Background: The overall utility of the Rothman Index (RI), a global measure of inpatient acuity, for surgical patients is unclear. We evaluate whether RI variability can predict rapid response team (RRT) activation in surgical patients.
Methods: Surgical patients who underwent RRT activation from 2013 to 2015 were matched to four control cases. RI variability was gauged by maximum minus minimum RI (MMRI) and RI standard deviation (RISD) within a 24-h period before RRT. The primary outcome measured was RRT activation, and our secondary outcome was in-hospital mortality.
Results: Two hundred seventeen (217) patients underwent RRT. RISD (odds ratio, OR, 1.31, 95% confidence interval, CI, 1.23-1.38, P < 0.001; area under receiver operating characteristic, AUROC, curve 0.74, 95% CI 0.70-0.77) and MMRI (OR 1.10, 95% CI 1.08-1.12, P < 0.001; AUROC 0.76, 95% CI 0.72-0.79) predicted increased likelihood of RRT.
Conclusions: RISD is predictive of RRT.
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http://dx.doi.org/10.1016/j.amjsurg.2017.07.031 | DOI Listing |
Nefrologia (Engl Ed)
January 2025
Servicio de Nefrología, Hospital del Mar, Instituto Hospital del Mar de Investigaciones Médicas, RD16/0009/0013 (ISCIII FEDER REDinREN), Barcelona, Spain; Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
Few studies have analyzed the freedom to choose their renal replacement treatment (RRT) modality in Spain. In a total of 673 patients with ACKD (stage 4 and 5) seen at the outpatient ACKD clinic of Hospital del Mar, Barcelona, Catalonia (Spain) from 2009 to 2020, we retrospectively compared immigrant and Spanish patients in order to analyze the impact of migration on RRT decision-making and its subsequent evolution in advanced CKD (ACKD) consultation and identifies the social and economic needs of this population. One hundred thirteen (16.
View Article and Find Full Text PDFBMC Nurs
January 2025
Departamento de Práticas Assistenciais, Hospital Israelita Albert Einstein, Avenue Albert Einstein, 627-701, São Paulo, 05651-901, Brazil.
Background: Patients hospitalized outside of monitored environments may experience sudden clinical worsening requiring transfer to the Intensive Care Unit. Early detection based on the clinical nurse's identification of the risk of clinical deterioration represents an opportunity to prevent serious adverse events. Nurse worry is defined as the use of clinical reasoning combined with intuition that precedes the patient's clinical deterioration.
View Article and Find Full Text PDFNutrients
December 2024
Facultad de Ciencias, Escuela de Nutrición y Dietética, Universidad Mayor, Santiago 8580745, Chile.
Background: Walp. (LmW), known as maca, has been shown to increase physical performance. However, the effect size (ES) of LmW on the different manifestations of physical performance has not yet been described.
View Article and Find Full Text PDFCureus
December 2024
Critical Care Medicine, Star Care Multispeciality Hospital, Kozhikode, IND.
Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.
View Article and Find Full Text PDFJ Intensive Care Med
January 2025
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
Rapid response teams (RRT) are multidisciplinary teams activated to assess patients outside of the Intensive Care Unit (ICU) and require a shared framework for approaching a deteriorating patient. In this project, we aimed to improve the understanding of RRT protocols through the development and implementation of the RRT Huddle Checklist. This quality improvement project took place from 2019 to 2022.
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