Articles: mortality.
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Reversible myocardial depression occurs early in severe sepsis and septic shock. The question of whether or not early ventricular depression or dilatation is associated with lower mortality in these patients remains controversial. Most studies on this topic were small in size and hence lacked statistical power to answer the question. This meta-analysis attempted to answer the question by increasing the sample size via pooling relevant studies together. ⋯ This meta-analysis failed to find any evidence to support the view that the survivors from severe sepsis or septic shock had lower ejection fractions. However, non-indexed left ventricular dimensions were mildly increased in the survivor group but the indexed dimensions were similar between the groups. Both survivors and non-survivors had similar right ventricular dimensions.
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Comparative Study
A novel risk score to predict 1-year functional outcome after intracerebral hemorrhage and comparison with existing scores.
Spontaneous intracerebral hemorrhage (ICH) is one of leading causes of mortality and morbidity worldwide. Several predictive models have been developed for ICH; however, none of them have been consistently used in routine clinical practice or clinical research. In the study, we aimed to develop and validate a risk score for predicting 1-year functional outcome after ICH (ICH Functional Outcome Score, ICH-FOS). Furthermore, we compared discrimination of the ICH-FOS and 8 existing ICH scores with regard to 30-day, 3-month, 6-month, and 1-year functional outcome and mortality after ICH. ⋯ The ICH-FOS is a valid clinical grading scale for 1-year functional outcome after ICH. Further validation of the ICH-FOS in different populations is needed.
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We assessed rates and predictive factors of non-invasive ventilation (NIV) failure in patients admitted to the intensive care unit (ICU) for non-hypercapnic acute hypoxemic respiratory failure (AHRF). ⋯ With intubation rates below 35% in non-ARDS and mild ARDS, NIV stands as the first-line approach; NIV may be attempted in ARDS patients with a PaO2/FiO2 > 150. By contrast, 84% of severe ARDS required intubation and NIV did not appear beneficial in this subset of patients. However, the time to intubation had no influence on mortality.
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Economic evaluations of interventions in the hospital setting often rely on the estimated long-term impact on patient survival. Estimates of mortality rates and long-term outcomes among patients discharged alive from the intensive care unit (ICU) are lacking from lower- and middle-income countries. This study aimed to assess the long-term survival and life expectancy (LE) amongst post-ICU patients in Thailand, a middle-income country. ⋯ Post-ICU patients experienced much higher rates of mortality than members of the general population over the five-year follow-up period, particularly in the first year after discharge. Further work assessing Health Related Quality of Life (HRQOL) in both post-ICU patients and in the general population in developing countries is needed.
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ABSTRACTIntroduction:Drowning is a major public health concern, yet little is known about the characteristics of drowning patients. The objectives of this study were to describe the demographic and clinical characteristics of out-of-hospital cardiac arrest (OHCA) attributed to drowning in Ontario and to compare the characteristics of OHCA attributed to drowning to those of presumed cardiac etiology. Methods:A retrospective, observational study was carried out of consecutive OHCA patients of drowning etiology in Ontario between August 2006 and July 2011. ⋯ Conclusions:Significant differences exist between OHCA of drowning and presumed cardiac etiologies. Most drownings are unwitnessed, occur in public locations, and present with nonshockable initial rhythms, suggesting that treatment should focus on bystander CPR. Future initiatives should focus on strategies to improve supervision in targeted locations and greater emphasis on bystander-initiated CPR, both of which may reduce drowning mortality.