13 research outputs found
Symptom experience and care needs of Turkish palliative care patients
No full textBackground: Nurses need to focus on supporting patients' quality of life, supporting their families, reducing the morbidity rate, providing psychosocial support services to improve symptom management and delivering high-quality care. Aim: This study aimed to determine the symptom experience and care needs of Turkish patients who received inpatient treatment in palliative care units. Methods: This descriptive research was conducted between May 2019 and May 2020. The study sample was composed of 200 palliative care patients selected using a convenience-purposive sampling method. The personal and disease-related characteristics were collected using the Patient Information Survey and the Functional Assessment of Chronic Illness Therapy-Palliative Care scale. Findings: The mean age of the sample was 75 +/- 15 years, and 56.5% were women. The patients' overall quality of life scores were below average (mean 84.05 +/- 19.44). The functional wellbeing and other concerns subscales of the scale were affected the most adversely. The Physical Wellbeing subscale was affected minimally, while the Emotional Wellbeing and Social Wellbeing subscales were affected moderately. Conclusion: The palliative care patients mostly needed support for the prevention and management of infections, management of respiratory distress and swallowing problems, dealing with confusion and improving compliance with treatment. The low quality of life scores emphasise the importance of urgent interventions for improving the functional wellbeing and symptom management in these patients
Evaluation of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in critical care patients with synthetic cannabinoid (bonzai) intoxication
No full textObjective: Synthetic cannabinoid drug abuse has been dramatically increasing among young individuals in many countries. There have been reports of serious side effects with SC abuse in these patients. Previous researches have exhibited that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with mortality and morbidity in many chronic diseases. The aim of this study was to evaluate PLR and NLR in critical care patients with synthetic cannabinoid (bonzai) intoxication. Materials and methods: One hundred and seven synthetic cannabinoid intoxication patients requiring intensive care and 40 healthy controls were included in the study. Patients characteristics and the complete blood count (CBC) variables, including white blood cell (WBC), hemoglobin (Hb), platelet count, NLR, PLR as well as AST, ALT, albumin total bilirubin, and other routine biochemical parameters were tested. Data analyses were conducted with SPSS-15 software (SPSS Inc., Chicago, Illinois, USA). Statistical significance was set at a p-value of 0.05). All the routine laboratory tests and inflammatory markers (Erythrocyte sedimentation rate and C-reactive protein) were similar between groups. As complete blood cell count; mean WBC values were 9.43 ± 3.27 × 103/mm3 vs 7.05 ± 2.12 × 103/mm3 (p < 0.001), mean platelet counts were 237.33 ± 60 × 103/mm3 vs 263.90 ± 65.98 × 103/mm3 (p = 0.022), NLR counts were 3.17 ± 1.95 vs 2.32 ± 1.27 (p = 0.003) and PLR values were 114.43 ± 36.39 vs 133.94 ± 45.27 (p = 0.008), in patients and controls, respectively. Cardiac side effects were observed among 36 patients but nobody was died. Conclusion: Our results exhibited a significant increase of NLR values and decrease of PLR counts among critical care patients with synthetic cannabinoid (bonzai) intoxication. After at least 24 h of intensive care stay without side effects, the patients might transfer out to inpatient clinic for ongoing follow up period and psychiatric consultation. Keywords: Synthetic cannabinoid, İntoxication, İntensive care unit, Neutrophil to lymphocyte ratio, Platelet to lymphocyte rati
Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV Mortality Prediction Score (IMPRES)
No full textConclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data
Development and validation of a modified quick SOFA scale for risk assessment in sepsis syndrome
No full textSepsis is a severe clinical syndrome owing to its high mortality. Quick Sequential Organ Failure Assessment (qSOFA) score has been proposed for the prediction of fatal outcomes in sepsis syndrome in emergency departments. Due to the low predictive performance of the qSOFA score, we propose a modification to the score by adding age. We conducted a multicenter, retrospective cohort study among regional referral centers from various regions of the country. Participants recruited data of patients admitted to emergency departments and obtained a diagnosis of sepsis syndrome. Crude in-hospital mortality was the primary endpoint. A generalized mixed-effects model with random intercepts produced estimates for adverse outcomes. Model-based recursive partitioning demonstrated the effects and thresholds of significant covariates. Scores were internally validated. The H measure compared performances of scores. A total of 580 patients from 22 centers were included for further analysis. Stages of sepsis, age, time to antibiotics, and administration of carbapenem for empirical treatment were entered the final model. Among these, severe sepsis (OR, 4.40; CIs, 2.35–8.21), septic shock (OR, 8.78; CIs, 4.37–17.66), age (OR, 1.03; CIs, 1.02–1.05) and time to antibiotics (OR, 1.05; CIs, 1.01–1.10) were significantly associated with fatal outcomes. A decision tree demonstrated the thresholds for age. We modified the quick Sequential Organ Failure Assessment (mod-qSOFA) score by adding age (> 50 years old = one point) and compared this to the conventional score. H-measures for qSOFA and mod-qSOFA were found to be 0.11 and 0.14, respectively, whereas AUCs of both scores were 0.64. We propose the use of the modified qSOFA score for early risk assessment among sepsis patients for improved triage and management of this fatal syndrome.</div
Demographics and other features of the cohort.
No full textDemographics and other features of the cohort.</p
Estimates from generalized mixed models with random intercepts.
No full textEstimates from generalized mixed models with random intercepts.</p
The model-based decision tree for fatal outcomes among patients with sepsis syndrome.
No full textThe fatal outcome is first partitioned among stages of sepsis (SOS). Sepsis node partitioned by time to antibiotics, followed by age. Age partitioned severe sepsis and septic shock nodes. Terminal nodes displayed as bar plots giving the percentages of fatal outcomes in the node. Of notice was the patients under 50 years old who received antibiotics within three hours were all survived.</p
Comparative performances of scores.
No full text(A) H measure at different severity ratios. Severity ratio is the ratio of the cost of false positive over the cost of false negative predictions.; (B) Table of H measure, AUC, true positive (TP), false positive (FP), true negative (TN) and false negative (FN) predictions of scores.</p
