Background:This study sought to evaluate the role of videoart in decreasing the risk of stress symptoms in patients hospitalized in the intensive care unit(ICU).Methods:This is a prospective observational cohort study...Background:This study sought to evaluate the role of videoart in decreasing the risk of stress symptoms in patients hospitalized in the intensive care unit(ICU).Methods:This is a prospective observational cohort study conducted in a general ICU in which 8 of 18 rooms are equipped with a videoart system.Competent patients who spent at least 48 h in the ICU were asked to complete an Impact of Events Scale(IES)questionnaire during hospitalization and at least 1 year after discharge.Patients were recruited from April 2017 until June 2020,and follow-up phone calls were made from June to August 2021.The primary outcome was an IES score indicative of significant stress symptoms during hospitalization.Secondary outcomes were IES scores indicative of significant stress symptoms after discharge and clinical parameters during hospital stay.The cut-off value for high-risk stress symptoms was 26.However,because there is uncertainty in the literature regarding the desired cut-off value,two other values were also analyzed.Outcomes that were found statistically significant were further examined using a logistic regression model for the control of confounders.Results:Eighty-one patients completed the questionnaire during hospital stay and 24 patients after discharge.At home,patients who were exposed to videoart had a marginally lower mean IES score(median=6[interquartile range:0-18]vs.median=32[interquartile range:10-45],P=0.054)and a significantly lower rate of high-risk stress symptoms using the primary cut-off value(11.8%vs.57.1%,P=0.038;odds ratio=10.0095%CI:1.22 to 81.80,P=0.03).However,statistical significance was lost after adjustment for confounders(odds ratio=12.00,95%CI:0.67 to 222.00,P=0.09).There was no difference in the mean IES score,significant stress symptoms rate,or in any of the other endpoints examined during the hospital stay.Conclusions:There is a trend toward the beneficial effect of videoart for the alleviation of stress symptoms among ICU patients.However,further study is needed to examine the role of this technology.展开更多
Background The Sequential Organ Failure Assessment(SOFA)score,originally designed to reflect disease severity,is now recognized as a prognostic tool for critically ill patients.Recently,calls have emerged to update th...Background The Sequential Organ Failure Assessment(SOFA)score,originally designed to reflect disease severity,is now recognized as a prognostic tool for critically ill patients.Recently,calls have emerged to update the score to better align it with contemporary clinical practice.Methods This single-center,prospective,observational study was conducted in a general intensive care unit(ICU)of a university-affiliated tertiary hospital from September 10,2023,to January 7,2025.Urinary creatinine clearance(CrCl)was calculated daily using 6-h urine collection(CrCl6h)obtained during the first five nights after admission.Based on CrCl and Kidney Disease:ImprovingGlobal Outcomes(KDIGO)chronic kidney disease criteria,patients were categorized into five groups(0−4),with subsequent calculation of a modified SOFA score according to this grouping.The predictive ability of serum creatinine(Scr),urine output,CrCl6h,the original SOFA score,and the modified SOFA score for ICU and 90-day mortality was compared by evaluating their area under the receiver operating characteristic(AUROC)values.Results A total of 200 patients were included in the study.The ICU mortality for these patients was 12.0%while the 90-day mortality reached 29.5%.Compared with Scr,CrCl6h displayed significantly higher AUROC values for mortality prediction on almost all days examined.For example,on day 3,the AUROC values were 0.821 vs.0.730(P=0.003)for ICU mortality,and 0.760 vs.0.662(P=0.002)for 90-day mortality.Similarly,the modified SOFA score showed significantly greater predictive performance on most days assessed.On day 3,the AUROC values were 0.791 vs.0.706(P=0.046)for ICU mortality,and 0.741 vs.0.655(P=0.007)for 90-day mortality.Conclusion The categorization of urinary CrCl based on a 6-h urine collection can improve the ability of the SOFA score for predicting mortality.展开更多
文摘Background:This study sought to evaluate the role of videoart in decreasing the risk of stress symptoms in patients hospitalized in the intensive care unit(ICU).Methods:This is a prospective observational cohort study conducted in a general ICU in which 8 of 18 rooms are equipped with a videoart system.Competent patients who spent at least 48 h in the ICU were asked to complete an Impact of Events Scale(IES)questionnaire during hospitalization and at least 1 year after discharge.Patients were recruited from April 2017 until June 2020,and follow-up phone calls were made from June to August 2021.The primary outcome was an IES score indicative of significant stress symptoms during hospitalization.Secondary outcomes were IES scores indicative of significant stress symptoms after discharge and clinical parameters during hospital stay.The cut-off value for high-risk stress symptoms was 26.However,because there is uncertainty in the literature regarding the desired cut-off value,two other values were also analyzed.Outcomes that were found statistically significant were further examined using a logistic regression model for the control of confounders.Results:Eighty-one patients completed the questionnaire during hospital stay and 24 patients after discharge.At home,patients who were exposed to videoart had a marginally lower mean IES score(median=6[interquartile range:0-18]vs.median=32[interquartile range:10-45],P=0.054)and a significantly lower rate of high-risk stress symptoms using the primary cut-off value(11.8%vs.57.1%,P=0.038;odds ratio=10.0095%CI:1.22 to 81.80,P=0.03).However,statistical significance was lost after adjustment for confounders(odds ratio=12.00,95%CI:0.67 to 222.00,P=0.09).There was no difference in the mean IES score,significant stress symptoms rate,or in any of the other endpoints examined during the hospital stay.Conclusions:There is a trend toward the beneficial effect of videoart for the alleviation of stress symptoms among ICU patients.However,further study is needed to examine the role of this technology.
文摘Background The Sequential Organ Failure Assessment(SOFA)score,originally designed to reflect disease severity,is now recognized as a prognostic tool for critically ill patients.Recently,calls have emerged to update the score to better align it with contemporary clinical practice.Methods This single-center,prospective,observational study was conducted in a general intensive care unit(ICU)of a university-affiliated tertiary hospital from September 10,2023,to January 7,2025.Urinary creatinine clearance(CrCl)was calculated daily using 6-h urine collection(CrCl6h)obtained during the first five nights after admission.Based on CrCl and Kidney Disease:ImprovingGlobal Outcomes(KDIGO)chronic kidney disease criteria,patients were categorized into five groups(0−4),with subsequent calculation of a modified SOFA score according to this grouping.The predictive ability of serum creatinine(Scr),urine output,CrCl6h,the original SOFA score,and the modified SOFA score for ICU and 90-day mortality was compared by evaluating their area under the receiver operating characteristic(AUROC)values.Results A total of 200 patients were included in the study.The ICU mortality for these patients was 12.0%while the 90-day mortality reached 29.5%.Compared with Scr,CrCl6h displayed significantly higher AUROC values for mortality prediction on almost all days examined.For example,on day 3,the AUROC values were 0.821 vs.0.730(P=0.003)for ICU mortality,and 0.760 vs.0.662(P=0.002)for 90-day mortality.Similarly,the modified SOFA score showed significantly greater predictive performance on most days assessed.On day 3,the AUROC values were 0.791 vs.0.706(P=0.046)for ICU mortality,and 0.741 vs.0.655(P=0.007)for 90-day mortality.Conclusion The categorization of urinary CrCl based on a 6-h urine collection can improve the ability of the SOFA score for predicting mortality.
