Intro duc tion: sur gi cal site in fec tion in li ver trans plant re sults in high mor bi mor ta ... more Intro duc tion: sur gi cal site in fec tion in li ver trans plant re sults in high mor bi mor ta lity for the se patients. Objec ti ve: to learn about the in ci den ce of sur gi cal si te in fec tion, iden tify the mi croor ga nisms in vol ved and the fac tors that fa vor it with the pur po se of op ti mi zing our proph ylac tic strategies. Met hod: cohort study whe re pa tients with li ver trans plant we re pros pec ti vely in clu ded in our na tio nal da ta ba se. Pe riod of study: July 14, 2009 through May 31, 2013. Sta tis ti cal analy sis: we used chi squa red test. If the va lue in the con tin gency ta ble was lo wer than or equal to 5 we used the exact Fis her test. Va lues p < 0,05 we re considered significant. Re sults: sixty-fi ve pa tients un der went trans plant du ring this pe riod. Re la ti ve fre quency ac cu mu la ted for sur gi cal si te in fec tion was 12 pa tients (18.46%); tem po ral dis tri bu tion evi den ces in ci den ce grew in the last 12 months du ring w...
Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most dat... more Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most data on its epidemiology is from single-center studies. Our aim was to conduct a multicenter study to evaluate the epidemiology of delirium in the ICU. Methods: A 1-day point-prevalence study was undertaken in 104 ICUs from 11 countries in South and North America and Spain. Results: In total, 975 patients were screened, and 497 fulfilled inclusion criteria and were enrolled (median age, 62 years; 52.5% men; 16.7% and 19.9% for ICU and hospital mortality); 64% were admitted to the ICU because of medical causes, and sepsis was the main diagnosis (n = 76; 15.3%). In total, 265 patients were sedated with the Richmond agitation and sedation scale (RASS) deeper than-3, and only 232 (46.6%) patients could be evaluated with the confusion-assessment method for the ICU. The prevalence of delirium was 32.3%. Compared with patients without delirium, those with the diagnosis of delirium had a greater severity of illness at admission, demonstrated by higher sequential organ-failure assessment (SOFA (P = 0.004)) and simplified acute physiology score 3 (SAPS3) scores (P < 0.0001). Delirium was associated with increased ICU (20% versus 5.7%; P = 0.002) and hospital mortality (24 versus 8.3%; P = 0.0017), and longer ICU (P < 0.0001) and hospital length of stay (LOS) (22 (11 to 40) versus 7 (4 to 18) days; P < 0.0001). Previous use of midazolam (P = 0.009) was more frequent in patients with delirium. On multivariate analysis, delirium was independently associated with increased ICU mortality (OR = 3.14 (1.26 to 7.86); CI, 95%) and hospital mortality (OR = 2.5 (1.1 to 5.7); CI, 95%). Conclusions: In this 1-day international study, delirium was frequent and associated with increased mortality and ICU LOS. The main modifiable risk factors associated with the diagnosis of delirium were the use of invasive devices and sedatives (midazolam).
Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most dat... more Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most data on its epidemiology is from single-center studies. Our aim was to conduct a multicenter study to evaluate the epidemiology of delirium in the ICU. Methods: A 1-day point-prevalence study was undertaken in 104 ICUs from 11 countries in South and North America and Spain. Results: In total, 975 patients were screened, and 497 fulfilled inclusion criteria and were enrolled (median age, 62 years; 52.5% men; 16.7% and 19.9% for ICU and hospital mortality); 64% were admitted to the ICU because of medical causes, and sepsis was the main diagnosis (n = 76; 15.3%). In total, 265 patients were sedated with the Richmond agitation and sedation scale (RASS) deeper than -3, and only 232 (46.6%) patients could be evaluated with the confusion-assessment method for the ICU. The prevalence of delirium was 32.3%. Compared with patients without delirium, those with the diagnosis of delirium had a greater severity of illness at admission, demonstrated by higher sequential organ-failure assessment (SOFA (P = 0.004)) and simplified acute physiology score 3 (SAPS3) scores (P < 0.0001). Delirium was associated with increased ICU (20% versus 5.7%; P = 0.002) and hospital mortality (24 versus 8.3%; P = 0.0017), and longer ICU (P < 0.0001) and hospital length of stay (LOS) (22 (11 to 40) versus 7 (4 to 18) days; P < 0.0001). Previous use of midazolam (P = 0.009) was more frequent in patients with delirium. On multivariate analysis, delirium was independently associated with increased ICU mortality (OR = 3.14 (1.26 to 7.86); CI, 95%) and hospital mortality (OR = 2.5 (1.1 to 5.7); CI, 95%). Conclusions: In this 1-day international study, delirium was frequent and associated with increased mortality and ICU LOS. The main modifiable risk factors associated with the diagnosis of delirium were the use of invasive devices and sedatives (midazolam).
Intro duc tion: sur gi cal site in fec tion in li ver trans plant re sults in high mor bi mor ta ... more Intro duc tion: sur gi cal site in fec tion in li ver trans plant re sults in high mor bi mor ta lity for the se patients. Objec ti ve: to learn about the in ci den ce of sur gi cal si te in fec tion, iden tify the mi croor ga nisms in vol ved and the fac tors that fa vor it with the pur po se of op ti mi zing our proph ylac tic strategies. Met hod: cohort study whe re pa tients with li ver trans plant we re pros pec ti vely in clu ded in our na tio nal da ta ba se. Pe riod of study: July 14, 2009 through May 31, 2013. Sta tis ti cal analy sis: we used chi squa red test. If the va lue in the con tin gency ta ble was lo wer than or equal to 5 we used the exact Fis her test. Va lues p < 0,05 we re considered significant. Re sults: sixty-fi ve pa tients un der went trans plant du ring this pe riod. Re la ti ve fre quency ac cu mu la ted for sur gi cal si te in fec tion was 12 pa tients (18.46%); tem po ral dis tri bu tion evi den ces in ci den ce grew in the last 12 months du ring w...
Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most dat... more Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most data on its epidemiology is from single-center studies. Our aim was to conduct a multicenter study to evaluate the epidemiology of delirium in the ICU. Methods: A 1-day point-prevalence study was undertaken in 104 ICUs from 11 countries in South and North America and Spain. Results: In total, 975 patients were screened, and 497 fulfilled inclusion criteria and were enrolled (median age, 62 years; 52.5% men; 16.7% and 19.9% for ICU and hospital mortality); 64% were admitted to the ICU because of medical causes, and sepsis was the main diagnosis (n = 76; 15.3%). In total, 265 patients were sedated with the Richmond agitation and sedation scale (RASS) deeper than-3, and only 232 (46.6%) patients could be evaluated with the confusion-assessment method for the ICU. The prevalence of delirium was 32.3%. Compared with patients without delirium, those with the diagnosis of delirium had a greater severity of illness at admission, demonstrated by higher sequential organ-failure assessment (SOFA (P = 0.004)) and simplified acute physiology score 3 (SAPS3) scores (P < 0.0001). Delirium was associated with increased ICU (20% versus 5.7%; P = 0.002) and hospital mortality (24 versus 8.3%; P = 0.0017), and longer ICU (P < 0.0001) and hospital length of stay (LOS) (22 (11 to 40) versus 7 (4 to 18) days; P < 0.0001). Previous use of midazolam (P = 0.009) was more frequent in patients with delirium. On multivariate analysis, delirium was independently associated with increased ICU mortality (OR = 3.14 (1.26 to 7.86); CI, 95%) and hospital mortality (OR = 2.5 (1.1 to 5.7); CI, 95%). Conclusions: In this 1-day international study, delirium was frequent and associated with increased mortality and ICU LOS. The main modifiable risk factors associated with the diagnosis of delirium were the use of invasive devices and sedatives (midazolam).
Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most dat... more Introduction: Delirium is a frequent source of morbidity in intensive care units (ICUs). Most data on its epidemiology is from single-center studies. Our aim was to conduct a multicenter study to evaluate the epidemiology of delirium in the ICU. Methods: A 1-day point-prevalence study was undertaken in 104 ICUs from 11 countries in South and North America and Spain. Results: In total, 975 patients were screened, and 497 fulfilled inclusion criteria and were enrolled (median age, 62 years; 52.5% men; 16.7% and 19.9% for ICU and hospital mortality); 64% were admitted to the ICU because of medical causes, and sepsis was the main diagnosis (n = 76; 15.3%). In total, 265 patients were sedated with the Richmond agitation and sedation scale (RASS) deeper than -3, and only 232 (46.6%) patients could be evaluated with the confusion-assessment method for the ICU. The prevalence of delirium was 32.3%. Compared with patients without delirium, those with the diagnosis of delirium had a greater severity of illness at admission, demonstrated by higher sequential organ-failure assessment (SOFA (P = 0.004)) and simplified acute physiology score 3 (SAPS3) scores (P < 0.0001). Delirium was associated with increased ICU (20% versus 5.7%; P = 0.002) and hospital mortality (24 versus 8.3%; P = 0.0017), and longer ICU (P < 0.0001) and hospital length of stay (LOS) (22 (11 to 40) versus 7 (4 to 18) days; P < 0.0001). Previous use of midazolam (P = 0.009) was more frequent in patients with delirium. On multivariate analysis, delirium was independently associated with increased ICU mortality (OR = 3.14 (1.26 to 7.86); CI, 95%) and hospital mortality (OR = 2.5 (1.1 to 5.7); CI, 95%). Conclusions: In this 1-day international study, delirium was frequent and associated with increased mortality and ICU LOS. The main modifiable risk factors associated with the diagnosis of delirium were the use of invasive devices and sedatives (midazolam).
Uploads
Papers by Gustavo Grecco