Towards the prevention of acute lung injury: a population based cohort study protocol

Thakur, Sweta; Trillo-Alvarez, Cesar; Malinchoc, Michael; Kashyap, Rahul; Thakur, Lokendra; Ahmed, Adil; Reriani, Martin; Cartin‐Ceba, Rodrigo; Sloan, Jeff A.; Gajić, Ognjen

doi:10.1186/1471-227x-10-8

Cited by 21 publications

(13 citation statements)

References 34 publications

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“…Additionally, the Single ALI control matched with the above example case was still alive 260 days after their initial hospitalization and never developed ALI. Both controls were individually matched to the index case by age, gender, lung injury prediction score (LIPS) [22–25], the duration of follow up, the year in which their initial hospitalization occurred, and their predisposing conditions at the time of their initial hospitalization including pneumonia, sepsis, trauma, or shock.…”

Section: Methodsmentioning

confidence: 99%

Incidence and risk factors of recurrent acute lung injury*

Bice

Malinchoc

et al. 2011

Critical Care Medicine

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OBJECTIVE-To determine risk factors for development of recurrent acute lung injury (ALI).DESIGN-A population-based case-control study. PATIENTS-Using a validated electronic screening protocol, investigators identified intensive care patients with acute hypoxemia and bilateral pulmonary infiltrates. SETTING-The MEASUREMENTS-The presence of ALI was independently confirmed according to American-European Consensus Conference (AECC) criteria. Recurrent ALI cases were subsequently matched (1:1:1) with two controls (single ALI and no ALI) on age, gender, duration of follow-up, and predisposing conditions. Risk factors evaluated included gastroesophageal reflux disease (GERD), alcohol consumption, smoking, chronic opioid use, and transfusions.MAIN RESULTS-We identified 917 patients with ALI, of which 19 developed a second episode, yielding an incidence of 2.02 (95%CI 1.10-2.93) per 100,000 person years. The median time to development of the second episode was 264 days (IQR 80 -460) days, with a mortality of 47% during the episode. The history of GERD was highly prevalent in patients who developed recurrent ALI: 15/19 patients (79%), compared to 5/19 (26%) matches with single episode of ALI (p=0.006) and 8/19 (42%) matches without ALI (p=0.016). Other exposures were similar between the cases and the two matched controls.CONCLUSIONS-Recurrent ALI is not a rare phenomenon in the ICU, and may continue to increase with improvements in survival following ALI. GERD was identified as an important risk factor for recurrent ALI and may suggest an important role of gastric aspiration in the development of this syndrome.Correspondence and Reprint Request to: Ognjen Gajic, MD, Mayo Clinic,

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Section: Methodsmentioning

confidence: 99%

Incidence and risk factors of recurrent acute lung injury*

Bice

Malinchoc

et al. 2011

Critical Care Medicine

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“…However, as predictive medicine improves, EHRs will become a dynamic tool that may actually improve patient care in real time. Although few studies have analyzed real-time data, studies that have are proven successful (23)(24)(25)(26).…”

Section: Discussionmentioning

confidence: 99%

Near-Term Prediction of Sudden Cardiac Death in Older Hemodialysis Patients Using Electronic Health Records

Goldstein¹,

Chang

Mitani³

et al. 2014

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Sudden cardiac death is the most common cause of death among individuals undergoing hemodialysis. The epidemiology of sudden cardiac death has been well studied, and efforts are shifting to risk assessment. This study aimed to test whether assessment of acute changes during hemodialysis that are captured in electronic health records improved risk assessment. died on the day of or day after a dialysis session that was serving as a training or test data session, respectively. A reasonably strong predictor was derived using just predialysis information (concordance statistic=0.782), which showed modest but significant improvement after inclusion of postdialysis information (concordance statistic=0.799, P,0.001). However, risk prediction decreased the farther out that it was forecasted (up to 1 year), and postdialytic information became less important.Conclusion Subtle changes in the experience of hemodialysis aid in the assessment of sudden cardiac death and are captured by modern electronic health records. The collected data are better for the assessment of near-term risk as opposed to longer-term risk.

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“…While the incidence was lower in other studies like: Gajic et al [65] where the incidence was 6.8% and Elie-Turenne et al [66] where the overall incidence was 7%. This can be explained by the type of collected patients where in the current study and in the study of Trillo-Alvarez et al the study was done in patients who required ICU admission while in the other two studies with the lower incidence rate they were done to inpatient, ICU and ER patients.…”

Section: Discussionmentioning

confidence: 92%

Predictive value of C-reactive protein in critically ill patients who develop acute lung injury

Mahrous

Hassanien

Atta

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Background: Acute lung injury (ALI) is associated with significant mortality and morbidity. C-reactive protein (CRP) level a marker of systematic inflammation is widely-used in numerous clinical conditions, however little is known about the characteristics of CRP levels in patients with ARDS and acute lung injury (ALI).The aim of this work was to examine the plasma level of C-reactive protein (CRP) in patients with acute lung injury (ALI) and its relationship with prognosis, outcome, and severity of illness.Patients and methods: The study was carried out on 100 consecutive patients, who were admitted to the Critical Care Medicine Departments in Alexandria Main University Hospital. Inclusion criteria were patients were aged >18 years who had one or more of the acute lung injury (ALI) predisposing conditions. Patients who developed ALI based on standard definition according to the American-European consensus conference were examined for C-reactive protein levels measured in serum (mg/dl) collected within 48 h after fulfillment of criteria.Results: CRP levels were the highest in patients with complete recovery ranging between 190 and 233 mg/dl with a mean of 211.5 ± 30.406 mg/dl, modest in patients who recovered with residual complications ranging between 107 and 120 with a mean of 111.33 ± 7.506 mg/dl, and lowest in patients who died ranging between 35 and 106 with a mean of 79.55 ± 24.007 mg/dl. Higher CRP levels were significantly associated with better survival (P = 0.000). There was an inverse relationship between CRP levels and duration of mechanical ventilation while ICU stay increased as the CRP levels increased. The relationships between CRP levels and both mechanical ventilation days and ICU stay were statistically non significant (P = 0.710 and 0.801 respectively). CRP levels were lower in patients who developed multiorgan dysfunction syndrome (MODS) with a mean of 76.6 ± 28.778 mg/dl compared to a mean of 111.43 ± 59.332 mg/dl in patients who didn't develop MODS, this relationship was not statistically significant (P = 0.060).Conclusions: Although CRP has widely been considered to be a marker of systemic inflammation, our findings show that higher levels of CRP are associated with decreased mortality, organ failure, and need for mechanical ventilation among patients with ALI.

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Towards the prevention of acute lung injury: a population based cohort study protocol

Cited by 21 publications

References 34 publications

Incidence and risk factors of recurrent acute lung injury*

Incidence and risk factors of recurrent acute lung injury*

Near-Term Prediction of Sudden Cardiac Death in Older Hemodialysis Patients Using Electronic Health Records

Predictive value of C-reactive protein in critically ill patients who develop acute lung injury

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