Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2021
Clinical impact of chronic substance abuse in a Norwegian ICU-population.
The clinical impact of chronic substance abuse of alcohol and drugs-referred to as substance use disorders (SUD)-is often overlooked in the intensive care (ICU) setting. The aims of the present study were to identify patients with SUD-regardless of cause of admission-in a mixed Norwegian ICU-population, and to compare patients with and without SUD with regard to clinical characteristics and mortality. ⋯ One in four ICU-patients had SUD regardless of cause of admission. Alcohol use disorder was associated with increased mortality in medical patients and in patients with sepsis.
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Acta Anaesthesiol Scand · Apr 2021
A novel digital clock drawing test as a screening tool for perioperative neurocognitive disorders: A feasibility study.
We developed a digital clock drawing test (dCDT), an adaptation of the original pen and paper clock test, that may be advantageous over previous dCDTs in the perioperative environment. We trialed our dCDT on a tablet device in the preoperative period to determine the feasibility of administration in this setting. To assess the clinical utility of this test, we examined the relationship between the performance on the test and compared derived digital clock measures with the 4 A's Test (4AT), a delirium and cognition screening tool. ⋯ The digital clock drawing test is feasible to administer and is highly acceptable to older adults in a preoperative setting. We demonstrated a significant association between both the dCDT time and clock score metrics, with the established 4AT. Our results provide convergent validity of the dCDT in the preoperative setting.
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Acta Anaesthesiol Scand · Apr 2021
Causes of death for intensive care survivors with and without acute kidney injury in 5-year follow-up.
Data on the causes of death and long-term mortality of intensive care unit-treated hospital survivors with acute kidney injury (AKI) are limited. The goal of this study was to analyze the causes of death among critically ill patients during a 5-year follow-up. ⋯ Cardiovascular causes and malignancies account for more than half of the causes of death in patients who had suffered AKI, while death from kidney disease after AKI is rare. Early cardiovascular deaths are more prevalent in AKI compared to non-AKI patients.
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Acta Anaesthesiol Scand · Apr 2021
Utility of coagulation analyses to assess thromboprophylaxis with dalteparin in intensive care unit patients.
The aim of this study was to evaluate the utility of coagulation analyses to assess thromboprophylaxis with dalteparin in intensive care unit (ICU) patients. ⋯ Intensive care unit patients receiving dalteparin prophylaxis had half of patients within prophylactic peak aFXa target range. Peak aFXa levels was affected by administered dalteparin dose, but not presence of VTE, major bleeding or AKI with RRT.