Abstract:
:No specific prognostic model has been developed for patients readmitted to the intensive care unit (ICU) during the same hospitalisation. This study assesses the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II predicted mortality measured at the time of ICU readmission and whether incorporating information prior to the readmission will improve its performance to predict hospital mortality of patients readmitted to ICU during the same hospitalisation. A total of 602 readmissions during the same hospitalisation between 1987 and 2002 were identified. The first admission APACHE II predicted mortality was significantly associated with the hospital mortality only in the subgroup of patients readmitted within seven days of ICU discharge (odds ratio 1.16, 95% confidence interval 1.01 to 1.34; P = 0.035). In the subgroups of patients readmitted within seven days of discharge, the readmission APACHE II predicted mortality was also significantly better than the first admission APACHE II predicted mortality in discriminating between survivors and non-survivors (area under the receiver operating characteristic curve: 0.785 vs. 0.676, z statistic = 2.93; P = 0.003). Incorporating the first admission APACHE II predicted mortality to the readmission APACHE II predicted mortality, either by multilevel likelihood ratios or logistic regression, did not significantly improve its discrimination (area under the receiver operating characteristic curve: 0.792 vs. 0.785, z statistic = 0.52; P = 0.603). Our results suggested that information on prior ICU admission during the same hospitalisation is not as important as the severity of illness measured at the time of readmission in determining the mortality of intensive care readmissions during the same hospitalisation.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Ho KM,Knuiman Mdoi
10.1177/0310057X0803600107subject
Has Abstractpub_date
2008-01-01 00:00:00pages
38-45issue
1eissn
0310-057Xissn
1448-0271pii
2007474journal_volume
36pub_type
杂志文章abstract::One hundred and fifty-nine adult patients undergoing elective colonoscopy in a major regional hospital were surveyed regarding their perceptions and expectations of sedation/anaesthesia for this procedure. The survey was undertaken on the day of the procedure, but before their assessment by the anaesthetist. Most of o...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1304100315
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abstract::Iatrogenic meningitis is a rare complication of spinal anaesthesia. It is mandatory to use a technique which minimises the risk of introducing bacteria into the subarachnoid space. Currently available fentanyl ampoules require a careful drawing-up technique, as the outside of the ampoule is not sterile and there is po...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700413
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abstract::In a series of patients who suffered severe histamine mediated reactions to induction agents and muscle relaxants, intradermal testing enabled the drug involved to be distinguished. The correct use of intradermal testing to give reliable results is discussed and a protocol described. Prausnitz Kustner testing was of l...
journal_title:Anaesthesia and intensive care
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doi:10.1177/0310057X7600400202
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journal_title:Anaesthesia and intensive care
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abstract::Self-assessment and audit in anaesthesia require a systematic approach to postoperative data collection. The increasing prevalence of mobile internet technology offers a new data collection method for anaesthetists. In this paper, a system for mobile internet data collection is described and the preliminary experience...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::A computer-based data storage and analysis system has been used to examine data obtained from 1257 patients admitted to an intensive care unit. The system readily provides administrative and clinical information which can be used to assess the workload, therapeutic efficiency and cost-effectiveness of such a unit. As ...
journal_title:Anaesthesia and intensive care
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abstract::In several recent clinical trials on cardiac surgery patients, remote ischaemic preconditioning (RIPC) showed a powerful myocardial protective effect. However the effect of RIPC has not been studied in patients undergoing off-pump coronary artery bypass graft surgery. We evaluated whether RIPC could induce myocardial ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
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abstract::We present a case of severe rigidity during emergence from general anaesthesia in a 64-year-old man who had suffered from Parkinson's disease for nine years. Controversy still exists over how to optimally manage these patients perioperatively. We successfully managed his Parkinsonism with administration of crushed Sin...
journal_title:Anaesthesia and intensive care
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abstract::Several studies have been conducted to evaluate the utilisation of the operating room, a fixed resource, in terms of conditions that prevent day-of-surgery cancellation due to deficient operative capacity. In this study, we surveyed the causes and overall rates of elective surgery cancellation and then compared the nu...
journal_title:Anaesthesia and intensive care
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abstract::Current donor management practices target macrohaemodynamic parameters, but it is unclear if this leads to improvements in microvascular perfusion and tissue oxygenation; the latter may have more impact on organ status. In a recent preclinical study we determined that brain death impaired tissue perfusion and oxygen u...
journal_title:Anaesthesia and intensive care
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abstract::This retrospective casenote audit involving 374 patients requiring intubation for an anaesthetic found that when the availability of sugammadex became unrestricted, its use increased from 7.1 to 65.3% (P <0.0001) of all muscle relaxant reversals, while neostigmine use decreased from 59.6 to 12.5%. Rocuronium use decre...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1204000218
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abstract::Intravenous lipid emulsion is, in some countries, the recommended treatment for local anaesthetic toxicity. Systemic local anaesthetic toxicity results in hypoxaemia and acidosis, and whether this influences the effects of lipid therapy on drug concentrations and cardiovascular recovery is currently unknown. Twenty an...
journal_title:Anaesthesia and intensive care
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abstract::A technique of subclavian vein catheterization is described, tailored to the individual patient, to reduce the risk of right atrial placement with central venous catheter (CVC) insertion. Using data gathered retrospectively for Quality Improvement purposes, CVC tip location was assessed. The standard technique used in...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
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journal_title:Anaesthesia and intensive care
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doi:10.1177/0310057X0102900614
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abstract::Seventy patients who underwent a total of 77 consecutive carotid endarterectomies were given thiopentone (mean dose 19 mg/kg) under EEG control for cerebral protection during the period of carotid clamping. This technique was used instead of elective insertion of a temporary bypass shunt in response to adverse EEG cha...
journal_title:Anaesthesia and intensive care
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doi:10.1177/0310057X8601400106
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abstract::Tracheal extubation can evoke an equally strong haemodyamic stress response as tracheal intubation. We present a patient with myocardial infarction who repeatedly failed tracheal extubation. He developed acute pulmonary oedema following each attempt at tracheal extubation due to sympathetic overactivity. A change of a...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0403200319
更新日期:2004-06-01 00:00:00
abstract::Fibreoptic intubation remains an essential skill for anaesthetists to master. In addition to the reusable fibrescope, an alternative disposable videoscope is available (aScope(™)2, Ambu®, Ballerup, Denmark). A total of 60 anaesthetised adult patients were randomised to either having orotracheal intubation using the aS...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
doi:10.1177/0310057X1504300410
更新日期:2015-07-01 00:00:00
abstract::The effects of halothane (0.5-2%) and enflurane (1-4%) on two Transoxode transcutaneous oxygen (TcPO2) electrodes (Hellige Servomed Oxymonitor SM.361 system) were serially tested in atmospheres of nitrogen, air and 50% nitrous oxide in oxygen. Both TcPO2 electrodes reduced and "read" halothane but no enflurane. Calibr...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8100900207
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abstract::Plasma osmolalities were measured in 100 normal, 100 general hospital and 100 intensive care patients, and compared with the osmolalities calculated from the plasma concentrations of sodium, potassium, glucose and urea, using five different published formulae. The mean osmolar gaps in the 100 consecutive intensive car...
journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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abstract::Seven out of eight piglets which were susceptible to malignant hyperthermia (MHS) died when subjected to a heat challenge which was well tolerated by controls. The piglets which succumbed developed the classical clinical and biochemical changes of malignant hyperthermia before they died. These results show that overhe...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
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abstract::Neuromuscular blocking actions of diazepam and its interaction with some myoneural blocking agents were studied in dogs and in humans undergoing surgery under general anaesthesia. Diazepam alone had no effect on the response of tibialis anterior muscle to indirect stimulation in dogs. Again, diazepam in a bolus dose o...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7600400207
更新日期:1976-05-01 00:00:00
abstract::Human error is a pervasive and normal part of everyday life and is of interest to the anaesthetist because errors may lead to accidents. Definitions of, and the relationships between, errors, incidents and accidents are provided as the basis to this introduction to the psychology of human error in the context of the w...
journal_title:Anaesthesia and intensive care
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abstract::This study assessed the performance of Sequential Organ Failure Assessment, Logistic Organ Dysfunction Score and Multiple Organ Dysfunction Score in outcome prediction in severe sepsis. A total of 528 consecutive patients with a diagnosis of severe sepsis were enrolled from two surgical intensive care units of univers...
journal_title:Anaesthesia and intensive care
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abstract::Organic insecticide poisoning continues to be a major health problem not only in the developing communities but also in the Western population. The insecticides commonly used are the organophosphates, organocarbamates, organochlorides and pyrethroids. Patients with organic insecticide poisoning present with a spectrum...
journal_title:Anaesthesia and intensive care
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abstract::Hypertension after cardiac surgery is common and requires accurate control by carefully regulated infusions of drugs such as sodium nitroprusside. A microprocessor-based controller has been designed to close the loop between the blood pressure response and the infusion rate of a hypotensive drug. This system has been ...
journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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