Articles: intensive-care-units.
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Critical care medicine · May 1999
Comparative StudyPrognostic usefulness of scoring systems in critically ill patients with severe acute pancreatitis.
To compare prognostic scoring systems in a retrospective series of patients with severe acute pancreatitis admitted to a surgical intensive care unit (ICU). ⋯ Once a patient is admitted to the surgical ICU, several predictors of mortality or complications that will require long hospitalization times are evident. In this sample of patients, APACHE III scores >30 at 96 hrs, 5 or more Ranson criteria, and a modified Imrie (Glasgow) score of >3 predicted those who died or had multiple complications. Those patients with combined 48-hr and 96-hr APACHE III scores of >60 either died or had hospitalizations of >60 days. These patients had major pancreatic complications that included pancreatic necrosis, pancreatic abscess, pseudocyst, hemorrhagic pancreatitis, and pancreatic ascites.
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Critical care medicine · May 1999
Comparative StudyThe Pediatric Risk of Mortality (PRISM) Score and Injury Severity Score (ISS) for predicting resource utilization and outcome of intensive care in pediatric trauma.
Mortality prediction in trauma is assessed using the Injury Severity Score (ISS) and Revised Trauma Score using Trauma Injury Severity Score (TRISS) methodology. The Pediatric Risk of Mortality (PRISM) score assesses mortality risk in critically ill children. We compared the ability of PRISM and ISS (using TRISS methodology) to predict resource utilization and outcome in pediatric trauma. ⋯ PRISM readily stratifies pediatric trauma patients for resource utilization. PRISM appears to underestimate mortality in pediatric trauma as compared with ISS using TRISS methodology.
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To describe patients' and family members' perceptions of transfer from an intensive care unit (ICU). ⋯ Patients and family members perceived the transfer from the ICU as a significant and sometimes negative event.
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J R Coll Physicians Lond · May 1999
Unexpected deaths and referrals to intensive care of patients on general wards. Are some cases potentially avoidable?
(i) To determine the incidence of unexpected deaths occurring on general wards, and whether any were potentially avoidable; (ii) to assess whether the quality of care on general wards prior to admission to intensive care affected subsequent outcome. ⋯ Patients with obvious clinical indicators of acute deterioration can be overlooked or poorly managed on the ward. This may lead to potentially avoidable unexpected deaths or to a poorer eventual outcome following ICU admission. Early recognition and correction of abnormalities may result in outcome benefit, but this requires further investigation.
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Mayo Clinic proceedings · May 1999
Probable alcohol abuse or dependence: a risk factor for intensive-care readmission in patients undergoing elective vascular and thoracic surgical procedures. Mayo Perioperative Outcomes Group.
To determine whether alcohol abuse or dependence is a risk factor for perioperative complications, increased duration of hospital stay, and increased utilization of nursing resources in patients undergoing thoracic and vascular surgical procedures. ⋯ Except for the occurrence of alcohol withdrawal syndrome, study patients classified in the probable alcohol abuse group did not have more medical or surgical perioperative complications than patients in the nonalcoholic group. They did have significantly more intensive-care setting readmissions. Patients with documented alcohol withdrawal episodes frequently were dismissed without a diagnosis of substance abuse or dependence.