Abstract:
OBJECTIVES:Atrial fibrillation is frequently seen in sepsis-related hospitalizations. However, large-scale contemporary data from the United States comparing outcomes among sepsis-related hospitalizations with versus without atrial fibrillation are limited. The aim of our study was to assess the frequency of atrial fibrillation and its impact on outcomes of sepsis-related hospitalizations. DESIGN:Retrospective cohort study. SETTING:The National Inpatient Sample databases (2010-2014). PATIENTS:Primary discharge diagnosis of sepsis with and without atrial fibrillation were identified using prior validated International Classification of Diseases, 9th Edition, Clinical Modification codes. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Overall, 5,808,166 hospitalizations with the primary diagnosis of sepsis, of which 19.4% (1,126,433) were associated with atrial fibrillation. The sepsis-atrial fibrillation cohort consisted of older (median [interquartile range] age of 79 yr [70-86 yr] vs 67 yr [53-79 yr]; p < 0.001) white (80.9% vs 68.8%; p < 0.001) male (51.1% vs 47.5%; p < 0.001) patients with an extended length of stay (median [interquartile range] 6 d [4-11 d] vs 5 d [3-9 d]; p < 0.001) and higher hospitalization charges (median [interquartile range] $44,765 [$23,234-$88,657] vs $35,737 [$18,767-$72,220]; p < 0.001) as compared with the nonatrial fibrillation cohort. The all-cause mortality rate in the sepsis-atrial fibrillation cohort was significantly higher (18.4% and 11.9%; p = 0.001) as compared with those without atrial fibrillation. Although all-cause mortality (20.4% vs 16.6%) and length of stay (median [interquartile range] 7 d [4-11 d] vs 6 d [4-10 d]) decreased between 2010 and 2014, hospitalization charges increased (median [interquartile range] $41,783 [$21,430-$84,465] vs $46,251 [$24,157-$89,995]) in the sepsis-atrial fibrillation cohort. The greatest predictors of mortality in the atrial fibrillation-sepsis cohort were African American race, female gender, advanced age, and the presence of medical comorbidities. CONCLUSIONS:The presence of atrial fibrillation among sepsis-related hospitalizations is a marker of poor prognosis and increased mortality. Although we observed rising trends in sepsis and sepsis-atrial fibrillation-related hospitalizations during the study period, the rate and odds of mortality progressively decreased.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Desai R,Hanna B,Singh S,Omar A,Deshmukh A,Kumar G,Foreman MG,Sachdeva Rdoi
10.1097/CCM.0000000000003806subject
Has Abstractpub_date
2019-08-01 00:00:00pages
e630-e638issue
8eissn
0090-3493issn
1530-0293journal_volume
47pub_type
杂志文章abstract::Bacterial translocation and ileal and cecal injury have been shown to occur 24 h after limited periods of hemorrhagic shock. The present studies were performed to determine the temporal sequence of mucosal injury, permeability, and bacterial translocation after hemorrhagic shock. The results indicated that bacterial t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199005000-00014
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:To evaluate diagnostic and prognostic values of C-reactive protein (CRP) dosage in critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) in a university hospital. PATIENTS:A consecutive series of 74 patients admitted to the ICU. INTERVENTION:CRP measur...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200203000-00006
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND AND METHODS:To determine the effects of reduced cerebral perfusion pressures produced by hemorrhage alone or in combination with intracranial hypertension on thromboxane A2 (TxA2) production, we undertook a randomized study in 38 anesthetized, mongrel dogs. Animals were subjected to 30 mins of hemorrhagic sh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199104000-00013
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:To determine the specific effect of peak volume history pressure on the inflation limb of the pressure-volume curve and peak pressure-volume curve pressure on the deflation limb of the pressure-volume curve. DESIGN:Prospective assessment of pressure-volume curves in saline, lung lavage injured sheep. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000128573.28173.2e
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:To study the impact of a clinical pharmacist in a pediatric intensive care unit. The goals of the study were to determine the type and quantity of patient care interventions recommended by a clinical pharmacist and to specifically examine cost savings (or loss) that resulted from clinical pharmacist recommend...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00035
更新日期:2002-04-01 00:00:00
abstract::To understand better the incidence and meaning of hyperamylasemia in the intensive care setting, cellulose acetate membrane electrophoresis was used to measure the isoenzymes of serum amylase in 192 patients with a variety of critical illnesses. Seventy of these patients had elevated serum amylase levels, but none had...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00003
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:To determine the reliability of volitional and nonvolitional limb muscle strength assessment in critically ill patients and to provide guidelines for the implementation of limb muscle strength assessment this population. DATA SOURCES:The following computerized bibliographic databases were searched with MeSH...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000030
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To assess the influence of private attending physician status on the withdrawal of life-sustaining interventions among patients dying within a medical intensive care unit (ICU). DESIGN:Retrospective cohort analysis. SETTING:An academic tertiary care center. PATIENTS:One hundred fifty-nine consecutive patie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199606000-00016
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To characterize the withholding or withdrawing of life support from patients with severe head injury. SETTING:San Francisco General Hospital, a city and county hospital with a Level I trauma center. DESIGN:A standardized questionnaire was used to collect data on demographics and functional outcome of severe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199509000-00018
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the impact of a comprehensive unit-based safety program on safety climate in a large cohort of intensive care units participating in the Keystone intensive care unit project. DESIGN/SETTING:A prospective cohort collaborative study to improve quality of care and safety culture by implementing and...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318206d26c
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To compare intraosseous with central venous blood samples for biochemical analyses and hemoglobin levels during cardiopulmonary resuscitation (CPR) and during cardiopulmonary resuscitation with infusion of sodium bicarbonate, epinephrine, and saline boluses through the intraosseous site. DESIGN:Prospective, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199906000-00039
更新日期:1999-06-01 00:00:00
abstract::It has become accepted that nitric oxide serves important functions in biological systems as a second messenger. Another diatomic gaseous molecule, carbon monoxide (CO), is also rapidly gaining acceptance as a signaling agent. Some of the activities of CO are analogous to those of nitric oxide in the vascular system a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To examine the effect of hypertonic saline on bacterial translocation and the number and function of natural killer and T cells in controlled hemorrhagic shock. DESIGN:Randomized controlled study. Duration of follow-up was 24 hrs. SETTING:University research laboratory. SUBJECTS:Adult male Sprague-Dawley r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00025
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To investigate glycemic dynamics and its relation with mortality in critically ill patients. We searched for differences in complexity of the glycemic profile between survivors and nonsurvivors in patients admitted to a multidisciplinary intensive care unit. DESIGN:Prospective, observational study, convenien...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181ce49cf
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVES:The main objective of the study was to determine the prevalence of venous thromboembolism events in patients infected with severe acute respiratory syndrome coronavirus 2 requiring venovenous extracorporeal membrane oxygenation. The secondary objective was to compare venous thromboembolism events and coagula...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004504
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To evaluate knowledge translation after publication of the target temperature management 33°C versus 36°C after out-of-hospital cardiac arrest trial and associated patient outcomes. Our primary hypothesis was that target temperature management at 36°C was rapidly adopted in Australian and New Zealand ICUs. S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003339
更新日期:2018-11-01 00:00:00
abstract::Severe complications sometimes occur in critically ill patients during intrahospital transport. Possible causes may be inadequate ventilation, insufficient monitoring, interrupted application of vasoactive drugs, or disconnections and accidental extubation. We constructed a transport unit equipped with a respirator; c...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199012000-00024
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVE:To determine the financial impact of a sepsis protocol designed for use in the emergency department. DESIGN:Retrospective analysis of a before-after study testing the implications of sepsis protocol. SETTING:Academic, tertiary care hospital in the United States. PATIENTS:Persons with septic shock presentin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000261886.65063.CC
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:Controversy exists regarding the ideal injectate temperature for measuring cardiac output. Iced temperature injectate gives a higher signal/noise ratio and less variability in the measured cardiac output. Thus, less volume and fewer measurements are required. Advocates of room temperature injectate have sugg...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199603000-00021
更新日期:1996-03-01 00:00:00
abstract::Quality improvement (QI) activities have been done as long as medicine has been practiced and are integral to safety and efficacy of patient care. The 20th century witnessed sophisticated advances of QI methods, with concurrent advances in research ethics. The suggestion that some interventional QI activities resemble...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000054902.85329.50
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To evaluate partial occlusion in patients with pulmonary hypertension with regard to a) the degree to which it leads to overestimation of pulmonary artery occlusion pressure (Ppao) and b) identification of factors that could enhance its recognition. DESIGN:Observational descriptive study. SETTING:Medical in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00015
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:To define the role of the intensivist in the initiation and management of patients on extracorporeal membrane oxygenation. DESIGN:Retrospective review of the literature and expert consensus. SETTING:Series of in-person meetings, conference calls, and emails from January 2018 to March 2019. SUBJECTS:A mult...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004330
更新日期:2020-06-01 00:00:00
abstract::Twenty preterm infants in respiratory distress, each with an umbilical catheter in place, were studied during their first 24 h of hospitalization, to determine the effects of continuous transcutaneous oxygen (PtcO2) monitoring on the frequency of arterial blood gas (ABG) determinations and on the incidence of hypoxia ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198402000-00009
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND AND METHODS:In the present study, we evaluated the effect of N-acetylcysteine treatment in a nonseptic shock model induced by zymosan in the rat. Animals were randomly divided into eight groups (ten animals in each group). The first group was treated with ip administration of saline solution (0.90% NaCl) and...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199908000-00021
更新日期:1999-08-01 00:00:00
abstract::This study was performed to determine if particulate material within the pulmonary vascular bed could be sampled by aspirating blood from a wedged pulmonary artery catheter. 99mTechnetium-labeled albumin microspheres (20 micrometers) were injected and embolized into the precapillary pulmonary vasculature of 6 critical...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198304000-00001
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Resuscitation from hemorrhagic shock (HS) predisposes to subsequent infections. Susceptibility to infection following sepsis has been attributed to apoptosis. Interleukin (IL)-6 has been shown to have antiapoptotic properties and to decrease postresuscitation inflammation in rodent and porcine models of HS. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000201901.30292.c2
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:Fibrotic changes are initiated early in acute respiratory distress syndrome. This may involve overproliferation of alveolar type II cells. In an animal model of acute respiratory distress syndrome, we have shown that the administration of an adenoviral vector overexpressing the 70-kd heat shock protein (AdHSP...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000295473.56522.EF
更新日期:2008-01-01 00:00:00
abstract::Doppler ultrasound has been used extensively in assessing adequacy of circulation. We have found it to be convenient in the identification of blood flow, particularly in hypotensive states where percutaneous radial artery cannulation of the vessel is tedious and difficult to perform. The technique is simple, atraumati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197611000-00011
更新日期:1976-11-01 00:00:00
abstract::Significant resistance was encountered when an attempt was made to withdraw a persistently wedged pulmonary artery catheter. A small amount of air was injected into the balloon lumen with great difficulty. This injection freed the catheter which was removed, but produced significant sudden hemoptysis and a pneumothora...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198106000-00013
更新日期:1981-06-01 00:00:00
abstract::Paranasal sinusitis is reported as a complication of prolonged nasal intubation and the source of sepsis in adult intensive care patients. In surgical neonates with congenital malformations, prolonged intubation with a nasotracheal (NT) or NG tube is often necessary, but sinusitis with complicating sepsis is seldom re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00