Critical care medicine
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Critical care medicine · Feb 2025
Health Care Disparities and Critical Illnesses-Related Mortality in the United States.
To examine the association between social vulnerability index (SVI) and social deprivation index (SDI) with critical illness-related mortality in the United States and to guide future research and interventions aimed at reducing disparities in outcomes in patients with critical illness. ⋯ Critical illness mortality is significantly associated with indicators of socioeconomic disadvantage. The SDI appears to be a more effective tool than the SVI for guiding resource allocation. Targeted interventions to address social determinants of health, including poverty, education, and unemployment, are essential to reduce disparities and improve outcomes in patients with critical illness. Public health strategies should focus on addressing these social determinants and enhancing support for vulnerable populations and areas.
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Critical care medicine · Feb 2025
Associations Between Social Economic Determinants and Long-Term Outcomes of Critically Ill Patients.
Differences in socioeconomic status (SES) may influence long-term physical, psychological, and cognitive health outcomes of ICU survivors. However, the relationship between SES and these three long-term health outcomes is rarely studied. The aim of this study was to investigate associations between SES and the occurrence of long-term outcomes 1-year post-ICU. ⋯ Indicators of lower SES, including low education level, low income, unemployment and migrants were associated with an increased risk of post-ICU health problems. Gaining insight into the complex relationship between SES and long-term health problems is necessary to decrease disparities in healthcare.
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Critical care medicine · Feb 2025
Ableism After Critical Illness: A Qualitative Translation of Key Concepts to the Post-ICU Context.
Ableism-discrimination and social prejudice against people with disabilities-defines people by their disability and assumes that disabled people require fixing. We sought to characterize ableism after critical illness and to describe its relationship with care delivery. ⋯ Ableism presents multifaceted barriers to participation after critical illness, undermining resilience and wellbeing. We hypothesize that anti-ableist interventions could reduce disability-related barriers to resilience to optimize recovery after critical illness.
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Critical care medicine · Feb 2025
Personal Public Disclosure: A New Paradigm for Meeting Regulatory Requirements Under Exception From Informed Consent.
To describe a novel approach to the requirement for public disclosure under regulations for Exception From Informed Consent (EFIC) in an inpatient clinical trial. ⋯ Personal public disclosure supports patient/family autonomy within an EFIC trial; however, this approach is limited by low cost-effectiveness, feasibility and appropriateness in many circumstances.
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Evaluate prediction models designed or used to identify patients with sepsis in the prehospital setting. ⋯ PRESEP was the only evaluated prediction model that demonstrated better discrimination than unaided EMS infection assessment for the identification of ambulance-transported adult patients who met Sepsis-3 criteria in the ED.