Journal of critical care
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Journal of critical care · Dec 2019
Sepsis quality in safety-net hospitals: An analysis of Medicare's SEP-1 performance measure.
Newly enacted policies at the state and federal level in the United States require acute care hospitals to engage in sepsis quality improvement. However, responding to these policies requires considerable resources and may disproportionately burden safety-net hospitals. To better understand this issue, we analyzed the relationship between hospital safety-net status and performance on Medicare's SEP-1 quality measure. ⋯ Existing sepsis policies may harm safety-net hospitals and widen health disparities. Our findings suggest that strategies to promote collaboration among hospitals may be an avenue for sepsis performance improvement in safety-net hospitals.
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Journal of critical care · Dec 2019
Acute critically ill elderly patients: What about long term caregiver burden?
Acute critical illness induce a high caregivers burden in the young population, however data in the older population are lacking. The objectives of this study were to evaluate caregiver burden in a critically ill old population and to assess factors associated with mild to severe burden level. ⋯ In our study, functional status and mental health at 6 months were associated with mild to severe burden unlike age and admission in ICU.
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Journal of critical care · Dec 2019
ReviewManaging the Alpha-1 patient in the ICU: Adapting broad critical care strategies in AATD.
Alpha-1 Antitrypsin Deficiency (AATD) is a progressive pulmonary disease under-recognized or misdiagnosed by clinicians. Patients with AATD can develop a variety of organ-specific complications and as a result, often require hospitalization and treatment within critical care and ICU settings. ⋯ In addition, we have outlined certain aspects of the care of this patient population that may be of interest to critical care practitioners. With greater disease awareness and earlier diagnosis the onset of symptoms can be delayed, which will ultimately reduce the frequency of deleterious health consequences.