Abstract:
INTRODUCTION:Recent data have suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region. METHODS:A multi-center retrospective cohort study was performed at five hospitals in Edmonton, Canada, between July 2002 and December 2009. Round-time ICU admission was defined as occurring between 8 and 11:59 a.m. Multivariable logistic regression analysis was used to explore the association between round-time admission and outcome. RESULTS:Of 18,857 unique ICU admissions, 2,055 (10.9%) occurred during round time. Round-time admissions were more frequent in community hospitals compared with tertiary hospitals (12.0% vs. 10.5%; odds ratio [OR] 1.16; 95% CI, 1.05-1.29, P < 0.004) and from the ward compared with the emergency department (ED) or operating theater (17.5% vs. 9.2%; OR 2.1; 95% CI, 1.9-2.3, P < 0.0001). Round-time admissions were more often medical than surgical (12.6% vs. 6.6%; OR 2.06; 95% CI, 1.83-2.31, P < 0.0001), had more comorbid illness (11.9% vs. 10.5%; OR 1.15; 95% CI, 1.04-1.27, P < 0.008) and higher APACHE II score (22.2 vs. 21.3, P < 0.001), and were more likely to have a primary diagnosis of respiratory failure (37.0% vs. 31.3%, P < 0.001) or sepsis (11.1% vs. 9.0%, P = 0.002). Crude ICU mortality (15.3% vs. 11.6%; OR 1.38; 95% CI, 1.21-1.57, P < 0.0001) and hospital mortality (23.9% vs. 20.6%; OR 1.21; 95% CI, 1.09-1.35, P < 0.001) were higher for round-time compared with non-round-time admissions. In multi-variable analysis, round-time admission was associated with increased ICU mortality (OR 1.19, 95% CI, 1.03-1.38, P = 0.017) but was not significantly associated with hospital mortality (OR 1.02; 95% CI, 0.90-1.16, P = 0.700). In the subgroup admitted from the ED, round-time admission showed significantly higher ICU mortality (OR 1.54; 95% CI, 1.21-1.95; P < 0.001) and a trend for higher hospital mortality (OR 1.22; 95% CI, 0.99-1.51, P = 0.057). CONCLUSIONS:Approximately 1 in 10 patients is admitted during morning rounds. These patients are more commonly admitted from the ward and are burdened by comorbidities, are non-operative, and have higher illness severity. These patients admitted during morning rounds have higher observed ICU mortality but no difference in hospital mortality.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
de Souza IA,Karvellas CJ,Gibney RT,Bagshaw SMdoi
10.1186/cc11329subject
Has Abstractpub_date
2012-05-03 00:00:00pages
R72issue
3eissn
1364-8535issn
1466-609Xpii
cc11329journal_volume
16pub_type
杂志文章,多中心研究相关文献
CRITICAL CARE文献大全abstract:INTRODUCTION:The respiratory variation in pulse pressure (PP) has been established as a dynamic variable of cardiac preload which indicates fluid responsiveness in mechanically ventilated patients. The impact of acute changes in cardiac performance on respiratory fluctuations in PP has not been evaluated until now. We ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc5779
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Due to resource limitations, few critical care interventions have been rigorously evaluated with adequately powered randomized clinical trials (RCTs). There is a need to improve the efficiency of RCTs in critical care so that more definitive high quality RCTs can be completed with the available resources. ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc10110
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Our understanding of septic acute kidney injury (AKI) remains incomplete. A fundamental step is the use of animal models designed to meet the criteria of human sepsis. Therefore, we dynamically assessed renal haemodynamic, microvascular and metabolic responses to, and ultrastructural sequelae of, sepsis in...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7164
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Pre-hospital triage is a key element in a trauma system that aims to admit patients to the most suitable trauma center, and may decrease intra-hospital mortality. We evaluated the performance of a pre-hospital procedure in a regional trauma system through measurements of the quality of pre-hospital medical...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0835-7
更新日期:2015-03-18 00:00:00
abstract:INTRODUCTION:Between 1 and 31% of patients suffering out-of-hospital cardiac arrest (OHCA) survive to discharge from hospital. International studies have shown that the level of care provided by the admitting hospital determines survival for patients suffering from OHCA. These data may only be partially transferable to...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11516
更新日期:2012-09-12 00:00:00
abstract::Certain noble gases, though inert, exhibit remarkable biological properties. Notably, xenon and argon provide neuroprotection in animal models of central nervous system injury. In the previous issue of Critical Care, Loetscher and colleagues provided further evidence that argon may have therapeutic properties for neur...
journal_title:Critical care (London, England)
pub_type: 评论,信件
doi:10.1186/cc8847
更新日期:2010-01-01 00:00:00
abstract::Using biomarkers as a guide to tailor the duration of antibiotic treatment in respiratory infections is an attractive hypothesis assessed in several studies. Recent work aiming to summarize the evidence assessed the effect of a procalcitonin (PCT)-guided antibiotic treatment on outcomes in acute lower respiratory trac...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-018-1948-6
更新日期:2018-01-27 00:00:00
abstract::The early recognition and management of sepsis remain the greatest challenges in the field of critical care medicine. Endothelial injury is one of the hallmarks of sepsis, leading to capillary leak, microcirculatory dysfunction, organ failure, and eventual death in many critically ill patients. The angiogenic growth f...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章,评审
doi:10.1186/cc7685
更新日期:2009-01-01 00:00:00
abstract::Acute hyperglycaemia has been associated with complications, prolonged intensive care unit and hospital stay, and increased mortality. We made an inventory of the prevalence and prognostic value of hyperglycaemia, and of the effects of glucose control in different groups of critically ill patients. The prevalence of h...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc4957
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Fractalkine is a chemokine implicated as a mediator in a variety of inflammatory conditions. Knowledge of fractalkine release in patients presenting with infection to the Intensive Care Unit (ICU) is highly limited. The primary objective of this study was to establish whether plasma fractalkine levels are ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-1125-0
更新日期:2015-11-25 00:00:00
abstract:INTRODUCTION:This prospective, randomized, controlled, experimental animal study looks at the effects of recombinant human activated protein C (rhAPC) on global hemodynamics and microcirculation in ovine acute lung injury (ALI) and septic shock, resulting from smoke inhalation injury. METHODS:Twenty-one sheep (37 ± 2 ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc9342
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine hospital mortality, long-term mortality, and health service utilization among critically ill patients. We also determined whether these outcomes differed according to demographic and clinical characteristics. METHODS:We conducted a retrospective cohort study of adult...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1248-y
更新日期:2016-03-31 00:00:00
abstract:INTRODUCTION:The aetiology of lower respiratory tract infections in young children admitted to the paediatric intensive care unit (PICU) is often difficult to establish. However, most infections are believed to be caused by respiratory viruses. A diagnostic study was performed to compare conventional viral tests with t...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc4895
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Delayed patient admission to the intensive care unit (ICU) due to lack of bed availability is a common problem, but the effect on patient outcome is not fully known. METHODS:A retrospective study was performed using departmental computerised records to determine the effect of delayed ICU admission and tem...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11650
更新日期:2012-10-01 00:00:00
abstract:INTRODUCTION:Resuscitation with saline is a standard initial response to hypotension or shock of almost any cause. Saline resuscitation is thought to generate an increase in cardiac output through a preload-dependent (increased end-diastolic volume) augmentation of stroke volume. We sought to confirm this to be the mec...
journal_title:Critical care (London, England)
pub_type: 临床试验,杂志文章
doi:10.1186/cc2844
更新日期:2004-06-01 00:00:00
abstract:INTRODUCTION:Lowering of hyperglycemia in the intensive care unit (ICU) is widely practiced. We investigated in which way glucose regulation, defined as mean glucose concentration during admission, is associated with ICU mortality in a medical and a surgical cohort. METHODS:Retrospective database cohort study includin...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9369
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:The endothelial specific angiopoietin (Ang)-Tie2 ligand-receptor system has been identified as a non-redundant mediator of endothelial activation in experimental sepsis. Binding of circulating Ang-1 to the Tie2 receptor protects the vasculature from inflammation and leakage, whereas binding of Ang-2 antago...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7130
更新日期:2008-01-01 00:00:00
abstract::In the publication of this article [1], there are 4 collaborating authors missing from the 'MARS consortium'. This has now been included in this correction article. ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,已发布勘误
doi:10.1186/s13054-020-2758-1
更新日期:2020-02-06 00:00:00
abstract:INTRODUCTION:Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. We evaluated the value of PCT as a marker of bacterial infection for emergency department patients. METHODS:This prospective observational study consecutively enrol...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc2396
更新日期:2004-02-01 00:00:00
abstract:INTRODUCTION:As a result of drug sequestration and increased volume of distribution, the extracorporeal membrane oxygenation (ECMO) procedure might lead to a decrease in drug concentrations during a patient's treatment. The aim of this study was to evaluate sedative, antibiotic and immunosuppressive drug loss in ECMO c...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0772-5
更新日期:2015-02-12 00:00:00
abstract:INTRODUCTION:We report a case of twin toddlers who both suffered near drowning but with different post-trauma treatment and course, and different neurological outcomes. METHODS AND RESULTS:Two twin toddlers (a boy and girl, aged 2 years and 3 months) suffered hypothermic near drowning with protracted cardiac arrest an...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc2926
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. METHODS:Retrospective case series of COVID-19 patien...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-02895-6
更新日期:2020-04-30 00:00:00
abstract::In the previous issue of Critical Care, Meybohm and colleagues provide evidence to support hypothermia as a kind of therapeutic option for patients suffering cardiac arrest. Although anesthetics had been used to induce hypothermia, sevoflurane post-conditioning fails to confer additional anti-inflammatory effects afte...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc8923
更新日期:2010-01-01 00:00:00
abstract::Outcomes studies of infections with resistant bacteria often do not account appropriately for intermediate variables--events in the causal pathway between the exposure and the outcome--when controlling for confounders. We discuss how failure to distinguish between confounders and intermediate variables can bias the an...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc5019
更新日期:2006-01-01 00:00:00
abstract:: ...
journal_title:Critical care (London, England)
pub_type: 评论,信件
doi:10.1186/s13054-018-2297-1
更新日期:2019-01-09 00:00:00
abstract::Impairment of the protein C pathway plays a central role in the pathogenesis of sepsis. Administration of recombinant human activated protein C (rhAPC) may correct the dysregulated anticoagulant mechanism and prevent propagation of thrombin generation and formation of microvascular thrombosis. Furthermore, it may simu...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc6154
更新日期:2007-01-01 00:00:00
abstract::Those involved in the airway management of COVID-19 patients are particularly at risk. Here, we describe a practical, stepwise protocol for safe in-hospital airway management in patients with suspected or confirmed COVID-19 infection. ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-020-03018-x
更新日期:2020-06-05 00:00:00
abstract:BACKGROUND:Accurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user c...
journal_title:Critical care (London, England)
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/s13054-018-2037-6
更新日期:2018-05-05 00:00:00
abstract:INTRODUCTION:Prothrombin complex concentrates (PCC) are haemostatic blood preparations indicated for urgent anticoagulation reversal, though the optimal dose for effective reversal is still under debate. The latest generation of PCCs include four coagulation factors, the so-called 4-factor PCC. The aim of this study wa...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/cc11923
更新日期:2013-01-10 00:00:00
abstract:BACKGROUND:There are no easily available markers of renal recovery to guide intermittent hemodialysis (IHD) weaning. The aim of this study was to identify markers for IHD weaning in critically ill patients with acute kidney injury (AKI). METHODS:We performed a retrospective single-center cohort study of patients treat...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1225-5
更新日期:2016-02-19 00:00:00