Journal of critical care
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Journal of critical care · Mar 2005
ReviewA systematic review of the Charlson comorbidity index using Canadian administrative databases: a perspective on risk adjustment in critical care research.
The Charlson index is commonly used for risk adjustment in critical care health services research. However, the literature supporting this methodology has not been thoroughly explored. We systematically reviewed the literature related to administrative database adaptations of the Charlson index. ⋯ Time and cost barriers prevent widespread use of physiology-based risk adjustment in population-based research. The decreased predictive ability of the Charlson index must be weighed against the advantages of using this instrument for population-based research. Future research should focus on updating the Charlson index for recent changes in the prognosis of comorbid diseases and introduction of International Statistical Classification of Diseases, 10th Revision coding of discharge abstracts.
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Journal of critical care · Mar 2005
Comparative StudyInfrared ear thermometry in the critically ill patient.
The purpose of this clinical study was to determine the accuracy of infrared tympanic membrane thermometry compared to axillary temperature (tempAx) for detecting body temperature reliably in critically ill patients in the daily practice. ⋯ In adult intensive care unit patients, the infrared tympanic thermometer (ThermoScan 07) produced highly reliable measurements when compared to tempAx measured using a conventional mercury-in-glass thermometer. Both methods correlated positively and significantly.
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Estimating the required sample size for a study is necessary during the design phase to ensure that it will have maximal efficiency to answer the primary question of interest. Clinicians require a basic understanding of the principles underlying sample size calculation to interpret and apply research findings. This article reviews the critical components of sample size calculation, including the selection of a primary outcome, specification of the acceptable types I and II error rates, identification of the minimal clinically important difference, and estimation of the error associated with measuring the primary outcome. The relationship among confidence intervals, precision, and study power is also discussed.
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Journal of critical care · Mar 2005
Multicenter StudyCanadian nurses' and respiratory therapists' perspectives on withdrawal of life support in the intensive care unit.
To describe perspectives of nurses (RNs) and respiratory therapists (RTs) related to end-of-life care for critically ill patients. ⋯ Most RNs and RTs were comfortable with decision making and the process of life support withdrawal, but they suggested several ways to improve end-of-life care.
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Journal of critical care · Mar 2005
Multicenter StudySymptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. A prospective multicenter study.
More than two thirds of family members visiting intensive care unit (ICU) patients have symptoms of anxiety or depression during the first days of hospitalization. Identifying determinants of these symptoms would help caregivers support families at patient discharge or when death is imminent. ⋯ The prevalence of symptoms of anxiety and depression remains high at the end of the ICU stay, whether the patient is well enough to be discharged or is near death.