Abstract:
OBJECTIVE:The aim of this study was to refine and validate an automatic risk of unplanned readmission (Stability and Workload Index for Transfer, or SWIFT) calculator in a prospective cohort of consecutive medical intensive care unit (ICU) patients in a teaching hospital with comprehensive electronic medical records (EMRs). DESIGN:A 2-phase (derivation and validation) prospective cohort study was conducted. SETTINGS:The study was conducted in an academic medical ICU. SUBJECTS:A consecutive cohort of adult (age >18 years) patients with research authorization were analyzed. INTERVENTION:The EMR-based automatic SWIFT calculator was used for this study. MEASUREMENT:Agreement between the manual ("gold standard") and automatic SWIFT calculation tool was obtained. MAIN RESULTS:During the derivation phase, we enrolled 191 consecutive medical ICU patients. Scores of SWIFT for these patients calculated manually by the 2 reviewers had strong positive correlation (r = 0.97), and the mean (SD) difference was 0.43 (3.5). The first iteration of the automatic SWIFT calculator in the derivation cohort demonstrated excellent agreement with manual calculation, partial pressure of carbon dioxide in arterial blood (κ = 0.95), partial pressure of oxygen in arterial blood/fraction of inspired oxygen ratio (κ = 0.69), length of ICU stay (κ = 0.91), and Glasgow comma scale (κ = 0.90) and no agreement for source of ICU admission (κ = -0.15). After adjustment in rules, the κ value for hospital admission source improved to 1.0. Automatic calculation demonstrated strong correlation with manual (r = 0.92), and mean (SD) difference was -2.3 (5.9). During validation phase, 100 subjects were enrolled at 5 days. The automatic tool retained excellent correlation with gold-standard calculation for SWIFT (r = 0.92), and the mean (SD) difference was -2.2 (5.5). CONCLUSION:The EMR-based automatic tool accurately calculates SWIFT score and can facilitate ICU discharge decisions without the need for manual data collection.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Chandra S,Agarwal D,Hanson A,Farmer JC,Pickering BW,Gajic O,Herasevich Vdoi
10.1016/j.jcrc.2011.05.003subject
Has Abstractpub_date
2011-12-01 00:00:00pages
634.e9-634.e15issue
6eissn
0883-9441issn
1557-8615pii
S0883-9441(11)00205-Xjournal_volume
26pub_type
杂志文章abstract:PURPOSE:Alcohol-use disorders (AUDs) have been associated with increased sepsis-related mortality. As patients with AUDs are often thiamine deficient, we investigated practice patterns relating to thiamine administration in patients with AUDs presenting with septic shock and explored the association between receipt of ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.022
更新日期:2018-02-01 00:00:00
abstract:PURPOSE:Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2012.08.019
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.008
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock. MATERIAL AND METHODS:A retrospective cohort study was conducted in nine French specialized rehabilitation centers. Thirty-two ICU adult patients hospitalized b...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2019.06.027
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:Analgesia and sedation protocols (ASPs) reduce duration of mechanical ventilation (MV) in the medical intensive care unit (ICU), but data in the surgical ICU (SICU) are limited. The objective of this study was to determine the impact of a nursing-driven ASP with criteria for infusion initiation in the SICU. MA...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.029
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:To compare the application of three standardized definitions of acute kidney injury (AKI), using corrected serum creatinine values, in children immediately after liver transplantation. METHODS:Retrospective search of a tertiary pediatric hospital database yielded 77 patients (age < 18 years) who underwent live...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.010
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Current guidelines for traumatic brain injury (TBI) recommend antiepileptic drugs (AEDs) for 7 days after injury to decrease posttraumatic seizure risk. Phenytoin decreases seizure risk 73% vs placebo during this time. Levetiracetam (LEV) is an alternative; however, no published data validate comparable efficac...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.11.020
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:The primary objective of this survey was to describe pharmacists' attitudes regarding probiotic use in the intensive care unit (ICU); secondary objectives were to evaluate pharmacists' knowledge and use of probiotics for critically ill patients. METHODS:The survey instrument was rigorously designed and pretest...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.10.016
更新日期:2016-02-01 00:00:00
abstract::Invasive pulmonary aspergillosis (IPA) is an emerging and life-threatening infectious disease in patients admitted to the intensive care unit (ICU). Most diagnostic studies are conducted in hematological patients and results cannot readily be transferred to ICU patients lacking classical host factors. In a multicenter...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2018.07.001
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:It is uncertain whether, in critical care medicine, non-blinded trials are associated with a bias toward a different effect size. The aim of our study was to assess if conducting non-blinded/open label studies leads to greater effect size than blinded studies, and to provide an estimate of the weight of this di...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.09.031
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Under-triage is a major threat when admitting patients at the Intermediate Care Unit (IMCU). This study aims to identify risk factors and predict early deterioration of IMCU admissions, to reduce the risk of under-triage. MATERIALS AND METHODS:This retrospective cohort study included all admissions to the mixe...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.08.012
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:The aim of the study is to determine the incidence, demographic risk factors, and outcomes of critical illness among all adult status Aboriginal Canadians (SACs) admitted to intensive care units (ICUs). PATIENTS AND METHODS:A population-based cohort was conducted among adult residents of the Calgary Health Reg...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.03.012
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:To quantify resource requirements (additional beds and ventilator capacity), for critical care services in the event of pandemic influenza. MATERIALS AND METHODS:Cross-sectional survey about existing and potential critical care resources. Participants comprised 156 of the 176 Australasian (Australia and New...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2003.08.008
更新日期:2003-09-01 00:00:00
abstract:PURPOSE:This study was undertaken to assess recent trends of the choice of renal replacement therapy (RRT) modalities in Japanese intensive care units (ICUs). MATERIALS AND METHODS:Data were extracted from the Japanese Diagnosis Procedure Combination database for 2011. We identified adult patients without end-stage re...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.11.003
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Thoracic surgery patients are at high-risk for adverse pulmonary outcomes. Heated humidified high-flow nasal cannula oxygen (HHFNC O2) may decrease such events. We hypothesized that patients randomized to prophylactic HHFNC O2 would develop fewer pulmonary complications compared to conventional O2 therapy. ...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2017.04.023
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Sodium retention occurs commonly in cardiac and liver disease, requiring the administration of diuretics to restore fluid balance. Whether obesity is associated with sodium retention has not been fully evaluated. METHODS:In a large single-center cohort of critically ill patients, we evaluated whether admissi...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.01.023
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:Sepsis damages the endothelial glycocalyx, contributing to fluid extravasation, organ injury, and death. Our goal was to determine if syndecan-1 level is associated with the risk of intubation and modifying effect of intravenous fluids (IVFs) in these patients. METHODS:Syndecan-1 was measured at enrollment in ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.06.027
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:A volume challenge is useful for determining whether cardiac output will respond to further volume loading by the Frank-Starling mechanism. To properly test this mechanism, there must be an increase in right atrial pressure (Pra) but this requires variable amounts of normal saline. The purpose of this study was...
journal_title:Journal of critical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0883-9441(99)90030-8
更新日期:1999-12-01 00:00:00
abstract:PURPOSE:The difficulties of fluid therapy in patients with septic shock are to maintain sufficient vascular volume while preventing pulmonary edema formation. Thus, it is important to find a biomarker that can reliably predict pulmonary edema formation after fluid loading. We evaluated the association of plasma protein...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.08.007
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:Optimal red blood cell (RBC) transfusion thresholds in acute brain injury (ABI) are poorly defined. MATERIALS AND METHODS:We conducted a retrospective cohort study of adult patients with ABI and moderate anemia (Hb 7-10 g/dL) in a neurological intensive care unit (ICU) at an academic medical center between 200...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.006
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Dynamometry is an objective tool for volitional strength evaluation that may overcome the limited sensitivity of the Medical Research Council scale for manual muscle tests, particularly at grades 4 and 5. The primary aims of this study were to investigate the reliability, minimal detectable change, and time to ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.03.001
更新日期:2013-02-01 00:00:00
abstract:PURPOSE:This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock. MATERIALS AND METHODS:We assessed 6929 consecutive patients...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.07.001
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:Prolonged exposure to normobaric hyperoxia (NH) is associated with blood leukocyte activation and sequestration in the lung. Whether NH-induced leukocyte activation and sequestration can affect extrapulmonary organs or blood cellular profile has not been systematically investigated. We studied simultaneous chan...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.09.057
更新日期:2006-03-01 00:00:00
abstract:PURPOSE:Genetic deletions decreasing serum alpha-Klotho (alpha-KL) have been associated with rapid aging, multi-organ failure and increased mortality in experimental sepsis. We hypothesized that lower alpha-KL obtained at the onset of septic shock correlates with higher mortality. MATERIALS AND METHODS:Prospective coh...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.11.023
更新日期:2018-04-01 00:00:00
abstract::Appropriate fluid resuscitation has been a major focus of critical care medicine since its inception. Currently, the most accurate method to guide fluid administration decisions uses "dynamic" measures that estimate the change in cardiac output that would occur in response to a fluid bolus. Unfortunately, their use re...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2015.09.016
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:Heart rate complexity, commonly described as a "new vital sign," has shown promise in predicting injury severity, but its use in clinical practice is not yet widely adopted. We previously demonstrated the ability of this noninvasive technology to predict lifesaving interventions (LSIs) in trauma patients. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.018
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations. OBJECTIVES:To assess whether a structured communication tool improves satisfaction with care and engenders realistic expec...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.011
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:We present a new electromyographic index, named Engagement of Respiratory Muscle (ERM), for assessing the level of participation of respiratory muscles during spontaneous breathing test in patients poisoned with organophosphorus compound. METHODS:Diaphragm and sternocleidomastoid muscles activity was recorded ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.05.022
更新日期:2017-10-01 00:00:00
abstract::Sepsis and SIRS is the outward manifestation of a generalized uncontrolled inflammatory response, which, if sustained, induces widespread endothelial damage and MODS. Immunomodulating therapies, at present, have proven ineffective in reducing morbidity and mortality, presumably because of the heterogeneous nature of s...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/s0883-9441(96)90024-6
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Delirium is thought to be associated with systemic inflammatory response. However, its association with the most widely used inflammatory biomarker C-reactive protein (CRP) has not been well established. We aimed to examine whether CRP on intensive care unit (ICU) entry was associated with subseq...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.09.002
更新日期:2014-02-01 00:00:00