Publications by authors named "Ruckly S"
Objectives: To evaluate whether early appropriate antimicrobial therapy (EAAT) is associated with improved outcomes in critically ill patients with hospital-acquired pneumonia (HAP), ventilated HAP (vHAP), or ventilator-associated pneumonia (VAP) involving Gram-negative bacteria (GNB).
Design: Retrospective cohort study based on prospectively collected data.
Setting: Thirty-two-French ICUs (OutcomeRéa network).
Background: Sepsis-associated encephalopathy (SAE) may be worsened by early systemic insults. We aimed to investigate the association of early systemic insults with outcomes of critically ill patients with severe SAE.
Methods: We performed a retrospective analysis using data from the French OUTCOMEREA prospective multicenter database.
Introduction: We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU).
Methods: We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019-2021). Univariable and multivariable analyses were conducted to identify predictors of 28-day mortality.
Purpose: Whether skin disinfection of the surgical site using chlorhexidine-alcohol is superior to povidone-iodine-alcohol in reducing reoperation and surgical site infection rates after major cardiac surgery remains unclear.
Methods: CLEAN 2 was a multicenter, open-label, randomized, two-arm, assessor-blind, superiority trial conducted in eight French hospitals. We randomly assigned adult patients undergoing major heart or aortic surgery via sternotomy, with or without saphenous vein or radial artery harvesting, to have all surgical sites disinfected with either 2% chlorhexidine-alcohol or 5% povidone-iodine-alcohol.
Background: Prolonged grief is a chronic and debilitating condition that affects millions of persons worldwide. The aim of this study was to use a qualitative approach to better understand how relatives with prolonged grief disorder perceive what does or not help them and whether they were able to make recommendations.
Methods: Participants were all relatives of deceased patients admitted to 26 palliative care units involved in the FamiLife study; relatives were included if diagnosed with prolonged grief symptoms (i.
Article Synopsis
- Hospital-acquired bloodstream infections (HA-BSI) in ICU patients can be life-threatening, and this study aimed to see how early adequate antibiotic treatment affects 28-day mortality rates for patients who survive at least one day after infection onset.
- Using data from a multicenter study with 2,418 patients, researchers found that those who received adequate treatment within 24 hours had a lower 28-day mortality rate (32.8%) compared to those who were inadequately treated (40%).
- The study concluded that inadequate antibiotic therapy within 24 hours contributes significantly to 28-day mortality, indicating that quicker treatment could greatly improve patient outcomes in cases of HA-BSI.
Purpose: This study aimed to evaluate the impact on subsequent infections and mortality of an adequate antimicrobial therapy within 48 h after catheter removal in intensive care unit (ICU) patients with positive catheter tip culture.
Methods: We performed a retrospective analysis of prospectively collected data from 29 centers of the OUTCOMEREA network. We developed a propensity score (PS) for adequate antimicrobial treatment, based on expert opinion of 45 attending physicians.
Purpose: Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI).
Methods: Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021.
Background: Hospital-acquired bloodstream infections are common in the intensive care unit (ICU) and have a high mortality rate. Patients with cirrhosis are especially susceptible to infections, yet there is a knowledge gap in the epidemiological distinctions in hospital-acquired bloodstream infections between cirrhotic and non-cirrhotic patients in the ICU. It has been suggested that cirrhotic patients, present a trend towards more gram-positive infections, and especially enterococcal infections.
View Article and Find Full Text PDFPurpose: The primary objective of this study was to evaluate the associations between centre/country-based factors and two important process and outcome indicators in patients with hospital-acquired bloodstream infections (HABSI).
Methods: We used data on HABSI from the prospective EUROBACT-2 study to evaluate the associations between centre/country factors on a process or an outcome indicator: adequacy of antimicrobial therapy within the first 24 h or 28-day mortality, respectively. Mixed logistical models with clustering by centre identified factors associated with both indicators.
Background: Current guidelines for adult patients with pneumococcal meningitis (PM) recommend initial management in intermediate or intensive care units (ICU), but evidence to support these recommendations is limited. We aimed to describe ICU admission practices of patients with PM.
Methods: We conducted a retrospective analysis of the French medico administrative database of consecutive adult patients with PM and sepsis criteria hospitalized between 2011 and 2020.
Article Synopsis
- * There was no increased risk of acute kidney injury (AKI) in patients receiving combination therapy, suggesting it may not be more harmful than single-drug therapy.
- * The research utilized data from a multicenter database and included various analyses based on patient characteristics and the resistance profiles of the bacteria involved, indicating a comprehensive approach to assessing treatment outcomes.
Article Synopsis
- This study investigates the link between sepsis and the development of immune-mediated inflammatory diseases (IMIDs) in patients who survived sepsis, focusing on data from France in 2020.* -
- Researchers used a matched-cohort study design to compare the incidence of IMIDs in patients who had sepsis versus those who experienced acute myocardial infarction, finding a significantly higher risk of IMIDs in sepsis survivors.* -
- Results indicate an incidence rate of 7956 IMIDs per 100,000 patient-years after sepsis, with certain types of IMIDs, such as immune thrombocytopenia and autoimmune hemolytic anemia, showing particularly high risks.*
Background: Data on ventilator associated pneumonia (VAP) in COVID-19 and influenza patients admitted to intensive care units (ICU) are scarce. This study aimed to estimate day-60 mortality related to VAP in ICU patients ventilated for at least 48 h, either for COVID-19 or for influenza, and to describe the epidemiological characteristics in each group of VAP.
Design: Multicentre retrospective observational study.
Background: Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP), a nosocomial pneumonia that is not related to invasive mechanical ventilation (IMV), has been less studied than ventilator-associated pneumonia, and never in the context of patients in an ICU for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a common cause of ICU admission. This study aimed to determine the factors associated with NV-ICU-AP occurrence and assess the association between NV-ICU-AP and the outcomes of these patients.
Methods: Data were extracted from the French ICU database, OutcomeRea™.
Article Synopsis
- * Out of 364 patients, 66.5% experienced poor functional outcomes after one year, with a significant portion (52.2%) having died, while age, comorbidities, initial coma score, and stroke type were key factors linked to worse outcomes.
- * Notably, delays in starting mechanical ventilation after stroke diagnosis appeared to improve survival chances, and over half of the survivors reported ongoing physical and mental health issues one year later.
Objectives: To uncover clinical epidemiology, microbiological characteristics and outcome determinants of hospital-acquired bloodstream infections (HA-BSIs) in Turkish ICU patients.
Methods: The EUROBACT II was a prospective observational multicontinental cohort study. We performed a subanalysis of patients from 24 Turkish ICUs included in this study.
Objectives: We aimed to describe the infectious risk during the dwell time for different catheter types. Furthermore, we wanted to identify risk factors for infections from catheters in place for >10 days.
Methods: We performed a post hoc analysis using prospectively collected data from four randomized controlled trials.
Introduction: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a frequent cause of intensive care unit (ICU) admission. However, data are scarce and conflicting regarding the impact of systemic corticosteroid treatment in critically ill patients with acute exacerbation of COPD. The aim of the study was to assess the impact of systemic corticosteroids on the occurrence of death or need for continuous invasive mechanical ventilation at day 28 after ICU admission.
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