Journal of critical care
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Journal of critical care · Dec 2012
Comparative StudyA comparison of seriously ill patients with or without AIDS requiring prolonged mechanical ventilation.
The aim of this study was to compare differences in underlying diagnoses, weaning outcomes, discharge disposition, and survival in prolonged mechanical ventilator (PMV)-dependent patients with and without AIDS. ⋯ AIDS had little effect on weaning success or survival. Successful weaning increased survival regardless of a diagnosis of AIDS. The AIDS patients had more home discharges and fewer to nursing facilities, which likely resulted from the AIDS patients having more acute illnesses leading to PMV than the non-AIDS patients.
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Journal of critical care · Dec 2012
A qualitative study to identify opportunities for improving trauma quality improvement.
Quality improvement (QI) is a central tenant of trauma center accreditation in most countries, but its effectiveness is largely unknown. We sought to explore opportunities for improving trauma QI. ⋯ Quality improvement programs exist as accreditation requirements in most centers. However, trauma QI practices depend on a range of local and regional factors, and concrete opportunities for improvement that address impact and sustainability exist.
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Journal of critical care · Dec 2012
Adverse outcomes associated with delayed intensive care consultation in medical and surgical inpatients.
The impact of delay in obtaining an intensive care unit (ICU) consult from inpatient wards is unclear. The goal of this study was to examine the effect of time to ICU consult from medical and surgical wards on mortality and length of stay (LOS). ⋯ Increased duration to ICU consult from MET time is associated with adverse outcomes. These adverse outcomes are different between medical and surgical patients.
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Journal of critical care · Dec 2012
Predicting in-hospital mortality among critically ill patients with end-stage liver disease.
Critically-ill patients with end-stage liver disease (ESLD) are at high risk for death during intensive care unit hospitalization, and currently available prognostic models have limited accuracy in this population. We aimed to identify variables associated with in-hospital mortality among critically ill ESLD patients and to develop and validate a simple, parsimonious model for bedside use. ⋯ In critically ill ESLD patients, a parsimonious model including only MELD and mechanical ventilation is more accurate than APACHE II alone for predicting in-hospital mortality. This simple bedside model can provide clinicians and patients with valuable prognostic information for medical decision-making.
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Journal of critical care · Dec 2012
Homeward bound: an analysis of patients discharged home from an oncologic intensive care unit.
The objectives of our study were to evaluate the characteristics and outcomes of patients discharged home directly from an oncologic intensive care unit (ICU) and their 30-day hospital readmission patterns. ⋯ Home discharge of ICU patients at our institution is infrequent but consistent. Almost one third of these patients were readmitted to the hospital within 30 days. Enhancements to the ICU home discharge process may be required to ensure optimal post-ICU care.