Tag: disability

Upvote Story 5
Non-technical skills and human factors are increasingly recognized as critical ingredients in the success or failure of acute care delivery in a number of high stakes clinical domains. This is reflected in the evolution of life support courses, which now incorporate components of the zero point survey (ZPS). For example, the European Trauma Course emphasizes team briefs and equipment checks, and the Advanced Pediatric Life... Read More | Comment
Upvote Story 10
In this cohort, the major risk factors for septicemia death were similar to those for other causes of death, there was approximately a 2-fold Black-White disparity in septicemia deaths, and the strongest mediators of this disparity was across domains of socioeconomic status. Of 206,691 adult survey participants, 1,523 experienced a septicemia death. Factors associated with > 2-fold larger hazard of septicemia death included: need for... Read More | Comment
Upvote Story 6
In the study cohort, ICU admission pectoralis muscle area (PMA) was associated with survival during and following critical illness; it was unable to predict regaining an independent lifestyle following discharge. ICU admission SAT mass was not associated with survival or other measured outcomes. PMA of patients admitted to a medical intensive care unit (MICU) is associated with survival both during and after critical illness, but... Read More | Comment
Upvote Story 5
These results underline the importance of delirium screening in stroke patients specifically during the night. Since even short delirious episodes are associated with more complications and increased disability, future studies are needed to find delirium prevention strategies. 309 patients were included. The overall prevalence of delirium was 10.7% (33 patients) mostly on the first and second hospital day. Duration of delirium on SU was in... Read More | Comment
Upvote Story 13
Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic hypothermia for patients with severe traumatic brain injury. Among 511 patients who were randomized, 500 provided ongoing consent (mean age, 34.5 years [SD, 13.4]; 402 men [80.2%]) and 466 completed the primary outcome... Read More | Comment
Upvote Story 6
Cognitive impairment (CI) is an important but an under-recognized extra-pulmonary feature of chronic obstructive pulmonary disease (COPD). It is related to the burden of disability, worse health outcomes and impaired self-management. Areas covered: CI includes deterioration of a wide range of cognitive functions, such as memory and various executive functions. Risk of hospitalization might be higher in patients with COPD compared to those without, with... Read More | Comment
Upvote Story 5
In this multicenter cohort study, one or more post-intensive care syndrome problems were present in the majority of survivors, but co-occurring problems were present in only one out of four. Education was protective from post-intensive care syndrome problems and frailty predictive of the development of post-intensive care syndrome problems. Future studies are needed to understand better the heterogeneous subtypes of post-intensive care syndrome and to... Read More | Comment
Upvote Story 15
In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of a favorable neurologic outcome because more survivors had severe neurologic impairment in the epinephrine group. In a randomized, double-blind trial involving 8014 patients with out-of-hospital cardiac arrest in the United... Read More | Comment
Upvote Story 9
After adjusting for important covariates, total days of MICU delirium were significantly associated with increased post-discharge sleep disturbance. Delirium incidence showed a trend toward association with increased functional disability in the year following discharge. This was an observational cohort study of MICU patients enrolled in a biorepository and assessed upon MICU admission by demographics, comorbidities, and baseline characteristics. Delirium was assessed daily using the Confusion... Read More | Comment
Upvote Story 4
Internationally accepted approaches to the study of functioning and disability can inform critical care practitioners and scholars in their study of functional limitations, disability, and quality of life after critical illness and intensive care. Therefore this article provides an introduction to the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). The Institute of Medicine has also recommended this approach for the study... Read More | Comment
Upvote Story 9
Pre-ICU frailty status was associated with increased post-ICU disability and new nursing home admission among ICU survivors, and death among all admissions. Pre-ICU frailty status may provide prognostic information about outcomes after a critical illness. The mean age was 84.0 years. Frailty and pre-frailty were present prior to 213 (54.5%) and 140 (35.8%) of the 391 admissions, respectively. Relative to non-frailty, frailty was associated with... Read More | Comment
Upvote Story 10
Traumatic brain injury (TBI) is a major cause of death and disability, yet many predictors of outcome are not precise enough to guide initial clinical decision-making. Although increasingly used in the early phase following traumatic brain injury, the prognostic utility of MRI remains uncertain. We thus undertook a systematic review and meta-analysis of studies evaluating the predictive value of acute MRI lesion patterns for discriminating... Read More | Comment
Upvote Story 9
Ability to participate in the community is an important outcome for all patients after a major illness, it signposts reaching the end of the road home. A patient’s ability to return to the priority tasks of daily living impacts their satisfaction with life, their carers, their family and ultimately the health system. A large body of literature has demonstrated that long term impairments of physical,... Read More | Comment
Upvote Story 5
The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those aged 18 years and older with critical illness is unclear. Frailty is common in critically ill adults aged 18 years and older and is independently associated with increased mortality and greater disability. Future studies should explore routine screening for clinical frailty in critically ill patients of all ages. Interventions to reduce... Read More | Comment