No abstract available.
Blood Glucose* ; Critical Illness* ; Humans ; Mortality*

No abstract available.
Blood Glucose* ; Critical Illness* ; Humans ; Mortality*

Introduction: The APACHE II scoring system has been promulgated as a useful tool in the assessment of the severity of disease and prognosis for patients with acute-on-chronic medical conditions. The purpose of this study was to assess the statistical association of APACHE II score and multiple variables in ICU patients. METHODS: Prospective data on 803 ICU patients for validation of the APACHE II system were analysed. We evaluated the relationship between APACHE II scores within the first 24 hours of ICU admission and multiple variables that included days in the ICU, mortality rate and age. The patients were classified as operation and nonoperation, survival and nonsurvival groups. RESULT: 1) The APACHE II score was significantly higher in the 153 nonsurvivals (23.97+/-10.98) than in the 651 survivals (11.51+/-6.14) (p<0.05). 2) The mean APACHE II score of the nonoperation group (14.52+/-9.29) was significantly higher than operation group (12.40+/-7.30) (p<0.05). 3) The overall mortality rate was 17.8%. 4) All patients with an APACHE II score over 40 died. CONCLUSION: The APACHE II score is statistically related with the mortality of critically ill patients.
APACHE* ; Critical Illness ; Humans ; Critical Care ; Mortality ; Prognosis ; Prospective Studies

PURPOSE: An intensivist is a key factor in the mortality of patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an intensivist on clinical outcomes of patients admitted to a surgical ICU. METHODS: During the study period, the surgical ICU was converted from an open ICU to an intensivist-directed ICU managed by an intensivist who was board certified in both general surgery and critical care medicine. We compared consecutive patients admitted to the surgical ICU before and after implementing the intensivist-directed care. The primary outcome was ICU mortality, and secondary outcomes were hospital mortality, 90-day mortality, length of hospital stay, ICU-free days, ventilator-free days, and ICU readmission rate. RESULTS: A total of 441 patients were included in this study: 188 before implementation of the intensivist and 253 after implementation. Clinical characteristics were not different between the two groups. ICU mortality decreased from 11.7% to 6.3% (P = 0.047) after implementation, and 90-day mortality also decreased significantly (P = 0.008). The adjusted hazard ratio of the intensivist for ICU mortality was 0.43 (95% confidence interval, 0.22-0.87; P = 0.020). ICU-free days (P = 0.013) and the hospital length of stay (P = 0.032) were significantly improved after implementing the intensivist-directed care. Before implementation period, 16.0% of patients were readmitted, compared with only 9.9% after implementation (P = 0.05). CONCLUSION: Implementing intensivist-directed care in the surgical ICU was associated with significant improvements in ICU mortality and significant clinical outcomes.
Critical Care ; Critical Illness ; Hospital Mortality ; Humans ; Intensive Care Units ; Critical Care* ; Length of Stay ; Mortality

No abstract available.
Intensive Care Units ; Sepsis ; Critical Illness ; Chronic Disease ; Hospital Mortality

No abstract available.
Intensive Care Units ; Sepsis ; Critical Illness ; Chronic Disease ; Hospital Mortality

BACKGROUND: The primary objective of this meta-analysis is aimed at determining whether β-lactams prolonged infusion in patients with nosocomial pneumonia (NP) results in higher cure rate and improved mortality compared to intermittent infusion. MATERIALS AND METHODS: Relevant studies were identified from searches of MEDLINE, EMBASE, and CENTRAL from inception to September 1st, 2015. All published articles which evaluated the outcome of extended/continuous infusion of antimicrobial therapy versus intermittent infusion therapy in the treatment of NP were reviewed. RESULTS: A total of ten studies were included in the analysis involving 1,051 cases of NP. Prolonged infusion of β-lactams was associated with higher clinical cure rate (OR 2.45, 95% CI, 1.12, 5.37) compared to intermittent infusion. However, there was no significant difference in mortality (OR 0.85, 95% CI 0.63-1.15) between the two groups. Subgroup analysis for β-lactam subclasses and for severity of illness showed comparable outcomes. CONCLUSION: The limited data available suggest that reduced clinical failure rates when using prolonged infusions of β-lactam antibiotics in critically ill patients with NP. More detailed studies are needed to determine the impact of such strategy on mortality in this patient population.
Anti-Bacterial Agents ; Critical Illness ; Humans ; Mortality ; Pneumonia*

Child ; Critical Illness ; Hospital Mortality ; Humans ; Virus Diseases/epidemiology*

BACKGROUND: Cardiac troponin I (cTnI) is a specific marker of myocardial injury. It is known that a higher level of cTnI is associated with a poor clinical outcome in patients with acute coronary syndrome. An elevation in cTnI is also observed in various noncardiac critical illnesses. This study evaluated whether cTnI is useful for predicting the prognosis in noncardiac critically ill patients. METHODS: From June 2003 to July 2004 at Gyeongsang National University Hospital, we enrolled 215 patients (male:142, female:73, mean age:63+/-15 years ) who were admitted for critical illness other than acute coronary syndrome at the medical intensive care unit(ICU). The severity score of critical illness (SAPS II and SOFA) was determined and serum cTnI level was measured within 24 hours after admission to the ICU. The mortality rate was compared between the cTnI-positive (> or =0.1microgram/L) and cTnI-negative (cTnI<0.1microgram/L) patients at the 10th and 30th day after admission to the ICU. The mean cTnI value was compared between the survivors and non-survivors at the 10th and 30th day after admission to the ICU in the cTnI-positive patients. The correlation between cTnI and the severity of the critical illness score (SAPS II and SOFA) was also analyzed in cTnI-positive patients. RESULTS: 1) The number of cTnI-negative and positive patients were 95(44%) and 120(56%), respectively. 2) The mortality rate at the 10th and 30th day after admission to the ICU was significantly higher in the cTnI-positive patients (29%, 41%) than in the cTnI-negative patients (12%, 21%)(p<0.01). 3) In the cTnI-positive patients, the mean value of the cTnI at the 10th and 30th day after admission to the ICU was significantly higher in the non-survivors (4.5 +/- 9.2 microgram/L, 3.5 +/- 7.9 microgram/L) than in the survivors( 1.8 +/- 3.6 microgram/L, 2.0 +/- 3.9 microgram/L) (p < 0.05). 4) In the cTnI-positive patients, the cTnI level was significantly correlated with the SAPS II score (r=0.24, p<0.001) and SOFA score (r=0.30, p<0.001). CONCLUSION: The cTnI may be a useful prognostic marker in noncardiac critically ill patients.
Acute Coronary Syndrome ; Critical Illness* ; Humans ; Critical Care ; Mortality ; Prognosis ; Survivors ; Troponin I* ; Troponin*

BACKGROUND: The APACHE II scoring system has been regarded as a useful tool in the assessment of the severity of injury and prognosis for acutely ill patients. Recently, there have been many reports that multiple organ failure(MOF) score is the better predictor of the mortality of critically ill patients than any other scoring system. The purpose of this study was to compare APACHE II score and MOF score for mortality prediction in critically ill patients. METHODS: 163 critically ill patients were studied. We analyzed the correlation between the mortality rate and the scores that were produced by APACHE II and MOF scoring system within the first 24 hours in the ICU. We analyzed the correlation between each score and the number of days of ICU stay. We also calculated the mortality rate according to the number of organ failure. RESULTS: 1) The APACHE II score and MOF score of the survivors(n=129) were 9 6 and 1 1, respectively and those of nonsurvivors(n=34) were 16 7 and 5 2(mean SD), respectively. 2) The r2 was 0.62 between APACHE II score and mortality rate, and 0.77 between MOF score and mortality rate. 3) The r2 was 0.06 between APACHE II score and ICU stay, 0.01 between MOF score and ICU stay. 4) The mortality rates were 0, 2, 20, 64, 73, 75 and 100 % in 0, 1, 2, 3, 4, 5 and 6 organ failures, respectively. CONCLUSIONS: The MOF score was more sensitive predictor of the mortality of critically ill patients than the APACHE II score.
APACHE* ; Critical Illness* ; Humans ; Critical Care ; Mortality* ; Multiple Organ Failure* ; Prognosis