Objective: To determine whether differences exist among large community hospitals in length of Intensive Care Unit (ICU) stay, hospital stay or hospital mortality for patients admitted to ICU and whose most responsible diagnosis was chronic obstructive pulmonary disease (COPD).
Design: Retrospective cohort study.
Setting: All seven large community hospitals in British Columbia, Canada. PATIENTS. All 296 patients who were admitted to ICUs and whose most responsible diagnosis was COPD during the 3 fiscal years 1994-1997.
Interventions: None.
Measurements And Main Results: After adjusting for age, gender, case-mix group, and co-morbidity, we found a significant difference in length of ICU stay for these patients among hospitals ( P <0.03). No differences were found in hospital mortality or length of hospital stay for the same patients among the same hospitals.
Conclusions: There is significant variation in length of ICU stay for patients who are admitted to ICU and whose most responsible diagnosis is COPD, among large community hospitals. These small area variations may point to opportunities to improve efficiency of care. Further prospective, detailed data collection is required to validate these observations and to identify factors responsible for any differences found.
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http://dx.doi.org/10.1007/s00134-003-1670-x | DOI Listing |
JAMA Netw Open
January 2025
Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Importance: Multisystem inflammatory syndrome in children (MIS-C) is an uncommon but severe hyperinflammatory illness that occurs 2 to 6 weeks after SARS-CoV-2 infection. Presentation overlaps with other conditions, and risk factors for severity differ by patient. Characterizing patterns of MIS-C presentation can guide efforts to reduce misclassification, categorize phenotypes, and identify patients at risk for severe outcomes.
View Article and Find Full Text PDFJ Intensive Med
January 2025
Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, Jilin, China.
Background: The effect of the modality of hydrocortisone administration on clinical outcomes in patients with septic shock remains uncertain. This systematic review and meta-analysis evaluate the impact of intermittent bolus and continuous infusion of hydrocortisone on these outcomes.
Methods: We searched the PubMed, Embase databases, and Cochrane Library for randomized controlled trials (RCTs) and cohort studies published from inception to January 1, 2023.
Cureus
December 2024
Intensive Care Unit, General Chest Diseases Hospital Sotiria, Athens, GRC.
Descending necrotizing mediastinitis (DNM) is a rare and potentially life-threatening condition characterized by the rapid spread of infection within the mediastinum. This severe form of mediastinitis poses a significant challenge to clinicians due to its aggressive nature and potential for rapid deterioration. In this case report, we present a challenging case of descending necrotizing mediastinitis in a 39-year-old patient with persistent pyrexia and an extended hospital stay in the intensive care unit (ICU), cardiothoracic unit (CTU), and surgical intensive care unit (SICU).
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Kütahya University of Health Sciences, Kütahya, TUR.
Objective: The mortality risk for critically ill patients in the intensive care unit (ICU) can be predicted through clinical assessments and laboratory test results. The accurate utilization of these parameters is essential for timely intervention and the initiation of appropriate therapeutic strategies. This study aims to retrospectively examine the relationship between patients' clinical status at ICU admission, prognostic risk scoring systems, biochemical and hematological parameters, and mortality outcomes.
View Article and Find Full Text PDFCureus
December 2024
Emergency Medicine, Christiana Care Health System, Newark, USA.
Introduction: Sepsis remains a prevalent critical illness encountered in emergency departments and intensive care units (ICU), with culture-negative sepsis constituting 30-60% of cases. The effect of culture type on treatment and outcomes remains unclear, and conflicting evidence exists regarding disparities between Gram-positive and Gram-negative infections.
Objective: To further describe and compare characteristics and outcomes of culture-positive versus culture-negative sepsis.
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