Objectives: To evaluate 1-year outcomes (mortality, and recurrent hospital and ICU readmission) in adult survivors of COVID-19 critical illness compared with survivors of critical illness from non-COVID-19 pneumonia.
Design: Population-based retrospective observational cohort study.
Setting: Province of Ontario, Canada.
Patients: Six thousand ninety-eight consecutive adult patients (≥ 18 yr old) from 102 centers, admitted to ICU with COVID-19 (from January 1, 2020, to March 31, 2022), and surviving to hospital discharge.
Interventions: None.
Measurements And Main Results: The primary outcome was 1-year mortality. We also evaluated the number of emergency department (ED) visits, hospital readmissions, and ICU readmissions over this same time period. We compared patients using overlap propensity score-weighted, cause-specific proportional hazard models. Mean age was 59.6 years and 38.5% were female. Of these patients, 1610 (26.4%) and 375 (6.1%) were readmitted to hospital and ICU, respectively, and 917 (15.0%) died within 1 year. Compared with survivors of critical illness from non-COVID-19 pneumonia (n = 2568), those who survived COVID-19 critical illness had a lower risk of ED visit (hazard ratio [HR], 0.65 [95% CI, 0.60-0.71]), hospital readmission (HR, 0.56 [95% CI, 0.51-0.62]), ICU readmission (HR, 0.44 [95% CI, 0.37-0.53]), and mortality (HR, 0.67 [95% CI, 0.58-0.78]) within 1 year.
Conclusions: Risk of ED visit, hospital readmission, ICU readmission, and mortality within 1 year of discharge among survivors of COVID-19 critical illness was lower than survivors of critical illness from non-COVID-19 pneumonia.
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http://dx.doi.org/10.1097/CCM.0000000000006603 | DOI Listing |
Acute Crit Care
February 2025
Department of Nephrology, Pusan National University School of Medicine, Yangsan, Korea.
The 2012 Kidney Disease Improving Global Outcomes guidelines clearly define emergent indications for kidney replacement therapy; however, whether dialysis should be initiated in critically ill patients without these indications remains unclear. This review briefly summarizes the results of recent landmark trials and discusses their limitations originating from a criteria-based approach at a single time point. Moreover, a personalized approach based on each patient's demand-capacity balance and its future benefits as a platform for kidney support therapy in critically ill patients are discussed.
View Article and Find Full Text PDFBMJ Open Qual
March 2025
Enteral and Parenteral Nutrition Team, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
Background: Nasoenteral tube (NET) use is common in critically ill patients but is associated with significant complications, including accidental dislodgement, malpositioning in the bronchial tree or mechanical failures, which can impede nutritional therapy. These complications often lead to adverse events that increase hospital stay, costs, and patient morbidity.
Objective: This study aimed to reduce complications related to the placement and maintenance of NETs in critically ill patients using multifaceted strategies.
BMJ Paediatr Open
March 2025
Children's Intensive Care Research Program, Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
Background: Sepsis affects 25 million children and neonates annually, causing significant mortality and morbidity. Early identification and treatment are crucial for improving outcomes. Identifying children at risk is challenging due to clinical heterogeneity and overlap with other conditions.
View Article and Find Full Text PDFEur J Oncol Nurs
March 2025
Library and University Collections, Murchison House, The King's Buildings, University of Edinburgh, UK.
Purpose: This meta-synthesis seeks to explore spiritual care provision by healthcare professionals and spiritual leaders to patients with advanced cancer and their families in Sub-Saharan Africa.
Methods: Studies were searched and retrieved from MEDLINE, EMBASE, PsycINFO, CINAHL, Global Health, Web of Science, and the Africa Index Medicus databases. The search was conducted on November 10, 2023 and repeated on October 18, 2024.
J Immunol
January 2025
Program in Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada.
Macrophages are important mediators of immune responses with critical roles in the recognition and clearance of pathogens, as well as in the resolution of inflammation and wound healing. The neuronal guidance cue SLIT2 has been widely studied for its effects on immune cell functions, most notably directional cell migration. Recently, SLIT2 has been shown to directly enhance bacterial killing by macrophages, but the effects of SLIT2 on inflammatory activation of macrophages are less known.
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