and varied health concerns of which severe disability requiring care and inability to return home were the highest. Respondents anticipated a relatively short recovery.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 2","pages":"Pages 95-99"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277224000103/pdfft?md5=cee43030dd7e195fb4d9ed4e617f67c7&pid=1-s2.0-S1441277224000103-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol and statistical analysis plan for the mega randomised registry trial comparing conservative vs. liberal oxygenation targets in adults in the intensive care unit with suspected hypoxic ischaemic encephalopathy following a cardiac arrest (Mega-ROX HIE)","authors":"Paul J. Young MBChB, FCICM, PhD ,&nbsp;Abdulrahman Al-Fares MBChB, FRCPC, ABIM, MRCP ,&nbsp;Diptesh Aryal MD ,&nbsp;Yaseen M. Arabi MD ,&nbsp;Muhammad Sheharyar Ashraf MD ,&nbsp;Sean M. Bagshaw MD, MSc, PhD ,&nbsp;Abigail Beane PhD ,&nbsp;Airton L. de Oliveira Manoel MD PhD ,&nbsp;Layoni Dullawe BSc ,&nbsp;Fathima Fazla BSc ,&nbsp;Tomoko Fujii MD, PhD ,&nbsp;Rashan Haniffa PhD ,&nbsp;Mohd Shahnaz Hasan MBBS, MAnes ,&nbsp;Carol L. Hodgson PT, MPhil, PhD ,&nbsp;Anna Hunt BN ,&nbsp;Cassie Lawrence BN ,&nbsp;Israel Silva Maia ,&nbsp;Diane Mackle MN, PhD ,&nbsp;Giacomo Monti MD ,&nbsp;Alistair D. Nichol PhD ,&nbsp;Jessica Kasza PhD","doi":"10.1016/j.ccrj.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.ccrj.2024.03.004","url":null,"abstract":"<div><h3>Background</h3><p>The effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults with hypoxic ischaemic encephalopathy (HIE) following a cardiac arrest who are receiving invasive mechanical ventilation in the intensive care unit (ICU) is uncertain.</p></div><div><h3>Objective</h3><p>To summarise the protocol and statistical analysis plan for the Mega-ROX HIE trial.</p></div><div><h3>Design, setting and participants</h3><p>Mega-ROX HIE is an international randomised clinical trial that will be conducted within an overarching 40,000-participant registry-embedded clinical trial comparing conservative and liberal ICU oxygen therapy regimens. We expect to enrol approximately 4000 participants with suspected HIE following a cardiac arrest who are receiving invasive mechanical ventilation in the ICU.</p></div><div><h3>Main outcome measures</h3><p>The primary outcome is in-hospital all-cause mortality up to 90 days from the date of randomisation. Secondary outcomes include duration of survival, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and the proportion of participants discharged home.</p></div><div><h3>Results and conclusions</h3><p>Mega-ROX HIE will compare the effect of conservative vs. liberal oxygen therapy regimens on day-90 in-hospital mortality in adults in the ICU with suspected HIE following a cardiac arrest. The protocol and planned analyses are reported here to mitigate analysis bias.</p></div><div><h3>Trial registration</h3><p>Australian and New Zealand Clinical Trials Registry (ACTRN 12620000391976).</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 2","pages":"Pages 87-94"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277224000097/pdfft?md5=bd9cfd07b4ef9f23c523fcf07f5af277&pid=1-s2.0-S1441277224000097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous glucose monitor accuracy during extracorporeal membrane oxygenation","authors":"Tipwarin Phongmekhin BS (Bachelor of Science) ,&nbsp;Ray Wang MBBS BMedSci FRACP","doi":"10.1016/j.ccrj.2023.11.003","DOIUrl":"10.1016/j.ccrj.2023.11.003","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 58-59"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022263/pdfft?md5=93c014843713d5c9af5db9b3f8c832e8&pid=1-s2.0-S1441277223022263-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138988602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Services for critical and emergency care of children in Victoria","authors":"Trevor Duke MD, FRACP, FCICM","doi":"10.1016/j.ccrj.2023.11.008","DOIUrl":"10.1016/j.ccrj.2023.11.008","url":null,"abstract":"<div><p>The population of children requiring intensive care in Victoria has increased and changed markedly since the 1990s, the result of many epidemiological, demographic, and social changes, and this is more evident during and after the Covid pandemic. The model of ultra-centralised paediatric intensive care services in the 1990s is not sufficient for the current era, and services are under daily pressure. Solutions will take time and need to be wide-ranging, including increased critical care capacity in selected regional centres, decentralisation of some services for low-risk conditions, improvements and reforms in medical and nursing education, pre-service and post-graduate, including for other acute care disciplines and for general practitioners and a more structured state-wide paediatric system.</p><p>The effects of changes in disease patterns, social trends and health practice should inform the design of an expanded model of critical and emergency care for children in Victoria that is more fit for purpose in the remainder of this decade and beyond.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 54-57"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022317/pdfft?md5=1775d1b02619a27698339e8895ef43f1&pid=1-s2.0-S1441277223022317-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological symptoms and health-related quality of life in intubated and non-intubated intensive care survivors: A multicentre, prospective observational cohort study","authors":"Sumeet Rai FCICM ,&nbsp;Teresa Neeman PhD ,&nbsp;Rhonda Brown PhD ,&nbsp;Krishnaswamy Sundararajan FCICM ,&nbsp;Arvind Rajamani FCICM ,&nbsp;Michelle Miu B.Med, MD ,&nbsp;Rakshit Panwar PhD ,&nbsp;Mary Nourse GradCertIntCareN ,&nbsp;Frank M.P. van Haren PhD ,&nbsp;Imogen Mitchell PhD ,&nbsp;Dale M. Needham MD, PhD ,&nbsp;for the PRICE study investigators","doi":"10.1016/j.ccrj.2023.10.011","DOIUrl":"10.1016/j.ccrj.2023.10.011","url":null,"abstract":"<div><h3>Objective</h3><p>To compare long-term psychological symptoms and health-related quality of life (HRQOL) in intubated versus non-intubated ICU survivors.</p></div><div><h3>Design</h3><p>Prospective, multicentre observational cohort study.</p></div><div><h3>Setting</h3><p>Four tertiary medical-surgical ICUs in Australia.</p></div><div><h3>Participants</h3><p>Intubated and non-intubated adult ICU survivors.</p></div><div><h3>Main outcome measures</h3><p><em>Primary outcomes</em>: clinically significant psychological symptoms at 3- and 12-month follow-up using Post-Traumatic Stress Syndrome-14 for post-traumatic stress disorder; Depression, Anxiety Stress Scales-21 for depression, anxiety, and stress. <em>Secondary outcomes</em>: HRQOL, using EuroQol-5D-5L questionnaire.</p></div><div><h3>Results</h3><p>Of the 133 ICU survivors, 54/116 (47 %) had at least one clinically significant psychological symptom (i.e., post-traumatic stress disorder, anxiety, depression, stress) at follow-up. Clinically significant scores for psychological symptoms were observed in 26 (39 %) versus 16 (32 %) at 3-months [odds ratio 1.4, 95 % confidence interval (0.66–3.13), p = 0.38]; 23 (37 %) versus 10 (31 %) at 12-months [odds ratio 1.3, 95 % confidence interval (0.53–3.31), p = 0.57] of intubated versus non-intubated survivors, respectively. Usual activities and mobility were the most commonly affected HRQOL dimension, with &gt;30 % at 3 versus months and &gt;20 % at 12-months of overall survivors reporting ≥ moderate problems. There was no difference between the groups in any of the EQ5D dimensions.</p></div><div><h3>Conclusions</h3><p>Nearly one-in-two (47 %) of the intubated and non-intubated ICU survivors reported clinically significant psychological symptoms at 3 and 12-month follow-ups. Overall, more than 30 % at 3-months and over 20 % at 12-months of the survivors in both groups had moderate or worse problems with their usual activities and mobility. The presence of psychological symptoms and HRQOL impairments was similar between the groups.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 8-15"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022226/pdfft?md5=a492e68faadb17e270bc1dfc1805a955&pid=1-s2.0-S1441277223022226-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139023796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care utilisation after elective surgery in Australia and New Zealand: A point prevalence study","authors":"Philip Emerson MBChB, BSc ,&nbsp;Arthas Flabouris MD, FANZCA, FCICM ,&nbsp;Josephine Thomas B.M., B.S, FRACP, PhD ,&nbsp;Jeremy Fernando MBChB, FANZCA, FCICM ,&nbsp;Siva Senthuran MBBS, FRCA, FCICM, FANZCA ,&nbsp;Serena Knowles BN, PhD ,&nbsp;Naomi Hammond BN, MPH, PhD ,&nbsp;Krish Sundararajan MBBS, MPH, FCICM ,&nbsp;with the George Institute of Global Health","doi":"10.1016/j.ccrj.2023.10.010","DOIUrl":"10.1016/j.ccrj.2023.10.010","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to describe the characteristics, outcomes and resource utilisation of patients being cared for in an ICU after undergoing elective surgery in Australia and New Zealand (ANZ).</p></div><div><h3>Methods</h3><p>This was a point prevalence study involving 51 adult ICUs in ANZ in June 2021. Patients met inclusion criteria if they were being treated in a participating ICU on he study dates. Patients were categorised according to whether they had undergone elective surgery, admitted directly from theatre or unplanned from the ward. Descriptive and comparative analysis was performed according to the source of ICU admission. Resource utilisation was measured by Length of stay, organ support and occupied bed days.</p></div><div><h3>Results</h3><p>712 patients met inclusion criteria, with 172 (24%) have undergone elective surgery. Of these, 136 (19%) were admitted directly to the ICU and 36 (5.1%) were an unplanned admission from the ward. Elective surgical patients occupied 15.8% of the total ICU patient bed days, of which 44.3% were following unplanned admissions. Elective surgical patients who were an unplanned admission from the ward, compared to those admitted directly from theatre, had a higher severity of illness (AP2 17 vs 13, p&lt;0.01), require respiratory or vasopressor support (75% vs 44%, p&lt;0.01) and hospital mortality (16.7% vs 2.2%, p &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>ICU resource utilisation of patients who have undergone elective surgery is substantial. Those patients admitted directly from theatre have good outcomes and low resource utilisation. Patient admitted unplanned from the ward, although fewer, were sicker, more resource intensive and had significantly worse outcomes.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 1-7"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022214/pdfft?md5=8c3ac9d9a6fc9a882531704c09c851db&pid=1-s2.0-S1441277223022214-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138989654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological changes after fluid bolus therapy in cardiac surgery patients: A propensity score matched case–control study","authors":"Martin Faltys MD ,&nbsp;Ary Serpa Neto MD ,&nbsp;Luca Cioccari MD","doi":"10.1016/j.ccrj.2023.11.005","DOIUrl":"10.1016/j.ccrj.2023.11.005","url":null,"abstract":"<div><h3>Objective</h3><p>Fluid bolus therapy (FBT) is ubiquitous in intensive care units (ICUs) after cardiac surgery. However, its physiological effects remain unclear.</p></div><div><h3>Design</h3><p><strong>:</strong> We performed an electronic health record–based quasi-experimental ICU study after cardiac surgery. We applied propensity score matching and compared the physiological changes after FBT episodes to matched control episodes where despite equivalent physiology no fluid bolus was given.</p></div><div><h3>Setting</h3><p>The study was conducted in a multidisciplinary ICU of a tertiary-level academic hospital.</p></div><div><h3>Participants</h3><p>The study included 2,736 patients who underwent Coronary Artery Bypass Grafting and/or heart valve surgery.</p></div><div><h3>Main Outcome Measures</h3><p>Changes in cardiac output (CO) and mean arterial pressure (MAP) during the 60 minutes following FBT.</p></div><div><h3>Results</h3><p>We analysed 3572 matched fluid bolus (FB) episodes. After FBT, but not in control episodes, CO increased within 10 min, with a maximum increase of 0.2 l/min (95%CI 0.1 to 0.2) or 4% above baseline at 40 min (p &lt; 0.0001 vs. controls). CO increased by &gt; 10% from baseline in 60.6% of FBT and 49.1% of control episodes (p &lt; 0.0001). MAP increased by &gt; 10% in 51.7% of FB episodes compared to 53.4% of controls. Finally, FBT was not associated with changes in acid-base status or oxygen delivery.</p></div><div><h3>Conclusion</h3><p>In this quasi-experimental comparative ICU study in cardiac surgery patients, FBT was associated with statistically significant but numerically small increases in CO. Nearly half of FBT failed to induce a positive CO or MAP response.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 32-40"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022287/pdfft?md5=c05f831073f20bf5fd98bb007a054e85&pid=1-s2.0-S1441277223022287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital and long-term opioid use according to analgosedation with fentanyl vs. morphine: Findings from the ANALGESIC trial","authors":"Andrew Casamento MBBS, FACEM, FCICM ,&nbsp;Angajendra Ghosh MBBS, FACEM, FCICM ,&nbsp;Victor Hui MBBS, FANZCA ,&nbsp;Ary Serpa Neto PhD, FCICM","doi":"10.1016/j.ccrj.2023.11.004","DOIUrl":"10.1016/j.ccrj.2023.11.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Opioid use disorder is extremely common. Many long-term opioid users will have their first exposure to opioids in hospitals. We aimed to compare long-term opioid use in patients who received fentanyl vs. morphine analgosedation and assess ICU related risk factors for long-term opioid use.</p></div><div><h3>Design</h3><p>We performed a post-hoc analysis of the Assessment of Opioid Administration to Lead to Analgesic Effects and Sedation in Intensive Care (ANALGESIC) cluster randomised crossover trial of fentanyl and morphine infusions for analgosedation in mechanically ventilated patients.</p></div><div><h3>Setting</h3><p>Two mixed, adult, university affiliated intensive care units in Melbourne, Australia.</p></div><div><h3>Participants</h3><p>Adult patients who were mechanically ventilated and received fentanyl or morphine for analgosedation in the ANALGESIC trial.</p></div><div><h3>Main outcome measures</h3><p>We assessed discharge and long-term (90–365 days) opioid use in opioid-naïve patients at hospital admission according to the agent used for analgosedation.</p></div><div><h3>Results</h3><p>We studied 477 patients (242 fentanyl and 235 morphine). There were no differences between discharge (16.5% vs. 14.0%, p = 0.45), 90–180 day post-discharge use (3.7% vs 2.1%, p = 0.30) or 180–365 day post-discharge use (3.4% vs 1.3%, p = 0.22) of opioids when comparing those patients who received fentanyl vs. those who received morphine. Surgical diagnosis and one chronic condition were associated with increased hospital discharge prescription of opioids, whereas increasing APACHE II score was associated with decreased discharge prescription. No ICU-related factors were associated with long-term opioid use.</p></div><div><h3>Conclusions</h3><p>Approximately one in seven opioid-naïve patients who receive analgosedation for mechanical ventilation in ICU will be prescribed opioid medications at hospital discharge. There was no difference in discharge prescription or long-term use of opioids depending on whether fentanyl or morphine was used for analgosedation.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 24-31"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022275/pdfft?md5=8c3027f35904a1be48e6bb74ee086a39&pid=1-s2.0-S1441277223022275-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Blend to Limit OxygEN in ECMO: A RanDomised ControllEd Registry (BLENDER) trial: Study protocol and statistical analysis plan” [Crit Care Resuscit 25 (2023) 118–125]","authors":"Aidan Burrell PhD ,&nbsp;Sze Ng MBBS ,&nbsp;Kelly Ottosen MHealthSc ,&nbsp;Michael Bailey PhD ,&nbsp;Hergen Buscher MD ,&nbsp;John Fraser PhD ,&nbsp;Andrew Udy PhD ,&nbsp;David Gattas MMed(ClinEpi) ,&nbsp;Richard Totaro MBBS ,&nbsp;Rinaldo Bellomo PhD ,&nbsp;Paul Forrest MBChB ,&nbsp;Emma Martin BpharmSc ,&nbsp;Liadain Reid MPH ,&nbsp;Marc Ziegenfuss MBBS ,&nbsp;Glenn Eastwood PhD ,&nbsp;Alisa Higgins PhD ,&nbsp;Carol Hodgson PhD ,&nbsp;Edward Litton PhD ,&nbsp;Priya Nair PhD ,&nbsp;Neil Orford PhD ,&nbsp;David Pilcher MBBS","doi":"10.1016/j.ccrj.2024.01.003","DOIUrl":"10.1016/j.ccrj.2024.01.003","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Page 60"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277224000036/pdfft?md5=145a3cb312b74a4b65d18bc9bdaa6448&pid=1-s2.0-S1441277224000036-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139818779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of frailty on long-term survival in patients discharged alive from hospital after an ICU admission with COVID-19","authors":"Ashwin Subramaniam MBBS MMed FRACP FCICM PhD ,&nbsp;Ryan Ruiyang Ling Dr MBBS ,&nbsp;David Pilcher MBBS MRCP(UK) FRACP FCICM","doi":"10.1016/j.ccrj.2023.11.001","DOIUrl":"10.1016/j.ccrj.2023.11.001","url":null,"abstract":"<div><h3><strong>Objective</strong></h3><p>Though frailty is associated with mortality, its impact on long-term survival after an ICU admission with COVID-19 is unclear. We aimed to investigate the association between frailty and long-term survival in patients after an ICU admission with COVID-19.</p></div><div><h3><strong>Design, Setting and Participants</strong></h3><p>This registry-based multicentre, retrospective, cohort study included all patients ≥16 years discharged alive from the hospital following an ICU admission with COVID-19 and documented clinical frailty scale (CFS). Data from 118 ICUs between 01/01/2020 through 31/12/2020 in New Zealand and 31/12/2021 in Australia were reported in the Australian and New Zealand Intensive Care Society Adult Patient Database. The patients were categorised as ‘not frail’ (CFS 1-3), ‘mildly frail’ (CFS 4-5) and ‘moderately-to-severely frail’ (CFS 6-8).</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcome was survival time up to two years, which we analysed using Cox regression models.</p></div><div><h3>Results</h3><p>We included 4028 patients with COVID-19 in the final analysis. ‘Moderately-to-severely frail’ patients were older (66.6 [56.3–75.8] vs. 69.9 [60.3–78.1]; p &lt; 0.001) than those without frailty (median [interquartile range] 53.0 [40.1–64.6]), had higher sequential organ failure assessment scores (p &lt; 0.001), and less likely to receive mechanical ventilation (p &lt; 0.001) than patients without frailty or mild frailty. After adjusting for confounders, patients with mild frailty (adjusted hazards ratio: 2.31, 95%-CI: 1.75–3.05) and moderate-to-severe frailty (adjusted hazards ratio: 2.54, 95%-CI: 1.89–3.42) had higher mortality rates than those without frailty.</p></div><div><h3>Conclusions</h3><p>Frailty was independently associated with shorter survival times to two years in patients with severe COVID-19 in ANZ following hospital discharge. Recognising frailty provides individualised patient intervention in those with frailty admitted to ICUs with severe COVID-19.</p></div><div><h3>Clinical trial registration</h3><p>Not applicable.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 1","pages":"Pages 16-23"},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S144127722302224X/pdfft?md5=623a0c26eafbdc32cf648670cb8341a7&pid=1-s2.0-S144127722302224X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139014728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}