Journal of critical care
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Journal of critical care · Dec 2021
Effects of ondansetron use on outcomes of acute kidney injury in critically ill patients: An analysis based on the MIMIC-IV database.
Acute kidney injury (AKI) in intensive care units (ICUs) is a health priority with limited treatment options. This study aimed to estimate the effects of ondansetron use on AKI patient outcomes. ⋯ This cohort study showed that ondansetron use is significantly associated with reduced risk-adjusted in-hospital mortality in stages 1 and 2 AKI patients in the ICU. Further randomized controlled trials are needed.
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Journal of critical care · Dec 2021
Healthcare utilization and mortality outcomes in patients with pre-existing psychiatric disorders after intensive care unit discharge: A population-based retrospective cohort study.
Pre-existing psychiatric disorders may lead to negative outcomes following intensive care unit (ICU) discharge. We evaluated the association of pre-existing psychiatric disorders with subsequent healthcare utilization and mortality in patients discharged from ICU. ⋯ Critically ill patients with pre-existing psychiatric disorders have an increased risk of healthcare utilization and mortality outcomes following an ICU stay.
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Journal of critical care · Dec 2021
Observational StudyEndothelium-associated biomarkers mid-regional proadrenomedullin and C-terminal proendothelin-1 have good ability to predict 28-day mortality in critically ill patients with SARS-CoV-2 pneumonia: A prospective cohort study.
We assessed the ability of mid-regional proadrenomedullin (MR-proADM) and C-terminal proendothelin-1 (CT-proET-1) to predict 28-day mortality in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. ⋯ Baseline and serial MR-proADM and CT-proET-1 had good ability to predict 28-day mortality in critically ill patients with SARS-CoV-2 pneumonia.
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Journal of critical care · Dec 2021
Reconciling the obesity paradox: Obese patients suffer the highest critical illness associated mortality rates.
The obesity paradox refers to the observation that obese patients admitted to intensive care units (ICU) have lower case fatality as compared to healthy weight patients. However, selection bias could explain the apparent paradox. Our objective was to assess whether obese people have a different overall burden of critical illness associated mortality. ⋯ ICU admission incidence rates were 245.6, 138.2, 178.9, and 421.9 per 100,000 population; 90-day all cause case fatalities were 24.0%, 17.0%, 18.1%, and 16.0%; and critical illness associated mortality rates were 58.8, 23.4, 32.4, and 67.7 per 100,000 population among underweight, healthy weight, overweight, and obese patients, respectively. As compared to patients of healthy weight, those who were underweight (relative risk; RR 2.51; 95% CI, 1.79-3.44), overweight (RR 1.38; 95% CI, 1.16-1.65), and obese (RR 2.89; 2.43-3.43) were each at significantly higher risk for critical illness associated mortality. While obese patients have lower case fatality they are at much higher risk for ICU admission and as result suffer the highest burden of critical illness associated mortality in our region.
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Journal of critical care · Dec 2021
Intensive Care Unit prioritization: The impact of ICU bed availability on mortality in critically ill patients who requested ICU admission in court in a Brazilian cohort.
To assess hospital mortality in patients who requested ICU admission in court due to the scarcity of ICU beds in the Brazilian public health system and the consequences of these judicial litigations. ⋯ A large proportion of patients was denied ICU admission and it was associated with an increased mortality. A considerable portion of the ICU-admitted patients were classified as priority level III and IV, impairing the ICU admission of patients with priority level I which are the ones with the greatest benefit from it.