Archives

  • 2018-07
  • 2018-10
  • 2018-11
  • 2019-04
  • 2019-05
  • 2019-06
  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-07
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • In terms of outcome based

    2019-06-15

    In terms of outcome-based assessments, we analyzed the primary outcomes in both the 7-day and in-hospital mortality, to evaluate further whether the cause of death would be related to acute illness or chronic comorbidities, and furthermore to ensure care quality in both units. Illness severity and therapeutic intervention at admission to ICU were predictors of short-term mortality, whereas comorbidity was the strongest predictor for long-term mortality. There was no statistical significance in 7-day hospital mortality between the groups, indicating that both units provided equivalent care quality for acute illness management, in spite of higher initial APACHE II Score in the EICU group. The significantly higher in-hospital mortality rate in the atr inhibitor EICU group rather than in the CCU group of patients could be attributed to a higher comorbidity index, and multiple chronic comorbidities, infections, and complications in EICU patients. In this study, APACHE II score was identified as the only common predictor of both EICU and CCU mortality by multiple regression analysis. Further atr inhibitor of APACHE II score demonstrated no statistical significances in both the 7-day and in-hospital survival by Kaplan–Meier analysis (Fig. 2). This result indicates that, in elderly patients with cardiovascular emergency requiring ICU admission, APACHE II score remains an important predictor for mortality. Our study had several limitations. Firstly, the study design is a retrospective analysis, and thus subject to the limitations of all retrospective studies. Secondly, the potential for selection and outcomes bias exists, despite the fact that all admission decisions are the consensus of EPs and cardiologist. Thirdly, we did not comprehensively study all the ED patients admitted to the EICU, without the International Classification of Diseases diagnoses of inclusion criteria. Fourthly, this study was carried out in a single center study at a tertiary teaching medical center. The results may not be generalizable to other settings with differing admission demographics, diseases characteristics, or management practice. Multicenter studies are also needed to evaluate the proposed caring model, focusing on the efficacy and safety in ED settings. This observational study design has introduced a context for hospital-based preadmission criteria: patients with multiple comorbidities were admitted to EICU rather than CCU due to complex chronic diseases exacerbated by acute illness leading to higher mortality. All decisions focusing on where patients were subsequently transferred depended on both the patients\' clinical condition and the judgment of in-charge physicians. Therefore, there would be a probable confounding effect on patient survival. However, we did our best to identify any possible clinical factors with regard to the survival duration between groups (Tables 2–5). To avoid this bias, we used logistic regression models to take into account factors that had some biological plausibility and scientific rationale. A prospective study of two or more centers with similar protocols and managed as a closed unit, but staffed either by ED physicians or non-ED physicians would be informative to address the need for a suitable care model in our health care system.
    Introduction In patients with burn injuries, infection is the most common cause of death. This is due to the fact that burn patients are susceptible and have a high risk for infection.Acinetobacter baumannii has become an important and troubling pathogen in hospitals worldwide, and nosocomial outbreaks have been reported due to multidrug-resistant strains, particularly in the intensive care units and burn units. At patient burn sites, it is difficult to distinguish between colonization and infection with A. baumannii. In fact, this organism is one of the very important causes of infection in these patients, and is isolated with increasing frequency from burn patients. Furthermore, outbreaks of A. baumannii are common in burn units, and the affected patients show a reservoir for this organism. Most typically, carbapenems are the drugs of choice for treatment of A. baumannii infections, but the increased clinical use of these drugs has led to the progress of resistant strains. Carbapenem-resistant A. baumannii has become a problematic nosocomial pathogen globally. In the case of A. baumannii, different mechanisms, including change of penicillin binding protein, loss of outer membrane protein, efflux pump, and carbapenem-hydrolyzing enzymes are involved in carbapenem resistance. It should be noted that carbapenem-inactivating enzymes belonging to the Class D carbapenemase (OXA enzymes) are the main mechanism of resistance in A. baumannii worldwide. However, metallo-beta-lactamase (MBL) production is less common in this organism. For effective control and prevention of A. baumannii in hospitals, molecular typing is necessary to determine genomic fingerprinting. According to previous studies of repetitive extragenic palindromic sequence-based polymerase chain reaction (REP-PCR), in most cases, one or more epidemic clones of A. baumannii are circulating in the studied hospital or burn units. In this study, we decided to investigate antimicrobial resistance pattern, the prevalence of oxacillinase and MBL, and typing of A. baumannii isolates from burn patients.