Browsing by Author "Aldecoa, C"
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- Increased 30-Day Mortality in Very Old ICU Patients with COVID-19 Compared to Patients with Respiratory Failure without COVID-19Publication . Guidet, B; Jung, C; Flaatten, H; Fjølner, J; Artigas, A; Bollen Pinto, B; Schefold, J; Beil, M; Sigal, S; Vernon van Heerden, P; Szczeklik, W; Joannidis, M; Oeyen, S; Kondili, E; Marsh, B; Andersen, F; Moreno, R; Cecconi, M; Leaver, S; De Lange, D; Boumendil, A; Eller, P; Joannidis, M; Mesotten, D; Reper, P; Oeyen, S; Swinnen, W; Brix, H; Brushoej, J; Villefrance, M; Nedergaard, H; Bjerregaard, A; Balleby, I; Andersen, K; Hansen, M; Uhrenholt, S; Bundgaard, H; Fjølner, J; Hussein, A; Salah, R; Ali, Y; Wassim, K; Elgazzar, Y; Tharwat, S; Azzam, A; Habib, A; Abosheaishaa, H; Azab, M; Leaver, S; Galbois, A; Urbina, T; Charron, C; Guerot, E; Besch, G; Rigaud, JP; Maizel, J; Djibré, M; Burtin, P; Garcon, P; Nseir, S; Valette, X; Alexandru, N; Marin, N; Vaissiere, M; Plantefeve, G; Vanderlinden, T; Jurcisin, I; Megarbane, B; Caillard, A; Valent, A; Garnier, M; Besset, S; Oziel, J; Raphalen, J; Dauger, S; Dumas, G; Goncalves, B; Piton, G; Barth, E; Goebel, U; Barth, E; Kunstein, A; Schuster, M; Welte, M; Lutz, M; Meybohm, P; Steiner, S; Poerner, T; Haake, H; Schaller, S; Schaller, S; Schaller, S; Kindgen-Milles, D; Meyer, C; Kurt, M; Kuhn, K; Randerath, W; Wollborn, J; Dindane, Z; Kabitz, H; Voigt, I; Shala, G; Faltlhauser, A; Rovina, N; Aidoni, Z; Chrisanthopoulou, E; Papadogoulas, A; Gurjar, M; Mahmoodpoor, A; Ahmed, A; Marsh, B; Elsaka, A; Sviri, S; Comellini, V; Rabha, A; Ahmed, H; Namendys-Silva, S; Ghannam, A; Groenendijk, M; Zegers, M; de Lange, D; Cornet, A; Evers, M; Haas, L; Dormans, T; Dieperink, W; Romundstad, L; Sjøbø, B; Andersen, F; Strietzel, H; Olasveengen, T; Hahn, M; Czuczwar, M; Gawda, R; Klimkiewicz, J; Santos, ML; Gordinho, A; Santos, H; Assis, R; Oliveira, AI; Badawy, M; Perez-Torres, D; Gomà, G; Villamayor, M; Mira, A; Cubero, P; Rivera, S; Tomasa, T; Iglesias, D; Vázquez, E; Aldecoa, C; Ferreira, A; Zalba-Etayo, B; Canas-Perez, I; Tamayo-Lomas, L; Diaz-Rodriguez, C; Sancho, S; Priego, J; Abualqumboz, E; Hilles, M; Saleh, M; Ben-Hamouda, N; Roberti, A; Dullenkopf, A; Fleury, Y; Pinto, B; Schefold, J; Al-Sadaw, MPurpose: The number of patients ≥ 80 years admitted into critical care is increasing. Coronavirus disease 2019 (COVID-19) added another challenge for clinical decisions for both admission and limitation of life-sustaining treatments (LLST). We aimed to compare the characteristics and mortality of very old critically ill patients with or without COVID-19 with a focus on LLST. Methods: Patients 80 years or older with acute respiratory failure were recruited from the VIP2 and COVIP studies. Baseline patient characteristics, interventions in intensive care unit (ICU) and outcomes (30-day survival) were recorded. COVID patients were matched to non-COVID patients based on the following factors: age (± 2 years), Sequential Organ Failure Assessment (SOFA) score (± 2 points), clinical frailty scale (± 1 point), gender and region on a 1:2 ratio. Specific ICU procedures and LLST were compared between the cohorts by means of cumulative incidence curves taking into account the competing risk of discharge and death. Results: 693 COVID patients were compared to 1393 non-COVID patients. COVID patients were younger, less frail, less severely ill with lower SOFA score, but were treated more often with invasive mechanical ventilation (MV) and had a lower 30-day survival. 404 COVID patients could be matched to 666 non-COVID patients. For COVID patients, withholding and withdrawing of LST were more frequent than for non-COVID and the 30-day survival was almost half compared to non-COVID patients. Conclusion: Very old COVID patients have a different trajectory than non-COVID patients. Whether this finding is due to a decision policy with more active treatment limitation or to an inherent higher risk of death due to COVID-19 is unclear.
- Point Prevalence of Surgical Checklist Use in Europe: Relationship with Hospital MortalityPublication . Jammer, I; Ahmad, T; Aldecoa, C; Koulenti, D; Goranović, T; Grigoras, I; Mazul-Sunko, B; Matos, R; Moreno, R; Sigurdsson, GH; Toft, P; Walder, B; Rhodes, A; Pearse, RMBACKGROUND: The prevalence of use of the World Health Organization surgical checklist is unknown. The clinical effectiveness of this intervention in improving postoperative outcomes is debated. METHODS: We undertook a retrospective analysis of data describing surgical checklist use from a 7 day cohort study of surgical outcomes in 28 European nations (European Surgical Outcomes Study, EuSOS). The analysis included hospitals recruiting >10 patients and excluding outlier hospitals above the 95th centile for mortality. Multivariate logistic regression and three-level hierarchical generalized mixed models were constructed to explore the relationship between surgical checklist use and hospital mortality. Findings are presented as crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: A total of 45 591 patients from 426 hospitals were included in the analysis. A surgical checklist was used in 67.5% patients, with marked variation across countries (0-99.6% of patients). Surgical checklist exposure was associated with lower crude hospital mortality (OR 0.84, CI 0.75-0.94; P=0.002). This effect remained after adjustment for baseline risk factors in a multivariate model (adjusted OR 0.81, CI 0.70-0.94; P<0.005) and strengthened after adjusting for variations within countries and hospitals in a three-level generalized mixed model (adjusted OR 0.71, CI 0.58-0.85; P<0.001). CONCLUSIONS: The use of surgical checklists varies across European nations. Reported use of a checklist was associated with lower mortality. This observation may represent a protective effect of the surgical checklist itself, or alternatively, may be an indirect indicator of the quality of perioperative care.