Journal of critical care
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Journal of critical care · Feb 2020
Intensive care unit occupancy and premature discharge rates: A cohort study assessing the reporting of quality indicators.
ICU occupancy fluctuates. High levels may disadvantage patients. Currently, occupancy is benchmarked annually which may inaccurately reflect strained units. Outcomes potentially sensitive to occupancy include premature (early) ICU discharge and non-clinical transfer (NCT). This study assesses the association between daily occupancy and these outcomes, and evaluates benchmarking care across Scotland using daily occupancy. ⋯ We demonstrate a clear association between daily ICU occupancy and early discharge/NCT. Daily occupancy may better benchmark care quality than mean annual occupancy.
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To investigate if patient sex affects intensive care unit (ICU) admission and discharge patterns. Specifically, we investigate if the patients sex affects length of stay (LOS) and probability of ICU discharge and 30- and 90-day mortality. ⋯ In this large cohort study of critically ill patients we have shown that women and men had an equal length of stay, but women had a significantly higher probability of being discharged. There was no difference in mortality between women and men.
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Journal of critical care · Feb 2020
A novel mortality risk score predicting intensive care mortality in cardiogenic shock patients treated with veno-arterial extracorporeal membrane oxygenation.
Mortality after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) implantation remains a major problem in patients with cardiogenic shock. Our objective was to assess the utility of the SOFA score in combination with markers of right ventricular (RV) dysfunction in predicting mortality in the ICU. ⋯ Adding RV-function to the existing SOFA score improves significantly the prediction of ICU mortality in patients on VA-ECMO. Dedicated evaluation of RV function in patients with VA-ECMO is therefore recommended.
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Journal of critical care · Feb 2020
Review Historical ArticleThe history of critical care in Kenya.
Critical care is a young specialty in Kenya. From its humble beginnings in the 1960s to present day Kenya, the bulk of this service has largely been provided by anaesthetists. We provide a detailed account of the growth and development of this specialty in our country, the attempts made by our people to grow this service within our borders and the vital role our international partners have played throughout this process. We also share a selection of our successes over the years, the challenges we have faced and our aspirations as we look to the future.
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Journal of critical care · Feb 2020
Trends in opioid use before critical illness among elderly patients in Ontario.
To assess temporal trends in pre-existing opioid exposure prior to hospitalization among elderly intensive care unit (ICU) patients and its association with adverse outcomes. ⋯ Among elderly ICU patients, opioid exposure prior to admission is prevalent and use is associated with higher in-hospital mortality.