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3. Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial

Author

Michi, Teresa, Mattana, Chiara, Menga, Luca S., Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore L., Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, and Antonelli, Massimo

Published
2023
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4. Impact of Anti-SARS-CoV-2 Vaccination on Disease Severity and Clinical Outcomes of Individuals Hospitalized for COVID-19 Throughout Successive Pandemic Waves: Data from an Italian Reference Hospital.

Author

Mondi, Annalisa, Mastrorosa, Ilaria, Navarra, Assunta, Cimaglia, Claudia, Pinnetti, Carmela, Mazzotta, Valentina, Agresta, Alessandro, Corpolongo, Angela, Zolezzi, Alberto, Al Moghazi, Samir, Loiacono, Laura, Bocci, Maria Grazia, Matusali, Giulia, D'Annunzio, Alberto, Gallì, Paola, Maggi, Fabrizio, Vairo, Francesco, Girardi, Enrico, and Antinori, Andrea

Subjects
BOOSTER vaccines, VACCINE effectiveness, VACCINATION status, COVID-19, COVID-19 vaccines
Abstract

This is a retrospective observational study including all COVID-19 patients admitted at our Institute throughout three successive pandemic waves, from January 2021 to June 2023. The main in-hospital outcomes (clinical progression [CP], defined as admission to Intensive Care Unit [ICU]/death, and death within 28 days) were compared among participants unvaccinated (NV), fully vaccinated (FV), with one (FV&B1) and two (FV&B2) booster doses. Vaccinated participants were stratified into recently and waned FV/FV&B1/FV&B2, depending on the time elapsed from last dose (≤ and >120 days, respectively). There were 4488 participants: 2224 NV, 674 FV, 1207 FV&B1, and 383 FV&B2. Within 28 days, there were 604 ICU admissions, 396 deaths, and 737 CP. After adjusting for the main confounders, the risk of both in-hospital outcomes was reduced in vaccinated individuals, especially in those who received the booster dose (approximately by 36% for FV and >50% for FV&B1 and FV&B2 compared to NV). Similarly, after restricting the analysis to vaccinated participants only, we observed a risk reduction of approximately 40% for FV&B1 and 50% for FV&B2, compared to FV, regardless of the distance since the last dose. Our data confirm the vaccine's effectiveness in preventing severe COVID-19 and support the efforts to increase the uptake of booster doses, mainly among older and frailer individuals, still at a greater risk of clinical progression. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Predictors of Mortality and Orotracheal Intubation in Patients with Pulmonary Barotrauma Due to COVID-19: An Italian Multicenter Observational Study during Two Years of the Pandemic

Author

Tetaj, Nardi, primary, De Pascale, Gennaro, additional, Antonelli, Massimo, additional, Vargas, Joel, additional, Savino, Martina, additional, Pugliese, Francesco, additional, Alessandri, Francesco, additional, Giordano, Giovanni, additional, Tozzi, Pierfrancesco, additional, Rocco, Monica, additional, Biava, Anna Maria, additional, Maggi, Luigi, additional, Pisapia, Raffaella, additional, Fusco, Francesco Maria, additional, Stazi, Giulia Valeria, additional, Garotto, Gabriele, additional, Marini, Maria Cristina, additional, Piselli, Pierluca, additional, Beccacece, Alessia, additional, Mariano, Andrea, additional, Giancola, Maria Letizia, additional, Ianniello, Stefania, additional, Vaia, Francesco, additional, Girardi, Enrico, additional, Antinori, Andrea, additional, Bocci, Maria Grazia, additional, Marchioni, Luisa, additional, and Nicastri, Emanuele, additional

Published
2024
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6. Machine learning using the extreme gradient boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients

Author

Alfaro-Farias, Mario, Vizmanos-Lamotte, Gerardo, Tschoellitsch, Thomas, Meier, Jens, Aguirre-Bermeo, Hernán, Apolo, Janina, Martínez, Alberto, Jurkolow, Geoffrey, Delahaye, Gauthier, Novy, Emmanuel, Losser, Marie-Reine, Wengenmayer, Tobias, Rilinger, Jonathan, Staudacher, Dawid L., David, Sascha, Welte, Tobias, Stahl, Klaus, Pavlos”, “Agios, Aslanidis, Theodoros, Korsos, Anita, Babik, Barna, Nikandish, Reza, Rezoagli, Emanuele, Giacomini, Matteo, Nova, Alice, Fogagnolo, Alberto, Spadaro, Savino, Ceriani, Roberto, Murrone, Martina, Wu, Maddalena A., Cogliati, Chiara, Colombo, Riccardo, Catena, Emanuele, Turrini, Fabrizio, Simonini, Maria Sole, Fabbri, Silvia, Potalivo, Antonella, Facondini, Francesca, Gangitano, Gianfilippo, Perin, Tiziana, Grazia Bocci, Maria, Antonelli, Massimo, Gommers, Diederik, Rodríguez-García, Raquel, Gámez-Zapata, Jorge, Taboada-Fraga, Xiana, Castro, Pedro, Tellez, Adrian, Lander-Azcona, Arantxa, Escós-Orta, Jesús, Martín-Delgado, Maria C., Algaba-Calderon, Angela, Franch-Llasat, Diego, Roche-Campo, Ferran, Lozano-Gómez, Herminia, Zalba-Etayo, Begoña, Michot, Marc P., Klarer, Alexander, Ensner, Rolf, Schott, Peter, Urech, Severin, Zellweger, Nuria, Merki, Lukas, Lambert, Adriana, Laube, Marcus, Jeitziner, Marie M., Jenni-Moser, Beatrice, Wiegand, Jan, Yuen, Bernd, Lienhardt-Nobbe, Barbara, Westphalen, Andrea, Salomon, Petra, Drvaric, Iris, Hillgaertner, Frank, Sieber, Marianne, Dullenkopf, Alexander, Petersen, Lina, Chau, Ivan, Ksouri, Hatem, Sridharan, Govind Oliver, Cereghetti, Sara, Boroli, Filippo, Pugin, Jerome, Grazioli, Serge, Rimensberger, Peter C., Bürkle, Christian, Marrel, Julien, Brenni, Mirko, Fleisch, Isabelle, Lavanchy, Jerome, Perez, Marie-Helene, Ramelet, Anne-Sylvie, Weber, Anja Baltussen, Gerecke, Peter, Christ, Andreas, Ceruti, Samuele, Glotta, Andrea, Marquardt, Katharina, Shaikh, Karim, Hübner, Tobias, Neff, Thomas, Redecker, Hermann, Moret-Bochatay, Mallory, Bentrup, FriederikeMeyer zu, Studhalter, Michael, Stephan, Michael, Brem, Jan, Gehring, Nadine, Selz, Daniela, Naon, Didier, Kleger, Gian-Reto, Pietsch, Urs, Filipovic, Miodrag, Ristic, Anette, Sepulcri, Michael, Heise, Antje, Franchitti Laurent, Marilene, Laurent, Jean-Christophe, Wendel Garcia, Pedro D., Schuepbach, Reto, Heuberger, Dorothea, Bühler, Philipp, Brugger, Silvio, Fodor, Patricia, Locher, Pascal, Camen, Giovanni, Gaspert, Tomislav, Jovic, Marija, Haberthuer, Christoph, Lussman, Roger F., Colak, Elif, Montomoli, Jonathan, Romeo, Luca, Moccia, Sara, Bernardini, Michele, Migliorelli, Lucia, Berardini, Daniele, Donati, Abele, Carsetti, Andrea, Bocci, Maria Grazia, Wendel Garcia, Pedro David, Fumeaux, Thierry, Guerci, Philippe, Schüpbach, Reto Andreas, Ince, Can, Frontoni, Emanuele, and Hilty, Matthias Peter

Published
2021
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7. A novel risk score predicting 30-day hospital re-admission of patients with acute stroke by machine learning model

Author

Mercurio, Giovanna, Gottardelli, Benedetta, Lenkowicz, Jacopo, Patarnello, Stefano, Bellavia, Simone, Scala, Irene, Rizzo, Pierandrea, de Belvis, Antonio Giulio, Del Signore, Anna Benedetta, Maviglia, Riccardo, Bocci, Maria Grazia, Olivi, Alessandro, Franceschi, Francesco, Urbani, Andrea, Calabresi, Paolo, Valentini, Vincenzo, Antonelli, Massimo, Frisullo, Giovanni, Olivi, Alessandro (ORCID:0000-0002-4489-7564), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Urbani, Andrea (ORCID:0000-0001-9168-3174), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Mercurio, Giovanna, Gottardelli, Benedetta, Lenkowicz, Jacopo, Patarnello, Stefano, Bellavia, Simone, Scala, Irene, Rizzo, Pierandrea, de Belvis, Antonio Giulio, Del Signore, Anna Benedetta, Maviglia, Riccardo, Bocci, Maria Grazia, Olivi, Alessandro, Franceschi, Francesco, Urbani, Andrea, Calabresi, Paolo, Valentini, Vincenzo, Antonelli, Massimo, Frisullo, Giovanni, Olivi, Alessandro (ORCID:0000-0002-4489-7564), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Urbani, Andrea (ORCID:0000-0001-9168-3174), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

Background: The 30-day hospital re-admission rate is a quality measure of hospital care to monitor the efficiency of the healthcare system. The hospital re-admission of acute stroke (AS) patients is often associated with higher mortality rates, greater levels of disability and increased healthcare costs. The aim of our study was to identify predictors of unplanned 30-day hospital re-admissions after discharge of AS patients and define an early re-admission risk score (RRS).Methods: This observational, retrospective study was performed on AS patients who were discharged between 2014 and 2019. Early re-admission predictors were identified by machine learning models. The performances of these models were assessed by receiver operating characteristic curve analysis.Results: Of 7599 patients with AS, 3699 patients met the inclusion criteria, and 304 patients (8.22%) were re-admitted within 30 days from discharge. After identifying the predictors of early re-admission by logistic regression analysis, RRS was obtained and consisted of seven variables: hemoglobin level, atrial fibrillation, brain hemorrhage, discharge home, chronic obstructive pulmonary disease, one and more than one hospitalization in the previous year. The cohort of patients was then stratified into three risk categories: low (RRS = 0-1), medium (RRS = 2-3) and high (RRS >3) with re-admission rates of 5%, 8% and 14%, respectively.Conclusions: The identification of risk factors for early re-admission after AS and the elaboration of a score to stratify at discharge time the risk of re-admission can provide a tool for clinicians to plan a personalized follow-up and contain healthcare costs.

Published
2024

8. Prognostic factors associated with mortality risk and disease progression in 639 critically ill patients with COVID-19 in Europe: Initial report of the international RISC-19-ICU prospective observational cohort

Author

Alfaro Farias, Mario, Margarit, Antoni, Vizmanos-Lamotte, Gerardo, Tschoellitsch, Thomas, Meier, Jens, Cardona, Francesco S., Skola, Josef, Horakova, Lenka, Aguirre-Bermeo, Hernan, Apolo, Janina, Novy, Emmanuel, Losser, Marie-Reine, Jurkolow, Geoffrey, Delahaye, Gauthier, David, Sascha, Welte, Tobias, Wengenmayer, Tobias, Staudacher, Dawid L., Aslanidis, Theodoros, Babik, Barna, Korsos, Anita, Gal, Janos, Csaba, Hermann, Donati, Abele, Carsetti, Andrea, Turrini, Fabrizio, Simonini, Maria Sole, Ceriani, Roberto, Murrone, Martina, Rezoagli, Emanuele, Vitale, Giovanni, Fogagnolo, Alberto, Spadaro, Savino, Wu, Maddalena Alessandra, Cogliati, Chiara, Colombo, Riccardo, Catena, Emanuele, Facondini, Francesca, Potalivo, Antonella, Gangitano, Gianfilippo, Perin, Tiziana, Bocci, Maria Grazia, Antonelli, Massimo, Gommers, Diederik, Ince, Can, Mayor-Vázquez, Eric, Cruz, Maria, Delgado, Martin, Garcia, Raquel Rodriguez, Gamez Zapata, Jorge, Zalba-Etayo, Begoña, Lozano-Gomez, Herminia, Castro, Pedro, Tellez, Adrian, Jacas, Adriana, Muñoz, Guido, Andrea, Rut, Ortiz, Jose, Quintana, Eduard, Rovira, Irene, Reverter, Enric, Fernandez, Javier, Ferrer, Miquel, Badia, Joan R., Lander Azcona, Arantxa, Orta, Jesus Escos, Bühler, Philipp, Brugger, Silvio, Hofmaenner, Daniel, Unseld, Simone, Ruschitzka, Frank, Moret-Bochatay, Mallory, Yuen, Bernd, Hillermann, Thomas, Ksouri, Hatem, Sridharan, Govind Oliver, Ristic, Anette, Sepulcri, Michael, Filipovic, Miodrag, Pietsch, Urs, Salomon, Petra, Drvaric, Iris, Schott, Peter, Urech, Severin, Lambert, Adriana, Merki, Lukas, Laube, Marcus, Hillgaertner, Frank, Sieber, Marianne, Dullenkopf, Alexander, Petersen, Lina, Grazioli, Serge, Rimensberger, Peter C., Fleisch, Isabelle, Lavanchy, Jerome, Marquardt, Katharina, Shaikh, Karim, Redecker, Hermann, Stephan, Michael, Brem, Jan, Rogdo, Bjarte, Birkenmaier, Andre, Meyer zu Bentrup, Friederike, Fodor, Patricia, Locher, Pascal, Camen, Giovanni, Siegemund, Martin, Zellweger, Nuria, Jeitziner, Marie-Madlen, Jenni-Moser, Beatrice, Bürkle, Christian, Kleger, Gian-Reto, Franchitti Laurent, Marilene, Laurent, Jean-Christophe, Gaspert, Tomislav, Jovic, Marija, Studhalter, Michael, Haberthuer, Christoph, Lussman, Roger F., Selz, Daniela, Naon, Didier, Mauri, Romano, Ceruti, Samuele, Marrel, Julien, Brenni, Mirko, Ensner, Rolf, Gehring, Nadine, Heise, Antje, Huebner, Tobias, Neff, Thomas A., Cereghetti, Sara, Boroli, Filippo, Pugin, Jerome, Marczin, Nandor, Wong, Joyce, Wendel Garcia, Pedro David, Fumeaux, Thierry, Guerci, Philippe, Heuberger, Dorothea Monika, Montomoli, Jonathan, Roche-Campo, Ferran, Schuepbach, Reto Andreas, and Hilty, Matthias Peter

Published
2020
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10. Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

Author

Grieco, Domenico Luca, Bongiovanni, Filippo, Chen, Lu, Menga, Luca S., Cutuli, Salvatore Lucio, Pintaudi, Gabriele, Carelli, Simone, Michi, Teresa, Torrini, Flava, Lombardi, Gianmarco, Anzellotti, Gian Marco, De Pascale, Gennaro, Urbani, Andrea, Bocci, Maria Grazia, Tanzarella, Eloisa S., Bello, Giuseppe, Dell’Anna, Antonio M., Maggiore, Salvatore M., Brochard, Laurent, and Antonelli, Massimo

Published
2020
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11. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review

Author

Monti, Laura, primary, Marconi, Elisa, additional, Bocci, Maria Grazia, additional, Kotzalidis, Georgios Demetrios, additional, Mazza, Marianna, additional, Galliani, Carolina, additional, Tranquilli, Sara, additional, Vento, Giovanni, additional, Conti, Giorgio, additional, Sani, Gabriele, additional, Antonelli, Massimo, additional, and Chieffo, Daniela Pia Rosaria, additional

Published
2023
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12. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review

Author

Monti, Laura, Marconi, Elisa, Bocci, Maria Grazia, Kotzalidis, Georgios Demetrio, Mazza, Marianna, Galliani, Carolina, Tranquilli, Sara, Vento, Giovanni, Conti, Giorgio, Sani, Gabriele, Antonelli, Massimo, Chieffo, Daniela Pia Rosaria, Marconi, Elisa (ORCID:0000-0001-6722-8390), Vento, Giovanni (ORCID:0000-0002-8132-5127), Conti, Giorgio (ORCID:0000-0002-8566-9365), Sani, Gabriele (ORCID:0000-0002-9767-8752), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Monti, Laura, Marconi, Elisa, Bocci, Maria Grazia, Kotzalidis, Georgios Demetrio, Mazza, Marianna, Galliani, Carolina, Tranquilli, Sara, Vento, Giovanni, Conti, Giorgio, Sani, Gabriele, Antonelli, Massimo, Chieffo, Daniela Pia Rosaria, Marconi, Elisa (ORCID:0000-0001-6722-8390), Vento, Giovanni (ORCID:0000-0002-8132-5127), Conti, Giorgio (ORCID:0000-0002-8566-9365), Sani, Gabriele (ORCID:0000-0002-9767-8752), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients' risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.

Published
2023

14. Additional file 3 of Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial

Author

Michi, Teresa, Mattana, Chiara, Menga, Luca S., Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore L., Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, and Antonelli, Massimo

Abstract

Additional file 3.

Published
2023
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15. Additional file 4 of Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial

Author

Michi, Teresa, Mattana, Chiara, Menga, Luca S., Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore L., Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, and Antonelli, Massimo

Abstract

Additional file 4.

Published
2023
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17. Thromboelastography Profile Is Associated with Lung Aeration Assessed by Point-of-Care Ultrasound in COVID-19 Critically Ill Patients: An Observational Retrospective Study

Author

Biasucci, Daniele Guerino, primary, Bocci, Maria Grazia, additional, Buonsenso, Danilo, additional, Pisapia, Luca, additional, Consalvo, Ludovica Maria, additional, Vargas, Joel, additional, Grieco, Domenico Luca, additional, De Pascale, Gennaro, additional, and Antonelli, Massimo, additional

Published
2022
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18. Trauma-induced coagulopathy management

Author

Bocci, Maria Grazia and Bocci, Maria Grazia

Abstract

In the last years significant progress has been made in the understanding and treatment of hemorrhage caused by trauma which (along with the advances made in early resuscitation, and critical care) has led to a reduction of “late” deaths, meaning those due to trauma-induced organ failure/sepsis. Depending on the case, trauma is usually characterized by a variable equilibrium between hypo and hypercoagulation, with a majority of hypercoagulation cases. Trauma-induced coagulopathy (TIC), instead, is not only characterized by a coagulation disorder but also a state of inflammation which increases the need for transfusions, the risk of multiorgan failure and thromboembolic complications. In this clinical picture, hemostatic resuscitation, damage control resuscitation and homeostasis maintenance have been shown to reduce mortality. According to guidelines, the heart of TIC treatment is an early individualised goal-directed treatment relying on coagulation support and thromboprophylactic strategies (administration of tranexamic acid, fibrinogen concentrate and packed red blood cells), platelet function monitoring and viscoelastic Point-of-care testing. The implementation of the protocol suggested by the guidelines has allowed a more effective support of coagulopathy and has led to a reduction in hemoderivatives usage, hospitalization time and the death rate in severely injured trauma patients. The aforementioned improvements in TIC management were explicitly confirmed by a multicentric study in which the year the guidelines were implemented was compared with a prior year when no specific protocol was executed.

Published
2022

19. Machine Learning and Antibiotic Management

Author

Maviglia, Riccardo, Michi, Teresa, Passaro, Davide, Raggi, Valeria, Bocci, Maria Grazia, Piervincenzi, Edoardo, Mercurio, Giovanna, Lucente, Monica Christine, Murri, Rita, Lucente, Monica, Murri, Rita (ORCID:0000-0003-4263-7854), Maviglia, Riccardo, Michi, Teresa, Passaro, Davide, Raggi, Valeria, Bocci, Maria Grazia, Piervincenzi, Edoardo, Mercurio, Giovanna, Lucente, Monica Christine, Murri, Rita, Lucente, Monica, and Murri, Rita (ORCID:0000-0003-4263-7854)

Abstract

Machine learning and cluster analysis applied to the clinical setting of an intensive care unit can be a valuable aid for clinical management, especially with the increasing complexity of clinical monitoring. Providing a method to measure clinical experience, a proxy for that automatic gestalt evaluation that an experienced clinician sometimes effortlessly, but often only after long, hard consideration and consultation with colleagues, relies upon for decision making, is what we wanted to achieve with the application of machine learning to antibiotic therapy and clinical monitoring in the present work. This is a single-center retrospective analysis proposing methods for evaluation of vitals and antimicrobial therapy in intensive care patients. For each patient included in the present study, duration of antibiotic therapy, consecutive days of treatment and type and combination of antimicrobial agents have been assessed and considered as single unique daily record for analysis. Each parameter, composing a record was normalized using a fuzzy logic approach and assigned to five descriptive categories (fuzzy domain sub-sets ranging from "very low" to "very high"). Clustering of these normalized therapy records was performed, and each patient/day was considered to be a pertaining cluster. The same methodology was used for hourly bed-side monitoring. Changes in patient conditions (monitoring) can lead to a shift of clusters. This can provide an additional tool for assessing progress of complex patients. We used Fuzzy logic normalization to descriptive categories of parameters as a form nearer to human language than raw numbers.

Published
2022

20. Machine Learning and Antibiotic Management

Author

Maviglia, Riccardo, primary, Michi, Teresa, additional, Passaro, Davide, additional, Raggi, Valeria, additional, Bocci, Maria Grazia, additional, Piervincenzi, Edoardo, additional, Mercurio, Giovanna, additional, Lucente, Monica, additional, and Murri, Rita, additional

Published
2022
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21. Machine learning using the extreme gradient boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients

Author

Montomoli, Jonathan, primary, Romeo, Luca, additional, Moccia, Sara, additional, Bernardini, Michele, additional, Migliorelli, Lucia, additional, Berardini, Daniele, additional, Donati, Abele, additional, Carsetti, Andrea, additional, Bocci, Maria Grazia, additional, Wendel Garcia, Pedro David, additional, Fumeaux, Thierry, additional, Guerci, Philippe, additional, Schüpbach, Reto Andreas, additional, Ince, Can, additional, Frontoni, Emanuele, additional, Hilty, Matthias Peter, additional, Alfaro-Farias, Mario, additional, Vizmanos-Lamotte, Gerardo, additional, Tschoellitsch, Thomas, additional, Meier, Jens, additional, Aguirre-Bermeo, Hernán, additional, Apolo, Janina, additional, Martínez, Alberto, additional, Jurkolow, Geoffrey, additional, Delahaye, Gauthier, additional, Novy, Emmanuel, additional, Losser, Marie-Reine, additional, Wengenmayer, Tobias, additional, Rilinger, Jonathan, additional, Staudacher, Dawid L., additional, David, Sascha, additional, Welte, Tobias, additional, Stahl, Klaus, additional, Pavlos”, “Agios, additional, Aslanidis, Theodoros, additional, Korsos, Anita, additional, Babik, Barna, additional, Nikandish, Reza, additional, Rezoagli, Emanuele, additional, Giacomini, Matteo, additional, Nova, Alice, additional, Fogagnolo, Alberto, additional, Spadaro, Savino, additional, Ceriani, Roberto, additional, Murrone, Martina, additional, Wu, Maddalena A., additional, Cogliati, Chiara, additional, Colombo, Riccardo, additional, Catena, Emanuele, additional, Turrini, Fabrizio, additional, Simonini, Maria Sole, additional, Fabbri, Silvia, additional, Potalivo, Antonella, additional, Facondini, Francesca, additional, Gangitano, Gianfilippo, additional, Perin, Tiziana, additional, Grazia Bocci, Maria, additional, Antonelli, Massimo, additional, Gommers, Diederik, additional, Rodríguez-García, Raquel, additional, Gámez-Zapata, Jorge, additional, Taboada-Fraga, Xiana, additional, Castro, Pedro, additional, Tellez, Adrian, additional, Lander-Azcona, Arantxa, additional, Escós-Orta, Jesús, additional, Martín-Delgado, Maria C., additional, Algaba-Calderon, Angela, additional, Franch-Llasat, Diego, additional, Roche-Campo, Ferran, additional, Lozano-Gómez, Herminia, additional, Zalba-Etayo, Begoña, additional, Michot, Marc P., additional, Klarer, Alexander, additional, Ensner, Rolf, additional, Schott, Peter, additional, Urech, Severin, additional, Zellweger, Nuria, additional, Merki, Lukas, additional, Lambert, Adriana, additional, Laube, Marcus, additional, Jeitziner, Marie M., additional, Jenni-Moser, Beatrice, additional, Wiegand, Jan, additional, Yuen, Bernd, additional, Lienhardt-Nobbe, Barbara, additional, Westphalen, Andrea, additional, Salomon, Petra, additional, Drvaric, Iris, additional, Hillgaertner, Frank, additional, Sieber, Marianne, additional, Dullenkopf, Alexander, additional, Petersen, Lina, additional, Chau, Ivan, additional, Ksouri, Hatem, additional, Sridharan, Govind Oliver, additional, Cereghetti, Sara, additional, Boroli, Filippo, additional, Pugin, Jerome, additional, Grazioli, Serge, additional, Rimensberger, Peter C., additional, Bürkle, Christian, additional, Marrel, Julien, additional, Brenni, Mirko, additional, Fleisch, Isabelle, additional, Lavanchy, Jerome, additional, Perez, Marie-Helene, additional, Ramelet, Anne-Sylvie, additional, Weber, Anja Baltussen, additional, Gerecke, Peter, additional, Christ, Andreas, additional, Ceruti, Samuele, additional, Glotta, Andrea, additional, Marquardt, Katharina, additional, Shaikh, Karim, additional, Hübner, Tobias, additional, Neff, Thomas, additional, Redecker, Hermann, additional, Moret-Bochatay, Mallory, additional, Bentrup, FriederikeMeyer zu, additional, Studhalter, Michael, additional, Stephan, Michael, additional, Brem, Jan, additional, Gehring, Nadine, additional, Selz, Daniela, additional, Naon, Didier, additional, Kleger, Gian-Reto, additional, Pietsch, Urs, additional, Filipovic, Miodrag, additional, Ristic, Anette, additional, Sepulcri, Michael, additional, Heise, Antje, additional, Franchitti Laurent, Marilene, additional, Laurent, Jean-Christophe, additional, Wendel Garcia, Pedro D., additional, Schuepbach, Reto, additional, Heuberger, Dorothea, additional, Bühler, Philipp, additional, Brugger, Silvio, additional, Fodor, Patricia, additional, Locher, Pascal, additional, Camen, Giovanni, additional, Gaspert, Tomislav, additional, Jovic, Marija, additional, Haberthuer, Christoph, additional, Lussman, Roger F., additional, and Colak, Elif, additional

Published
2021
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22. Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

Author

Gabrielli, Maurizio, Pignataro, Giulia, Candelli, Marcello, Sacco Fernandez, Marta, Bizzarri, Martina, Esperide, Alessandra, Franceschi, Francesco, Abbate, Valeria, Nicola, Acampora, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Mariangela, Antonelli, Antonucci, Gabriele, Marco, Anzellotti Gian, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Fabiana, Barone, Bellantone, Rocco Domenico Alfonso, Andrea, Bellieni, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Stefano, Bibbò, Bini, Alessandra, Alessandra, Bisanti, Biscetti, Federico, Bocci, Maria Grazia, Nicola, Bonadia, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia Laura, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Teresa, Bruni, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Livia, Burzo, Angelo, Calabrese, Rosaria, Calvello Maria, Andrea, Cambieri, Cambise, Chiara, Camma, Giulia, Gennaro, Canistro, Antonello, Cantanale, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Silvia, Cardone, Carelli, Simone, Carfi', Angelo, Annamaria, Carnicelli, Caruso, Cristiano, Antonio, Casciaro Francesco, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Melania, Cesarano, Chiarito, Annalisa, Cianci, Rossella, Cicetti, Marta, Cicchinelli, Sara, Arturo, Ciccullo, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Ludovica Maria, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Matteo, Costanzi, Covino, Marcello, Davide, Crupi, Lucio, Cutuli Salvatore, D'Addio, Stefano, D'Alessandro, Alessia, D'Alfonso, Maria Elena, D'Angelo, Emanuela, Francesca, D’Aversa, Damiano, Fernando, De Maria, Berardinis Gian, De Cunzo, Tommaso, De Gaetano Donati, Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Paolo, Santis, De Martina, Siena, De Francesco, Vito, Del Valeria, Gatto, Del Paola, Giacomo, Del Fabio, Zompo, Maria, Dell’Anna Antonio, Della Davide, Polla, Di Luca, Gialleonardo, Di Simona, Giambenedetto, Di Roberta, Luca, Di Luca, Maurizio, Di Mariangela, Muro, Alex, Dusina, Davide, Eleuteri, Alessandra, Esperide, Daniele, Facheci, Domenico, Faliero, Cinzia, Falsiroli, Massimo, Fantoni, Annalaura, Fedele, Daniela, Feliciani, Cristina, Ferrante, Giuliano, Ferrone, Rossano, Festa, Chiara, Fiore Maria, Andrea, Flex, Evelina, Forte, Francesco, Franceschi, Alessandra, Francesconi, Laura, Franza, Barbara, Funaro, Mariella, Fuorlo, Domenico, Fusco, Maurizio, Gabrielli, Eleonora, Gaetani, Claudia, Galletta, Antonella, Gallo, Giovanni, Gambassi, Matteo, Garcovich, Antonio, Gasbarrini, Irene, Gasparrini, Silvia, Gelli, Antonella, Giampietro, Laura, Gigante, Gabriele, Giuliano, Giorgia, Giuliano, Bianca, Giupponi, Elisa, Gremese, Luca, Grieco Domenico, Manuel, Guerrera, Valeria, Guglielmi, Caterina, Guidone, Antonio, Gullì, Amerigo, Iaconelli, Aurora, Iafrati, Ianiro, Gianluca, Angela, Iaquinta, Michele, Impagnatiello, Riccardo, Inchingolo, Enrica, Intini, Raffaele, Iorio, Maria, Izzi Immacolata, Tamara, Jovanovic, Cristina, Kadhim, Rosa, La Macchia, Ignazio, La Milia Daniele, Francesco, Landi, Giovanni, Landi, Rosario, Landi, Raffaele, Landolfi, Massimo, Leo, Maria, Leone Paolo, Laura, Levantesi, Antonio, Liguori, Rosa, Liperoti, Maria, Lizzio Marco, Rita, Lo Monaco Maria, Pietro, Locantore, Francesco, Lombardi, Gianmarco, Lombardi, Loris, Lopetuso, Valentina, Loria, Raffaella, Losito Angela, Patricia, Lucia Mothanje Barbara, Francesco, Macagno, Noemi, Macerola, Giampaolo, Maggi, Giuseppe, Maiuro, Francesco, Mancarella, Francesca, Mangiola, Alberto, Manno, Debora, Marchesini, Marco, Maresca Gian, Giuseppe, Marrone, Ilaria, Martis, Maria, Martone Anna, Marzetti, Emanuele, Chiara, Mattana, Valeria, Matteo Maria, Riccardo, Maviglia, Ada, Mazzarella, Carmen, Memoli, Luca, Miele, Alessio, Migneco, Irene, Mignini, Alessandro, Milani, Domenico, Milardi, Massimo, Montalto, Giuliano, Montemurro, Flavia, Monti, Montini, Luca, Christian, Morena Tony, Vincenzina, Morra, Davide, Moschese, Ambra, Murace Celeste, Martina, Murdolo, Rita, Murri, Marco, Napoli, Elisabetta, Nardella, Gerlando, Natalello, Daniele, Natalini, Maria, Navarra Simone, Antonio, Nesci, Alberto, Nicoletti, Rocco, Nicoletti, Filippo, Nicoletti Tommaso, Rebecca, Nicolò, Nicola, Nicolotti, Celestino, Nista Enrico, Eugenia, Nuzzo, Marco, Oggiano, Veronica, Ojetti, Cosimo, Pagano Francesco, Gianfranco, Paiano, Cristina, Pais, Federico, Paolillo, Federico, Pallavicini, Andrea, Palombo, Alfredo, Papa, Domenico, Papanice, Giovanni, Papparella Luigi, Mattia, Paratore, Giuseppe, Parrinello, Giuliana, Pasciuto, Pierpaolo, Pasculli, Giovanni, Pecorini, Simone, Perniola, Erika, Pero, Luca, Petricca, Martina, Petrucci, Chiara, Picarelli, Andrea, Piccioni, Annalisa, Piccolo, Edoardo, Piervincenzi, Giulia, Pignataro, Raffaele, Pignataro, Gabriele, Pintaudi, Luca, Pisapia, Marco, Pizzoferrato, Fabrizio, Pizzolante, Roberto, Pola, Caterina, Policola, Maurizio, Pompili, Flavia, Pontecorvi, Valerio, Pontecorvi, Francesca, Ponziani, Valentina, Popolla, Enrica, Porceddu, Angelo, Porfidia, Maria, Porro Lucia, Annalisa, Potenza, Francesca, Pozzana, Giuseppe, Privitera, Daniela, Pugliese, Gabriele, Pulcini, Simona, Racco, Francesca, Raffaelli, Vittoria, Ramunno, Ludovico, Rapaccini Gian, Richeldi, Luca, Rinninella, Emanuele, Sara, Rocchi, Bruno, Romanò, Stefano, Romano, Federico, Rosa, Laura, Rossi, Raimondo, Rossi, Enrica, Rossini, Elisabetta, Rota, Fabiana, Rovedi, Carlotta, Rubino, Gabriele, Rumi, Andrea, Russo, Luca, Sabia, Andrea, Salerno, Sara, Salini, Lucia, Salvatore, Dehara, Samori, Sandroni, Claudio, Maurizio, Sanguinetti, Luca, Santarelli, Paolo, Santini, Danilo, Santolamazza, Angelo, Santoliquido, Francesco, Santopaolo, Cosimo, Santoro Michele, Francesco, Sardeo, Caterina, Sarnari, Angela, Saviano, Luisa, Saviano, Scaldaferri, Franco, Roberta, Scarascia, Tommaso, Schepis, Francesca, Schiavello, Giancarlo, Scoppettuolo, Davide, Sedda, Flaminio, Sessa, Luisa, Sestito, Carlo, Settanni, Matteo, Siciliano, Valentina, Siciliano, Rossella, Sicuranza, Benedetta, Simeoni, Jacopo, Simonetti, Andrea, Smargiassi, Maurizio, Soave Paolo, Chiara, Sonnino, Domenico, Staiti, Claudia, Stella, Leonardo, Stella, Eleonora, Stival, Eleonora, Taddei, Rossella, Talerico, Elio, Tamburello, Enrica, Tamburrini, Sofia, Tanzarella Eloisa, Elena, Tarascio, Claudia, Tarli, Alessandra, Tersali, Pietro, Tilli, Jacopo, Timpano, Enrico, Torelli, Flavia, Torrini, Matteo, Tosato, Alberto, Tosoni, Luca, Tricoli, Marcello, Tritto, Mario, Tumbarello, Maria, Tummolo Anita, Sole, Vallecoccia Maria, Federico, Valletta, Francesco, Varone, Francesco, Vassalli, Giulio, Ventura, Lucrezia, Verardi, Lorenzo, Vetrone, Giuseppe, Vetrugno, Elena, Visconti, Felicia, Visconti, Andrea, Viviani, Raffaella, Zaccaria, Carmelina, Zaccone, Lorenzo, Zelano, Lorenzo, Zileri Dal Verme, and Giuseppe, Zuccalà

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Emergency department, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, asthma, medicine.disease, Hospitalization, Emergency medicine, CE-Research Letter to the Editor, SARS-CoV2, Emergency Medicine, Internal Medicine, medicine, Prevalence, Humans, In patient, business, Emergency Service, Hospital, Asthma, Retrospective Studies
Published
2021

23. Lung ultrasound predicts non-invasive ventilation outcome in COVID-19 acute respiratory failure: a pilot study

Author

Biasucci, Daniele Guerino, Buonsenso, Danilo, Piano, Alfonso, Bonadia, Nicola, Vargas, Joel, Settanni, Donatella, Bocci, Maria Grazia, Grieco, Domenico L, Carnicelli, Annamaria, Scoppettuolo, Giancarlo, Eleuteri, Davide, De Pascale, Gennaro, Pennisi, Mariano Alberto, Franceschi, Francesco, Antonelli, Massimo, Biasucci, Daniele G, Bocci, Maria G, DE Pascale, Gennaro (ORCID:0000-0002-8255-0676), Pennisi, Mariano A (ORCID:0000-0001-8761-5144), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Biasucci, Daniele Guerino, Buonsenso, Danilo, Piano, Alfonso, Bonadia, Nicola, Vargas, Joel, Settanni, Donatella, Bocci, Maria Grazia, Grieco, Domenico L, Carnicelli, Annamaria, Scoppettuolo, Giancarlo, Eleuteri, Davide, De Pascale, Gennaro, Pennisi, Mariano Alberto, Franceschi, Francesco, Antonelli, Massimo, Biasucci, Daniele G, Bocci, Maria G, DE Pascale, Gennaro (ORCID:0000-0002-8255-0676), Pennisi, Mariano A (ORCID:0000-0001-8761-5144), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

BACKGROUND: The aim of this study is to determine relationships between lung aeration assessed by lung ultrasound (WS) with non-invasive ventilation (NIMV) outcome, intensive care unit (ICU) admission and mechanical ventilation (MV) needs in COVID-19 respiratory failure.METHODS: A cohort of adult patients with COVID-19 respiratory failure underwent LUS during initial assessment. A simplified LUS protocol consisting in scanning six areas, three for each side. was adopted. A score from 0 to 3 was assigned to each area. Comprehensive LUS score (LUSsc) was calculated as the sum of the score in all areas. LUSsc, the amount of involved sonographic lung areas (LUSq), the number of lung quadrants radiographically infiltrated and the degree of oxygenation impairment at admission (SpO(2)/FiO(2) ratio) were compared to NIMV Outcome, MV needs and ICU admission.RESULTS: Among 85 patients prospectively included in the analysis, 49 of 61 needed MV. LUSsc and LUSq were higher in patients who required MV (median 12 [IQR 8-14] and median 6 [IQR 4-6], respectively) than in those who did not (6 [IQR 2-9] and 3 [IQR 1-5], respectively), both P<0.001. NIMV trial failed in 26 patients out 36. LUSsc and LUSq were significantly higher in patients who failed NIMV than in those who did not. From ROC analysis, LUSsc >= 12 and LUSq >= 5 gave the best cut-off values for NIMV failure prediction (AUC=0.95, 95% CI 0.83-0.99 and AUC=0.81, 95% CI 0.65-0.91, respectively).CONCLUSIONS: Our data suggest LUS as a possible tool for identifying patients who are likely to require MV and ICU admission or to fail a NIMV trial.

Published
2021

24. Effect of Helmet Noninvasive Ventilation vs High-Flow Nasal Oxygen on Days Free of Respiratory Support in Patients With COVID-19 and Moderate to Severe Hypoxemic Respiratory Failure: The HENIVOT Randomized Clinical Trial

Author

Grieco, Domenico Luca, S Menga, Luca, Cesarano, Melania, Rosà, Tommaso, Spadaro, Savino, Maddalena Bitondo, Maria, Montomoli, Jonathan, Falò, Giulia, Tonetti, Tommaso, L Cutuli, Salvatore, Pintaudi, Gabriele, S Tanzarella, Eloisa, Piervincenzi, Edoardo, Bongiovanni, Filippo, M Dell'Anna, Antonio, Delle Cese, Luca, Berardi, Cecilia, Carelli, Simone, Bocci, Maria Grazia, Montini, Luca, Bell, Giuseppe, Natalini, Daniele, De Pascale, Gennaro, Velardo, Matteo, Alberto Volta, Carlo, Marco Ranieri, V, Conti, Giorgio, Maggiore, Salvatore Maurizio, Antonelli, Massimo, Gemelli Study Group, COVID-ICU, Domenico Luca Grieco (ORCID:0000-0002-4557-6308), Filippo Bongiovanni, Cecilia Berardi, Simone Carelli, Maria Grazia Bocci, Luca Montini (ORCID:0000-0003-4602-5134), Gennaro De Pascale (ORCID:0000-0002-8255-0676), Giorgio Conti (ORCID:0000-0002-8566-9365), Salvatore Maurizio Maggiore, Massimo Antonelli (ORCID:0000-0003-3007-1670), Grieco, Domenico Luca, S Menga, Luca, Cesarano, Melania, Rosà, Tommaso, Spadaro, Savino, Maddalena Bitondo, Maria, Montomoli, Jonathan, Falò, Giulia, Tonetti, Tommaso, L Cutuli, Salvatore, Pintaudi, Gabriele, S Tanzarella, Eloisa, Piervincenzi, Edoardo, Bongiovanni, Filippo, M Dell'Anna, Antonio, Delle Cese, Luca, Berardi, Cecilia, Carelli, Simone, Bocci, Maria Grazia, Montini, Luca, Bell, Giuseppe, Natalini, Daniele, De Pascale, Gennaro, Velardo, Matteo, Alberto Volta, Carlo, Marco Ranieri, V, Conti, Giorgio, Maggiore, Salvatore Maurizio, Antonelli, Massimo, Gemelli Study Group, COVID-ICU, Domenico Luca Grieco (ORCID:0000-0002-4557-6308), Filippo Bongiovanni, Cecilia Berardi, Simone Carelli, Maria Grazia Bocci, Luca Montini (ORCID:0000-0003-4602-5134), Gennaro De Pascale (ORCID:0000-0002-8255-0676), Giorgio Conti (ORCID:0000-0002-8566-9365), Salvatore Maurizio Maggiore, and Massimo Antonelli (ORCID:0000-0003-3007-1670)

Abstract

Importance: High-flow nasal oxygen is recommended as initial treatment for acute hypoxemic respiratory failure and is widely applied in patients with COVID-19. Objective: To assess whether helmet noninvasive ventilation can increase the days free of respiratory support in patients with COVID-19 compared with high-flow nasal oxygen alone. Design, setting, and participants: Multicenter randomized clinical trial in 4 intensive care units (ICUs) in Italy between October and December 2020, end of follow-up February 11, 2021, including 109 patients with COVID-19 and moderate to severe hypoxemic respiratory failure (ratio of partial pressure of arterial oxygen to fraction of inspired oxygen ≤200). Interventions: Participants were randomly assigned to receive continuous treatment with helmet noninvasive ventilation (positive end-expiratory pressure, 10-12 cm H2O; pressure support, 10-12 cm H2O) for at least 48 hours eventually followed by high-flow nasal oxygen (n = 54) or high-flow oxygen alone (60 L/min) (n = 55). Main outcomes and measures: The primary outcome was the number of days free of respiratory support within 28 days after enrollment. Secondary outcomes included the proportion of patients who required endotracheal intubation within 28 days from study enrollment, the number of days free of invasive mechanical ventilation at day 28, the number of days free of invasive mechanical ventilation at day 60, in-ICU mortality, in-hospital mortality, 28-day mortality, 60-day mortality, ICU length of stay, and hospital length of stay. Results: Among 110 patients who were randomized, 109 (99%) completed the trial (median age, 65 years [interquartile range {IQR}, 55-70]; 21 women [19%]). The median days free of respiratory support within 28 days after randomization were 20 (IQR, 0-25) in the helmet group and 18 (IQR, 0-22) in the high-flow nasal oxygen group, a difference that was not statistically significant (mean difference, 2 days [95% CI, -2 to 6]; P = .26). Of 9 prespeci

Published
2021

25. Blood Glucose Levels Combined with Triage Revised Trauma Score Improve the Outcome Prediction in Adults and in Elderly Patients with Trauma

Author

Covino, Marcello, Zaccaria, Raffaella, Bocci, Maria Grazia, Carbone, Luigi, Torelli, Enrico, Fuorlo, Mariella, Piccioni, Andrea, Santoro, Michele, Sandroni, Claudio, Franceschi, Francesco, Marcello Covino (ORCID:0000-0002-6709-2531), Maria Grazia Bocci, Claudio Sandroni (ORCID:0000-0002-8878-2611), Francesco Franceschi (ORCID:0000-0001-6266-445X), Covino, Marcello, Zaccaria, Raffaella, Bocci, Maria Grazia, Carbone, Luigi, Torelli, Enrico, Fuorlo, Mariella, Piccioni, Andrea, Santoro, Michele, Sandroni, Claudio, Franceschi, Francesco, Marcello Covino (ORCID:0000-0002-6709-2531), Maria Grazia Bocci, Claudio Sandroni (ORCID:0000-0002-8878-2611), and Francesco Franceschi (ORCID:0000-0001-6266-445X)

Abstract

Introduction: This study was aimed to assess if combining the evaluation of blood glucose level (BGL) and the Triage Revised Trauma Score (T-RTS) may result in a more accurate prediction of the actual clinical outcome, both in general adult population and in elderly patients with trauma. Methods: This is a retrospective cohort study, conducted in the emergency department (ED) of an urban teaching hospital, with an average ED admission rate of 75,000 patients per year. Those excluded: known diagnosis of diabetes, age <18 years old, pregnancy, and mild trauma (classified as isolate trauma of upper or lower limb, in absence of exposed fractures). A combined Revised Trauma Score Glucose (RTS-G) score was obtained adding to T-RTS: two for BGL <160mg/dL (8.9mmol/L); one for BGL ≥160mg/dL and < 200mg/dL (11.1mmol/L); and zero for BGL ≥ 200mg/dL. The primary outcome was a composite of patient's death in ED or admission to intensive care unit (ICU). Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the overall performance of T-RTS and of the combined RTS-G score. Results: Among a total of 68,933 traumas, 9,436 patients (4,407 females) were enrolled, aged from 18 to 103 years; 4,288 were aged ≥65 years. A total of 577 (6.1%) met the primary endpoint: 38 patients died in ED (0.4%) and 539 patients were admitted to ICU. The T-RTS and BGL were independently associated to primary endpoint at multivariate analysis. The cumulative RTS-G score was significantly more accurate than T-RTS and reached the best accuracy in elderly patients. In general population, ROC area under curve (AUC) for T-RTS was 0.671 (95% CI, 0.661 - 0.680) compared to RTS-G ROC AUC 0.743 (95% CI, 0.734 - 0.752); P <.001. In patients ≥65 years, T-RTS ROC AUC was 0.671 (95% CI, 0.657 - 0.685) compared to RTS-G ROC AUC 0.780 (95% CI, 0.768 - 0.793); P <.001. Conclusions: Results showed RTS-G could be used effectively at ED triage for the risk stratification for death in ED

Published
2021

26. Thromboelastography clot strength profiles and effect of systemic anticoagulation in COVID-19 acute respiratory distress syndrome: a prospective, observational study

Author

Bocci, Maria Grazia, Maviglia, Riccardo, Consalvo, Ludovica Maria, Domenico Luca Grieco, Montini, Luca, Mercurio, Giovanna, Nardi, G, Pisapia, Luca, L Cutuli, S, Domenico, G Biasucci, Gori, Giovanni Cristiano, Rosenkranz, R, De Candia, Erica, Carelli, Simone, Daniele, Natalini, Antonelli, Massimo, and Franceschi, Francesco

Subjects
Male, Neutrophils, coronavirus, Antithrombins, blood coagulation, Fibrin Fibrinogen Degradation Products, Leukocyte Count, respiratory insufficiency, Humans, International Normalized Ratio, Lymphocyte Count, Prospective Studies, Enoxaparin, Aged, Aged, 80 and over, Respiratory Distress Syndrome, Heparin, Platelet Count, SARS-CoV-2, Settore MED/09 - MEDICINA INTERNA, Anticoagulants, COVID-19, Fibrinogen, Blood Coagulation Disorders, Middle Aged, Thrombelastography, COVID-19 Drug Treatment, Treatment Outcome, Settore MED/41, haemostasis, Female, Partial Thromboplastin Time, Blood Coagulation Tests
Abstract

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection may yield a hypercoagulable state with fibrinolysis impairment. We conducted a single-center observational study with the aim of analyzing the coagulation patterns of intensive care unit (ICU) COVID-19 patients with both standard laboratory and viscoelastic tests. The presence of coagulopathy at the onset of the infection and after seven days of systemic anticoagulant therapy was investigated.Forty consecutive SARS-CoV-2 patients, admitted to the ICU of a University hospital in Italy between 29th February and 30th March 2020 were enrolled in the study, providing they fulfilled the acute respiratory distress syndrome criteria. They received full-dose anticoagulation, including Enoxaparin 0.5 mg·kg-1 subcutaneously twice a day, unfractionated Heparin 7500 units subcutaneously three times daily, or low-intensity Heparin infusion. Thromboelastographic (TEG) and laboratory parameters were measured at admission and after seven days.At baseline, patients showed elevated fibrinogen activity [rTEG-Ang 80.5° (78.7 to 81.5); TEG-ACT 78.5 sec (69.2 to 87.9)] and an increase in the maximum amplitude of clot strength [FF-MA 42.2 mm (30.9 to 49.2)]. No alterations in time of the enzymatic phase of coagulation [CKH-K and CKH-R, 1.1 min (0.85 to 1.3) and 6.6 min (5.2 to 7.5), respectively] were observed. Absent lysis of the clot at 30 minutes (LY30) was observed in all the studied population. Standard coagulation parameters were within the physiological range: [INR 1.09 (1.01 to 1.20), aPTT 34.5 sec (29.7 to 42.2), antithrombin 97.5% (89.5 to 115)]. However, plasma fibrinogen [512.5 mg·dl-1 (303.5 to 605)], and D-dimer levels [1752.5 ng·ml-1 (698.5 to 4434.5)], were persistently increased above the reference range. After seven days of full-dose anticoagulation, average TEG parameters were not different from baseline (rTEG-Ang p = 0.13, TEG-ACT p = 0.58, FF-MA p = 0.24, CK-R p = 0.19, CKH-R p = 0.35), and a persistent increase in white blood cell count, platelet count and D-dimer was observed (white blood cell count p0.01, neutrophil count p = 0.02, lymphocyte count p0.01, platelet count p = 0.130.01, D-dimer levels p= 0.02).SARS-CoV-2 patients with acute respiratory distress syndrome show elevated fibrinogen activity, high D-dimer levels and maximum amplitude of clot strength. Platelet count, fibrinogen, and standard coagulation tests do not indicate a disseminated intravascular coagulation. At seven days, thromboelastographic abnormalities persist despite full-dose anticoagulation.

Published
2020

27. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years)

Author

Flaatten, Hans, De Lange, Dylan W., Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Boumendil, Ariane, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjølner, Jesper, Jung, Christian, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agwald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zaferidis, Tilemachos, Guidet, Bertrand, Schmutz, René, Wimmer, Franz, Eller, Philipp, Zotter, Klemens, Swinnen, Walter, De Buysscher, Pieter, De Neve, Nikolaas, Abraham, Paul, Fleury, Yvan, Schefold, Joerg C., Biskup, Ewelina, Taliadoros, Ioannis, Piza, Petr, Lauten, Alexander, Sacher, Anna Lena, Brenner, Thorsten, Franz, Marcus, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobias, Nia, Amir M., Janosi, Rolf Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Dey, Nilanjan, Sølling, Christoffer, Rasmussen, Bodil Steen, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Jaimes, Marián Irazábal, Prado Mira, Ángela, Bodi, Maria A., Barea Mendoza, Jesus A., López-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesús, Ibarz, Mercedes, Trenado-Alvarez, Josep, Forceville, Xavier, Besch, Guillaume, Mentec, Herve, Michel, Philippe, Mateu, Philippe, Vettoretti, Lucie, Bourenne, Jeremy, Marin, Nathalie, Guillot, Max, Aissaoui, Naida, Goulenok, Cyril, Thieulot-Rolin, Nathalie, Messika, Jonathan, Lamhaut, Lionel, Charron, Cyril, Dempsey, Ged, Mathew, Shiju J., Raj, Ashok S., Grecu, Irina, Cupitt, Jason, Lawton, Tom, Clark, Richard, Popescu, Monica, Spittle, Nick, Faulkner, Maria, Cowton, Amanda, Elloway, Esme, Williams, Patricia, Reay, Michael, Chukkambotla, Srikanth, Kumar, Ravi, Al-Subaie, Nawaf, Kent, Linda, Tamm, Tiina, Kajtor, Istvan, Burns, Karen, Pugh, Richard, Ostermann, Marlies, Kam, Elisa, Bowyer, Helen, Smith, Neil, Templeton, Maie, Henning, Jeremy, Goffin, Kelly, Kapoor, Ritoo, Laha, Shondipon, Chilton, Phil, Khaliq, Waqas, Crayford, Alison, Coetzee, Samantha, Tait, Moira, Boultoukas, Evangelos, Stoker, Wendy, Gimenez, Marc, Pope, Alan, Camsooksai, Julie, Pogson, David, Quigley, Kate, Ritzema, Jenny, Hormis, Anil, Boulanger, Carole, Balasubramaniam, M., Vamplew, Luke, Burt, Karen, Martin, Daniel, Craig, Jayne, Prowle, John, Doyle, Nanci, Shelton, Jonathon, Scott, Carmen, Donnison, Phil, Shelton, Sarah, Frey, Christian, Ryan, Christine, Spray, Dominic, Barnes, Veronica, Barnes, Kerry, Furneval, Julie, Ridgway, Stephanie, Saha, Rajnish, Clark, Thomas, Wood, James, Bolger, Clare, Bassford, Christopher, Lewandowski, john, Zhao, Xiaobei, Humphreys, Sally, Dowling, Susan, Richardson, Neil, Burtenshaw, Andrew, Stevenson, Carl, Wilcock, Danielle, Aidoni, Zoi, Aloizos, Stavros, Tasioudis, Polychronis, Lampiri, Kleri, Zisopoulou, Vasiliki, Ifigenia, Ravani, Eymorfia, Pagaki, Angela, Anttoniou, Katsoulas, Theodoros A., Kyparissi, Aikaterini, Aikaterini, Kounougeri, Marinakis, George, Tsimpoukas, Fotios, Spyropoulou, Anastasia, Zygoulis, Paris, Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, Rossi, Maurizio, Calicchio, Giuseppe, Cubattoli, Lucia, Di Lascio, Gabriella, Barbagallo, Maria, Berruto, Francesco, Codazzi, Daniela, Bottazzi, Andrea, Fumagalli, Paolo, Negro, Giancarlo, Lupi, Giuseppe, Savelli, Flavia, Vulcano, Giuseppe A., Fumagalli, Roberto, Marudi, Andrea, Lefons, Ugo, Lembo, Rita, Babini, Maria, Paggioro, Alessandra, Parrini, Vieri, Zaccaria, Maria, Clementi, Stefano, Gigliuto, Carmelo, Facondini, Francesca, Pastorini, Simonetta, Munaron, Susanna, Calamai, Italo, Bocchi, Anna, Brizio, Elisabetta, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, van Dijk, I., van Lelyveld-Haas, L. E. M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H. J., Dieperink, Willem, de Waard, Monique C., Bormans, Laura, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Fehrle, Lutz, Dybwik, Knut, Legernaes, Terje, Klepstad, Pål, Olaussen, Even Braut, Olsen, Knut Inge, Børresen, Ole Marius, Bjørsvik, Geir, Maini, Sameer, Czuczwar, Miroslaw, Krawczyk, Pawel, Ziętkiewicz, Mirosław, Nowak, Łukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Grudzień, Paweł, Nasiłowski, Paweł, Popek, Natalia, Cyrankiewicz, Waldemar, Wnuk, Marek, Maciejewski, Dariusz, Studzińska, Dorota, Zukowski, Maciej, Bernas, Szymon, Serwa, Marta, Stefaniak, Jan, Pawel, Maciejewski, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Castelo Branco, Miguel, Barros, Inês, Barros, Nelson, Krystopchuk, Andriy, Honrado, Teresa, Sousa, Cristina, Munoz, Francisco, Rebelo, Marta, Gomes, Rui, Nunes, Jorge, Dias, Celeste, Fernandes, Ana Margarida, Petrisor, Cristina, Constantin, Bodolea, Belskiy, Vladislav, Boskholov, Boris, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyrén, Johanna, Rockstroh, Katalin, Rydén, Sara, Spångfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Pålsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Mårten, Bark, Björn, Nordling, Berit, Sköld, Hans, Brorsson, Camilla, Persson, Stefan, Bergström, Anna, Berkius, Johan, Holmström, Johanna, Yapici, Nihan, University of Bergen (UiB), Haukeland University Hospital, University Medical Center [Utrecht], CIBER de Epidemiología y Salud Pública (CIBERESP), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), St George’s University Hospitals, Aarhus University Hospital, Mater Misericordiae University Hospital (The Mater Hospital), NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Ghent University Hospital, Karolinska University Hospital [Stockholm], Hôpitaux Universitaires de Genève (HUG), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Gestionnaire, Hal Sorbonne Université, Flaatten, H, De Lange, D, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, Boumendil, A, Cecconi, M, Christensen, S, Faraldi, L, Fjolner, J, Jung, C, Marsh, B, Moreno, R, Oeyen, S, Ohman, C, Pinto, B, Soliman, I, Szczeklik, W, Valentin, A, Watson, X, Zaferidis, T, Guidet, B, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, Swinnen, W, De Buysscher, P, De Neve, N, Abraham, P, Fleury, Y, Schefold, J, Biskup, E, Taliadoros, I, Piza, P, Lauten, A, Sacher, A, Brenner, T, Franz, M, Bloos, F, Ebelt, H, Schaller, S, Fuest, K, Rabe, C, Dieck, T, Steiner, S, Graf, T, Nia, A, Janosi, R, Meybohm, P, Simon, P, Utzolino, S, Rahmel, T, Barth, E, Schuster, M, Dey, N, Solling, C, Rasmussen, B, Rodriguez, E, Rebollo, S, Aguilar, G, Masdeu, G, Jaimes, M, Prado Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Homez Guzman, M, Rico-Feijoo, J, Ibarz, M, Trenado-Alvarez, J, Forceville, X, Besch, G, Mentec, H, Michel, P, Mateu, P, Vettoretti, L, Bourenne, J, Marin, N, Guillot, M, Aissaoui, N, Goulenok, C, Thieulot-Rolin, N, Messika, J, Lamhaut, L, Charron, C, Dempsey, G, Mathew, S, Raj, A, Grecu, I, Cupitt, J, Lawton, T, Clark, R, Popescu, M, Spittle, N, Faulkner, M, Cowton, A, Elloway, E, Williams, P, Reay, M, Chukkambotla, S, Kumar, R, Al-Subaie, N, Kent, L, Tamm, T, Kajtor, I, Burns, K, Pugh, R, Ostermann, M, Kam, E, Bowyer, H, Smith, N, Templeton, M, Henning, J, Goffin, K, Kapoor, R, Laha, S, Chilton, P, Khaliq, W, Crayford, A, Coetzee, S, Tait, M, Boultoukas, E, Stoker, W, Gimenez, M, Pope, A, Camsooksai, J, Pogson, D, Quigley, K, Ritzema, J, Hormis, A, Boulanger, C, Balasubramaniam, M, Vamplew, L, Burt, K, Martin, D, Craig, J, Prowle, J, Doyle, N, Shelton, J, Scott, C, Donnison, P, Shelton, S, Frey, C, Ryan, C, Spray, D, Barnes, V, Barnes, K, Furneval, J, Ridgway, S, Saha, R, Clark, T, Wood, J, Bolger, C, Bassford, C, Lewandowski, J, Zhao, X, Humphreys, S, Dowling, S, Richardson, N, Burtenshaw, A, Stevenson, C, Wilcock, D, Aidoni, Z, Aloizos, S, Tasioudis, P, Lampiri, K, Zisopoulou, V, Ifigenia, R, Eymorfia, P, Angela, A, Katsoulas, T, Kyparissi, A, Aikaterini, K, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Hayes, I, Kelly, Y, Westbrook, A, Fitzpatrick, G, Maheshwari, D, Motherway, C, Gupta, M, Gurjar, M, Maji, I, Negri, G, Spadaro, S, Nattino, G, Pedeferri, M, Boscolo, A, Rossi, S, Rossi, M, Calicchio, G, Cubattoli, L, Di Lascio, G, Barbagallo, M, Berruto, F, Codazzi, D, Bottazzi, A, Fumagalli, P, Negro, G, Lupi, G, Savelli, F, Vulcano, G, Fumagalli, R, Marudi, A, Lefons, U, Lembo, R, Babini, M, Paggioro, A, Parrini, V, Zaccaria, M, Clementi, S, Gigliuto, C, Facondini, F, Pastorini, S, Munaron, S, Calamai, I, Bocchi, A, Brizio, E, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, Dieperink, W, de Waard, M, Bormans, L, Hahn, M, Kemmerer, N, Strietzel, H, Fehrle, L, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Borresen, O, Bjorsvik, G, Maini, S, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Serwa, M, Stefaniak, J, Pawel, M, Szymkowiak, M, Adamik, B, Catorze, N, Castelo Branco, M, Barros, I, Barros, N, Krystopchuk, A, Honrado, T, Sousa, C, Munoz, F, Rebelo, M, Gomes, R, Nunes, J, Dias, C, Fernandes, A, Petrisor, C, Constantin, B, Belskiy, V, Boskholov, B, Kawati, R, Sivik, J, Nauska, J, Smole, D, Parenmark, F, Lyren, J, Rockstroh, K, Ryden, S, Spangfors, M, Strinnholm, M, Walther, S, De Geer, L, Nordlund, P, Palsson, S, Zetterquist, H, Nilsson, A, Thiringer, K, Jungner, M, Bark, B, Nordling, B, Skold, H, Brorsson, C, Persson, S, Bergstrom, A, Berkius, J, Holmstrom, J, Yapici, N, Flaatten, Han, De Lange, Dylan W., Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Boumendil, Ariane, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjølner, Jesper, Jung, Christian, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agwald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andrea, Watson, Ximena, Zaferidis, Tilemacho, Guidet, Bertrand, Schmutz, René, Wimmer, Franz, Eller, Philipp, Zotter, Klemen, Swinnen, Walter, De Buysscher, Pieter, De Neve, Nikolaa, Abraham, Paul, Fleury, Yvan, Schefold, Joerg C., Biskup, Ewelina, Taliadoros, Ioanni, Piza, Petr, Lauten, Alexander, Sacher, Anna Lena, Brenner, Thorsten, Franz, Marcu, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobia, Nia, Amir M., Janosi, Rolf Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Dey, Nilanjan, Sølling, Christoffer, Rasmussen, Bodil Steen, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Jaimes, Marián Irazábal, Prado Mira, Ángela, Bodi, Maria A., Barea Mendoza, Jesus A., López-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesú, Ibarz, Mercede, Trenado-Alvarez, Josep, Forceville, Xavier, Besch, Guillaume, Mentec, Herve, Michel, Philippe, Mateu, Philippe, Vettoretti, Lucie, Bourenne, Jeremy, Marin, Nathalie, Guillot, Max, Aissaoui, Naida, Goulenok, Cyril, Thieulot-Rolin, Nathalie, Messika, Jonathan, Lamhaut, Lionel, Charron, Cyril, Dempsey, Ged, Mathew, Shiju J., Raj, Ashok S., Grecu, Irina, Cupitt, Jason, Lawton, Tom, Clark, Richard, Popescu, Monica, Spittle, Nick, Faulkner, Maria, Cowton, Amanda, Elloway, Esme, Williams, Patricia, Reay, Michael, Chukkambotla, Srikanth, Kumar, Ravi, Al-Subaie, Nawaf, Kent, Linda, Tamm, Tiina, Kajtor, Istvan, Burns, Karen, Pugh, Richard, Ostermann, Marlie, Kam, Elisa, Bowyer, Helen, Smith, Neil, Templeton, Maie, Henning, Jeremy, Goffin, Kelly, Kapoor, Ritoo, Laha, Shondipon, Chilton, Phil, Khaliq, Waqa, Crayford, Alison, Coetzee, Samantha, Tait, Moira, Boultoukas, Evangelo, Stoker, Wendy, Gimenez, Marc, Pope, Alan, Camsooksai, Julie, Pogson, David, Quigley, Kate, Ritzema, Jenny, Hormis, Anil, Boulanger, Carole, Balasubramaniam, M., Vamplew, Luke, Burt, Karen, Martin, Daniel, Craig, Jayne, Prowle, John, Doyle, Nanci, Shelton, Jonathon, Scott, Carmen, Donnison, Phil, Shelton, Sarah, Frey, Christian, Ryan, Christine, Spray, Dominic, Barnes, Veronica, Barnes, Kerry, Furneval, Julie, Ridgway, Stephanie, Saha, Rajnish, Clark, Thoma, Wood, Jame, Bolger, Clare, Bassford, Christopher, Lewandowski, john, Zhao, Xiaobei, Humphreys, Sally, Dowling, Susan, Richardson, Neil, Burtenshaw, Andrew, Stevenson, Carl, Wilcock, Danielle, Aidoni, Zoi, Aloizos, Stavro, Tasioudis, Polychroni, Lampiri, Kleri, Zisopoulou, Vasiliki, Ifigenia, Ravani, Eymorfia, Pagaki, Angela, Anttoniou, Katsoulas, Theodoros A., Kyparissi, Aikaterini, Aikaterini, Kounougeri, Marinakis, George, Tsimpoukas, Fotio, Spyropoulou, Anastasia, Zygoulis, Pari, Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, Rossi, Maurizio, Calicchio, Giuseppe, Cubattoli, Lucia, Di Lascio, Gabriella, Barbagallo, Maria, Berruto, Francesco, Codazzi, Daniela, Bottazzi, Andrea, Fumagalli, Paolo, Negro, Giancarlo, Lupi, Giuseppe, Savelli, Flavia, Vulcano, Giuseppe A., Fumagalli, Roberto, Marudi, Andrea, Lefons, Ugo, Lembo, Rita, Babini, Maria, Paggioro, Alessandra, Parrini, Vieri, Zaccaria, Maria, Clementi, Stefano, Gigliuto, Carmelo, Facondini, Francesca, Pastorini, Simonetta, Munaron, Susanna, Calamai, Italo, Bocchi, Anna, Brizio, Elisabetta, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, van Dijk, I., van Lelyveld-Haas, L.E.M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H.J., Dieperink, Willem, de Waard, Monique C., Bormans, Laura, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Fehrle, Lutz, Dybwik, Knut, Legernaes, Terje, Klepstad, Pål, Olaussen, Even Braut, Olsen, Knut Inge, Børresen, Ole Mariu, Bjørsvik, Geir, Maini, Sameer, Czuczwar, Miroslaw, Krawczyk, Pawel, Ziętkiewicz, Mirosław, Nowak, Łukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Grudzień, Paweł, Nasiłowski, Paweł, Popek, Natalia, Cyrankiewicz, Waldemar, Wnuk, Marek, Maciejewski, Dariusz, Studzińska, Dorota, Zukowski, Maciej, Bernas, Szymon, Serwa, Marta, Stefaniak, Jan, Pawel, Maciejewski, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Castelo Branco, Miguel, Barros, Inê, Barros, Nelson, Krystopchuk, Andriy, Honrado, Teresa, Sousa, Cristina, Munoz, Francisco, Rebelo, Marta, Gomes, Rui, Nunes, Jorge, Dias, Celeste, Fernandes, Ana Margarida, Petrisor, Cristina, Constantin, Bodolea, Belskiy, Vladislav, Boskholov, Bori, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyrén, Johanna, Rockstroh, Katalin, Rydén, Sara, Spångfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Pålsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Mårten, Bark, Björn, Nordling, Berit, Sköld, Han, Brorsson, Camilla, Persson, Stefan, Bergström, Anna, Berkius, Johan, Holmström, Johanna, and Yapici, Nihan

Subjects
Male, Time Factors, Outcome Assessment, Frail Elderly/statistics & numerical data, [SDV]Life Sciences [q-bio], HSJ UCI, Passive, Critical Care and Intensive Care Medicine, Frailty/classification/diagnosis/mortality/therapy, Severity of Illness Index, Severity of illne, Elderly, 0302 clinical medicine, Quality of life, Frailty, ICU, Mortality, Octogenarians, Severity of illness, Aged, 80 and over, Critical Illness, Europe, Euthanasia, Passive, Female, Frail Elderly, Geriatric Assessment, Humans, Intensive Care Units, Length of Stay, Outcome Assessment, Health Care, Proportional Hazards Models, Prospective Studies, Quality of Life, Hospital Mortality, 80 and over, 030212 general & internal medicine, Prospective cohort study, education.field_of_study, ddc:617, Mortality rate, [SDV] Life Sciences [q-bio], Length of Stay/statistics & numerical data, Cohort, Intensive Care Units/statistics & numerical data, Critical Illne, SOFA score, Human, medicine.medical_specialty, Time Factor, Intensive Care Unit, Population, INTENSIVE-CARE, Europe/epidemiology, Outcome Assessment (Health Care), 03 medical and health sciences, Octogenarian, Intensive care, Journal Article, medicine, COHORT, Octogenarinans, Intensive care medicine, education, Aged, OLDER, Euthanasia, business.industry, 030208 emergency & critical care medicine, Health Care, Prospective Studie, Critical Illness/mortality, UNIT, Emergency medicine, Proportional Hazards Model, business
Abstract

Purpose: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. Methods: A transnational prospective cohort study from October 2016 to May 2017 with 30days follow-up was set up by the European Society of Intensive Care Medicine. In total 311 ICUs from 21 European countries participated. The ICUs included the first consecutive 20 very old (≥80years) patients admitted to the ICU within a 3-month inclusion period. Frailty, SOFA score and therapeutic procedures were registered, in addition to limitations of care. For measurement of frailty the Clinical Frailty Scale was used at ICU admission. The main outcomes were ICU and 30-day mortality and survival at 30days. Results: A total of 5021 patients with a median age of 84years (IQR 81–86years) were included in the final analysis, 2404 (47.9%) were women. Admission was classified as acute in 4215 (83.9%) of the patients. Overall ICU and 30-day mortality rates were 22.1% and 32.6%. During ICU stay 23.8% of the patients did not receive specific ICU procedures: ventilation, vasoactive drugs or renal replacement therapy. Frailty (values ≥5) was found in 43.1% and was independently related to 30-day survival (HR 1.54; 95% CI 1.38–1.73) for frail versus non-frail. Conclusions: Among very old patients (≥80years) admitted to the ICU, the consecutive classes in Clinical Frailty Scale were inversely associated with short-term survival. The scale had a very low number of missing data. These findings provide support to add frailty to the clinical assessment in this patient group. Trial registration: ClinicalTrials.gov (ID: NCT03134807).

Published
2017

28. Major trauma critical pathway: preliminary results from the monitoring system in the regional network and in a hub center in Rome metropolitan area

Author

De Belvis, Antonio, Bocci, Maria Grazia, Morsella, A., Balducci, F. M., Loconsole, L., Angioletti, C., Ribaldi, S., Cingolani, E., Cambieri, A., Pennisi, Mariano Alberto, Antonelli, Massimo, and Franceschi, Francesco

Subjects
Adult, Male, Time Factors, Adolescent, Rome, Outcome and Process Assessment, Patient Readmission, Time-to-Treatment, Young Adult, Trauma Centers, Integrated, Settore MED/41 - ANESTESIOLOGIA, Hospital Planning, Humans, Hospital Mortality, Critical pathway, Preschool, Child, Patient outcome assessments, Aged, Quality Indicators, Health Care, Retrospective Studies, Emergency department, Patient centred care, Delivery of Health Care, Integrated, Infant, Newborn, Infant, Middle Aged, Newborn, Health Care, Outcome and Process Assessment, Health Care, Treatment Outcome, Child, Preschool, Quality Indicators, Critical Pathways, Wounds and Injuries, Female, Triage, Trauma network, Delivery of Health Care
Abstract

The aim of this study is to collect the two years' data regarding the Integrated Trauma Management System (SIAT) by capturing the activity of its three Hubs in the Italian Lazio Region and test the performance of one of the Hubs' (Fondazione Policlinico Universitario A. Gemelli - IRCCS, FPG -IRCCS) Major Trauma Clinical Pathway's (MTCP) monitoring system, introducing the preliminary results through volume, process and outcome indicators.A retrospective analysis on SIAT was conducted on years 2016 to 2018, by collecting outcome and timeliness indicators through the Lazio Informative System whereas the MTCP was monitored through set of indicators from the FPG - IRCCS Informative System belonging to randomly selected clinical records of the established period.Hubs managed 11.3% of the 998,240 patients admitted in SIAT. All patients eligible for MTCP were "Flagged", and 83% underwent a CT within 2 hours; intra-hospital mortality was 13% whereas readmission rates 16.9%.SIAT converges the most severe patients to its Hubs. The MTCP monitoring system was able to measure a total of 9 out of 13 indicators from the original panel. This research may serve as a departing point to conduct a pre-post analysis on the performance of the MTCP.

Published
2020

29. Construction of a stress scale specific to intensive care units: the PS-ICU scale

Author

Fournier, Alicia, Martin Delgado, Maria Cruz, Bocci, Maria Grazia, Prestifilippo, Alessia, Anota, Amélie, Aslanian, Pierre, Besch, Guillaume, Constantin, Jean-Michel, Quenot, Jean-Pierre, Bouhemad, Belaïd, Capellier, Gilles, Laurent, Alexandra, Laboratoire de psychologie : dynamiques relationnelles et processus identitaires [Dijon] (PSY-DREPI), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Maison des Sciences de l'Homme et de l'Environnement Claude Nicolas Ledoux (MSHE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hospital Universitario de Torrejón, Fondazione 'Policlinico Universitario A. Gemelli' [Rome], Chercheur indépendant, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Maison des Sciences de l'Homme de Dijon (MSH Dijon (MSHD)), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), the French Intensive Care Society International Congress, Stress et Santé mentale des soignants en réanimation : de l’outil d’évaluation aux dispositifs d’accompagnement psychologique, Maison des Sciences de l'Homme et de l'Environnement Claude Nicolas Ledoux (UAR 3124) (MSHE), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SHS.PSY]Humanities and Social Sciences/Psychology
Abstract

International audience; Rationale: The intensive care units (ICU) are fertile ground for the emergence of professional stressors. Assessed by individuals as situations that weaken or are beyond their resources, work-related stressors impact the mental and physical health of workers and the quality and safety of care. Currently, many tools are used to assess caregiver stress in ICU, but do not consider the specificity of this work. The objective of this international and multicentric study was to develop a perceived stress scale specific to ICU.Patients and methods: Interviews were conducted with 166 caregivers (84 nurses and 81 physicians) in four countries (France, Italy, Spain, Canada). These interviews were recorded, transcribed and then a thematic analysis was carried out to identify stress factors. A first version of the scale was pre-tested with 70 caregivers (30 physicians and 40 nurses) in the same countries. Finally, we carried out qualitative and quantitative analyses select the most relevant items.Results: We identified 99 stressors specific to the ICU that were grouped into eight main themes: stress in relation to 1) the patient, 2) the task to be performed, 3) the institutional context, 4) the team, 5) the organization of the unit, 6) the personal dimensions, 7) the patient’s family, 8) the working conditions. Following the pre-test, 50 items were selected to constitute the PS-ICU scale.Conclusion: Our results highlight specific items related to vital risk/emergency management and ethically and morally problematic situations. These dimensions will be discussed and compared against existing scales (e.g., JCQ). The PS-ICU scale will allow to better identify and measure stressors in ICU. This scale will contribute to the development of targeted actions in terms of prevention, training and support for professionals. The creation of an internationally validated tool will make it possible to develop comparative studies on cultural and organizational factors.

Published
2020

30. Additional file 1 of Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

Author

Grieco, Domenico Luca, Bongiovanni, Filippo, Chen, Lu, Menga, Luca S., Cutuli, Salvatore Lucio, Pintaudi, Gabriele, Carelli, Simone, Michi, Teresa, Flava Torrini, Lombardi, Gianmarco, Anzellotti, Gian Marco, Pascale, Gennaro De, Urbani, Andrea, Bocci, Maria Grazia, Tanzarella, Eloisa S., Bello, Giuseppe, Dell’Anna, Antonio M., Maggiore, Salvatore M., Brochard, Laurent, and Antonelli, Massimo

Abstract

Additional file 1 : Supplementary Table 1. Individual data of studied patients.

Published
2020
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31. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, M., Iorio, R., Bentivoglio, A. R., Tricoli, L., Riso, V., Marotta, J., Piano, C., Primiano, G., Zileri Del Verme, L., Lo Monaco, M. R., Calabresi, P., Abbate, Valeria, Acampora, Nicola, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Antonelli, Mariangela, Antonucci, Gabriele, Anzellotti, Gian Marco, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Barone, Fabiana, Bellantone, Rocco Domenico Alfonso, Bellieni, Andrea, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Bibbò, Stefano, Bini, Alessandra, Bisanti, Alessandra, Biscetti, Federico, Bocci, Maria Grazia, Bonadia, Nicola, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Bruni, Teresa, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Burzo, Livia, Calabrese, Angelo, Calvello, Maria Rosaria, Cambieri, Andrea, Cambise, Chiara, Cammà, Giulia, Candelli, Marcello, Canistro, Gennaro, Cantanale, Antonello, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Cardone, Silvia, Carelli, Simone, Carfì, Angelo, Carnicelli, Annamaria, Caruso, Cristiano, Casciaro, Francesco Antonio, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Cesarano, Melania, Chiarito, Annalisa, Cianci, Rossella, Cicchinelli, Sara, Ciccullo, Arturo, Cicetti, Marta, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Maria Ludovica, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Costanzi, Matteo, Covino, Marcello, Crupi, Davide, Cutuli, Salvatore Lucio, DAddio, Stefano, DAlessandro, Alessia, DAlfonso, Maria Elena, DAngelo, Emanuela, DAversa, Francesca, Damiano, Fernando, De Berardinis, Gian Maria, De Cunzo, Tommaso, De Gaetano, Donati Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Santis, Paolo, De Siena, Martina, De Vito, Francesco, Del Gatto, Valeria, Del Giacomo, Paola, Del Zompo, Fabio, DellAnna, Antonio Maria, Della, Polla Davide, Di Gialleonardo, Luca, Di Giambenedetto, Simona, Di Luca, Roberta, Di Maurizio, Luca, Di Muro, Mariangela, Dusina, Alex, Eleuteri, Davide, Esperide, Alessandra, Fachechi, Daniele, Faliero, Domenico, Falsiroli, Cinzia, Fantoni, Massimo, Fedele, Annalaura, Feliciani, Daniela, Ferrante, Cristina, Ferrone, Giuliano, Festa, Rossano, Fiore, Maria Chiara, Flex, Andrea, Forte, Evelina, Franceschi, Francesco, Francesconi, Alessandra, Franza, Laura, Funaro, Barbara, Fuorlo, Mariella, Fusco, Domenico, Gabrielli, Maurizio, Gaetani, Eleonora, Galletta, Claudia, Gallo, Antonella, Gambassi, Giovanni, Garcovich, Matteo, Gasbarrini, Antonio, Gasparrini, Irene, Gelli, Silvia, Giampietro, Antonella, Gigante, Laura, Giuliano, Gabriele, Giuliano, Giorgia, Giupponi, Bianca, Gremese, Elisa, Grieco, Domenico Luca, Guerrera, Manuel, Guglielmi, Valeria, Guidone, Caterina, Gullì, Antonio, Iaconelli, Amerigo, Iafrati, Aurora, Ianiro, Gianluca, Iaquinta, Angela, Impagnatiello, Michele, Inchingolo, Riccardo, Intini, Enrica, Iorio, Raffaele, Izzi, Immacolata Maria, Jovanovic, Tamara, Kadhim, Cristina, La Macchia, Rosa, La Milia, Daniele Ignazio, Landi, Francesco, Landi, Giovanni, Landi, Rosario, Landolfi, Raffaele, Leo, Massimo, Leone, Paolo Maria, Levantesi, Laura, Liguori, Antonio, Liperoti, Rosa, Lizzio, Marco Maria, Lo Monaco Maria, Rita, Locantore, Pietro, Lombardi, Francesco, Lombardi, Gianmarco, Lopetuso, Loris, Loria, Valentina, Losito, Angela Raffaella, Lucia, Mothanje Barbara Patricia, Macagno, Francesco, Macerola, Noemi, Maggi, Giampaolo, Maiuro, Giuseppe, Mancarella, Francesco, Mangiola, Francesca, Manno, Alberto, Marchesini, Debora, Maresca, Gian Marco, Marrone, Giuseppe, Martis, Ilaria, Martone, Anna Maria, Marzetti, Emanuele, Mattana, Chiara, Matteo, Maria Valeria, Maviglia, Riccardo, Mazzarella, Ada, Memoli, Carmen, Miele, Luca, Migneco, Alessio, Mignini, Irene, Milani, Alessandro, Milardi, Domenico, Montalto, Massimo, Montemurro, Giuliano, Monti, Flavia, Montini, Luca, Morena, Tony Christian, Morra, Vincenzina, Morretta, Chiara, Moschese, Davide, Murace, Celeste Ambra, Murdolo, Martina, Murri, Rita, Napoli, Marco, Nardella, Elisabetta, Natalello, Gerlando, Natalini, Daniele, Navarra, Simone Maria, Nesci, Antonio, Nicoletti, Alberto, Nicoletti, Rocco, Nicoletti, Tommaso Filippo, Nicolò, Rebecca, Nicolotti, Nicola, Nista, Enrico Celestino, Nuzzo, Eugenia, Oggiano, Marco, Ojetti, Veronica, Pagano, Francesco Cosimo, Paiano, Gianfranco, Pais, Cristina, Pallavicini, Federico, Palombo, Andrea, Paolillo, Federico, Papa, Alfredo, Papanice, Domenico, Papparella, Luigi Giovanni, Paratore, Mattia, Parrinello, Giuseppe, Pasciuto, Giuliana, Pasculli, Pierpaolo, Pecorini, Giovanni, Perniola, Simone, Pero, Erika, Petricca, Luca, Petrucci, Martina, Picarelli, Chiara, Piccioni, Andrea, Piccolo, Annalisa, Piervincenzi, Edoardo, Pignataro, Giulia, Pignataro, Raffaele, Pintaudi, Gabriele, Pisapia, Luca, Pizzoferrato, Marco, Pizzolante, Fabrizio, Pola, Roberto, Policola, Caterina, Pompili, Maurizio, Pontecorvi, Flavia, Pontecorvi, Valerio, Ponziani, Francesca, Popolla, Valentina, Porceddu, Enrica, Porfidia, Angelo, Porro, Lucia Maria, Potenza, Annalisa, Pozzana, Francesca, Privitera, Giuseppe, Pugliese, Daniela, Pulcini, Gabriele, Racco, Simona, Raffaelli, Francesca, Ramunno, Vittoria, Rapaccini, Gian Ludovico, Richeldi, Luca, Rinninella, Emanuele, Rocchi, Sara, Romanò, Bruno, Romano, Stefano, Rosa, Federico, Rossi, Laura, Rossi, Raimondo, Rossini, Enrica, Rota, Elisabetta, Rovedi, Fabiana, Rubino, Carlotta, Rumi, Gabriele, Russo, Andrea, Sabia, Luca, Salerno, Andrea, Salini, Sara, Salvatore, Lucia, Samori, Dehara, Sandroni, Claudio, Sanguinetti, Maurizio, Santarelli, Luca, Santini, Paolo, Santolamazza, Danilo, Santoliquido, Angelo, Santopaolo, Francesco, Santoro, Michele Cosimo, Sardeo, Francesco, Sarnari, Caterina, Saviano, Angela, Saviano, Luisa, Scaldaferri, Franco, Scarascia, Roberta, Schepis, Tommaso, Schiavello, Francesca, Scoppettuolo, Giancarlo, Sedda, Davide, Sessa, Flaminio, Sestito, Luisa, Settanni, Carlo, Siciliano, Matteo, Siciliano, Valentina, Sicuranza, Rossella, Simeoni, Benedetta, Simonetti, Jacopo, Smargiassi, Andrea, Soave, Paolo Maurizio, Sonnino, Chiara, Staiti, Domenico, Stella, Claudia, Stella, Leonardo, Stival, Eleonora, Taddei, Eleonora, Talerico, Rossella, Tamburello, Elio, Tamburrini, Enrica, Tanzarella, Eloisa Sofia, Tarascio, Elena, Tarli, Claudia, Tersali, Alessandra, Tilli, Pietro, Timpano, Jacopo, Torelli, Enrico, Torrini, Flavia, Tosato, Matteo, Tosoni, Alberto, Tricoli, Luca, Tritto, Marcello, Tumbarello, Mario, Tummolo, Anita Maria, Vallecoccia, Maria Sole, Valletta, Federico, Varone, Francesco, Vassalli, Francesco, Ventura, Giulio, Verardi, Lucrezia, Vetrone, Lorenzo, Vetrugno, Giuseppe, Visconti, Elena, Visconti, Felicia, Viviani, Andrea, Zaccaria, Raffaella, Zaccone, Carmelina, Zelano, Lorenzo, Zileri Dal Verme, Lorenzo, and Zuccalà, Giuseppe

Subjects
Male, Hospitalized patients, muscle, Settore M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA, neurological disorders, 0302 clinical medicine, Hyposmia, 030212 general & internal medicine, Respiratory system, education.field_of_study, Brain Diseases, Headache, virus diseases, Neuromuscular Diseases, Middle Aged, Hospitalization, medicine.anatomical_structure, Neurology, Female, medicine.symptom, Adult, medicine.medical_specialty, SARS‐CoV2, Coronavirus disease 2019 (COVID-19), Patients, Short Communication, Anosmia, precision medicine, Population, Encephalopathy, Short Communications, Clinical Neurology, Settore MED/26, 03 medical and health sciences, COVID‐19, Internal medicine, Throat, Influenza, Human, medicine, Humans, education, Aged, Retrospective Studies, business.industry, SARS-CoV-2, COVID-19, Hypoxia (medical), medicine.disease, respiratory tract diseases, body regions, Neurology (clinical), Nervous System Diseases, business, 030217 neurology & neurosurgery
Abstract

Background and purpose The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

33. Blood Glucose Levels Combined with Triage Revised Trauma Score Improve the Outcome Prediction in Adults and in Elderly Patients with Trauma

Author

Covino, Marcello, Zaccaria, R., Bocci, Maria Grazia, Carbone, Luigi, Torelli, E., Fuorlo, M., Piccioni, Andrea, Santoro, Michele, Sandroni, Claudio, Franceschi, Francesco, Covino M. (ORCID:0000-0002-6709-2531), Bocci M. G., Carbone L., Piccioni A., Santoro M., Sandroni C. (ORCID:0000-0002-8878-2611), Franceschi F. (ORCID:0000-0001-6266-445X), Covino, Marcello, Zaccaria, R., Bocci, Maria Grazia, Carbone, Luigi, Torelli, E., Fuorlo, M., Piccioni, Andrea, Santoro, Michele, Sandroni, Claudio, Franceschi, Francesco, Covino M. (ORCID:0000-0002-6709-2531), Bocci M. G., Carbone L., Piccioni A., Santoro M., Sandroni C. (ORCID:0000-0002-8878-2611), and Franceschi F. (ORCID:0000-0001-6266-445X)

Abstract

Introduction: This study was aimed to assess if combining the evaluation of blood glucose level (BGL) and the Triage Revised Trauma Score (T-RTS) may result in a more accurate prediction of the actual clinical outcome, both in general adult population and in elderly patients with trauma. Methods: This is a retrospective cohort study, conducted in the emergency department (ED) of an urban teaching hospital, with an average ED admission rate of 75,000 patients per year. Those excluded: known diagnosis of diabetes, age <18 years old, pregnancy, and mild trauma (classified as isolate trauma of upper or lower limb, in absence of exposed fractures). A combined Revised Trauma Score Glucose (RTS-G) score was obtained adding to T-RTS: two for BGL <160mg/dL (8.9mmol/L); one for BGL ≥160mg/dL and < 200mg/dL (11.1mmol/L); and zero for BGL ≥ 200mg/dL. The primary outcome was a composite of patient's death in ED or admission to intensive care unit (ICU). Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the overall performance of T-RTS and of the combined RTS-G score. Results: Among a total of 68,933 traumas, 9,436 patients (4,407 females) were enrolled, aged from 18 to 103 years; 4,288 were aged ≥65 years. A total of 577 (6.1%) met the primary endpoint: 38 patients died in ED (0.4%) and 539 patients were admitted to ICU. The T-RTS and BGL were independently associated to primary endpoint at multivariate analysis. The cumulative RTS-G score was significantly more accurate than T-RTS and reached the best accuracy in elderly patients. In general population, ROC area under curve (AUC) for T-RTS was 0.671 (95% CI, 0.661 - 0.680) compared to RTS-G ROC AUC 0.743 (95% CI, 0.734 - 0.752); P <.001. In patients ≥65 years, T-RTS ROC AUC was 0.671 (95% CI, 0.657 - 0.685) compared to RTS-G ROC AUC 0.780 (95% CI, 0.768 - 0.793); P <.001. Conclusions: Results showed RTS-G could be used effectively at ED triage for the risk stratification for death in ED

Published
2020

34. Prognostic factors associated with mortality risk and disease progression in 639 critically ill patients with COVID-19 in Europe: Initial report of the international RISC-19-ICU prospective observational cohort

Author

Wendel Garcia, Pedro David, primary, Fumeaux, Thierry, additional, Guerci, Philippe, additional, Heuberger, Dorothea Monika, additional, Montomoli, Jonathan, additional, Roche-Campo, Ferran, additional, Schuepbach, Reto Andreas, additional, Hilty, Matthias Peter, additional, Alfaro Farias, Mario, additional, Margarit, Antoni, additional, Vizmanos-Lamotte, Gerardo, additional, Tschoellitsch, Thomas, additional, Meier, Jens, additional, Cardona, Francesco S., additional, Skola, Josef, additional, Horakova, Lenka, additional, Aguirre-Bermeo, Hernan, additional, Apolo, Janina, additional, Novy, Emmanuel, additional, Losser, Marie-Reine, additional, Jurkolow, Geoffrey, additional, Delahaye, Gauthier, additional, David, Sascha, additional, Welte, Tobias, additional, Wengenmayer, Tobias, additional, Staudacher, Dawid L., additional, Aslanidis, Theodoros, additional, Babik, Barna, additional, Korsos, Anita, additional, Gal, Janos, additional, Csaba, Hermann, additional, Donati, Abele, additional, Carsetti, Andrea, additional, Turrini, Fabrizio, additional, Simonini, Maria Sole, additional, Ceriani, Roberto, additional, Murrone, Martina, additional, Rezoagli, Emanuele, additional, Vitale, Giovanni, additional, Fogagnolo, Alberto, additional, Spadaro, Savino, additional, Wu, Maddalena Alessandra, additional, Cogliati, Chiara, additional, Colombo, Riccardo, additional, Catena, Emanuele, additional, Facondini, Francesca, additional, Potalivo, Antonella, additional, Gangitano, Gianfilippo, additional, Perin, Tiziana, additional, Bocci, Maria Grazia, additional, Antonelli, Massimo, additional, Gommers, Diederik, additional, Ince, Can, additional, Mayor-Vázquez, Eric, additional, Cruz, Maria, additional, Delgado, Martin, additional, Garcia, Raquel Rodriguez, additional, Gamez Zapata, Jorge, additional, Zalba-Etayo, Begoña, additional, Lozano-Gomez, Herminia, additional, Castro, Pedro, additional, Tellez, Adrian, additional, Jacas, Adriana, additional, Muñoz, Guido, additional, Andrea, Rut, additional, Ortiz, Jose, additional, Quintana, Eduard, additional, Rovira, Irene, additional, Reverter, Enric, additional, Fernandez, Javier, additional, Ferrer, Miquel, additional, Badia, Joan R., additional, Lander Azcona, Arantxa, additional, Orta, Jesus Escos, additional, Bühler, Philipp, additional, Brugger, Silvio, additional, Hofmaenner, Daniel, additional, Unseld, Simone, additional, Ruschitzka, Frank, additional, Moret-Bochatay, Mallory, additional, Yuen, Bernd, additional, Hillermann, Thomas, additional, Ksouri, Hatem, additional, Sridharan, Govind Oliver, additional, Ristic, Anette, additional, Sepulcri, Michael, additional, Filipovic, Miodrag, additional, Pietsch, Urs, additional, Salomon, Petra, additional, Drvaric, Iris, additional, Schott, Peter, additional, Urech, Severin, additional, Lambert, Adriana, additional, Merki, Lukas, additional, Laube, Marcus, additional, Hillgaertner, Frank, additional, Sieber, Marianne, additional, Dullenkopf, Alexander, additional, Petersen, Lina, additional, Grazioli, Serge, additional, Rimensberger, Peter C., additional, Fleisch, Isabelle, additional, Lavanchy, Jerome, additional, Marquardt, Katharina, additional, Shaikh, Karim, additional, Redecker, Hermann, additional, Stephan, Michael, additional, Brem, Jan, additional, Rogdo, Bjarte, additional, Birkenmaier, Andre, additional, Meyer zu Bentrup, Friederike, additional, Fodor, Patricia, additional, Locher, Pascal, additional, Camen, Giovanni, additional, Siegemund, Martin, additional, Zellweger, Nuria, additional, Jeitziner, Marie-Madlen, additional, Jenni-Moser, Beatrice, additional, Bürkle, Christian, additional, Kleger, Gian-Reto, additional, Franchitti Laurent, Marilene, additional, Laurent, Jean-Christophe, additional, Gaspert, Tomislav, additional, Jovic, Marija, additional, Studhalter, Michael, additional, Haberthuer, Christoph, additional, Lussman, Roger F., additional, Selz, Daniela, additional, Naon, Didier, additional, Mauri, Romano, additional, Ceruti, Samuele, additional, Marrel, Julien, additional, Brenni, Mirko, additional, Ensner, Rolf, additional, Gehring, Nadine, additional, Heise, Antje, additional, Huebner, Tobias, additional, Neff, Thomas A., additional, Cereghetti, Sara, additional, Boroli, Filippo, additional, Pugin, Jerome, additional, Marczin, Nandor, additional, and Wong, Joyce, additional

Published
2020
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35. Data on the application of early coagulation support protocol in the management of major trauma patients

Author

Bocci, Maria Grazia, primary, Nardi, Giuseppe, additional, Veronesi, Giovanni, additional, Rondinelli, Maria Beatrice, additional, Palma, Antonella, additional, Fiore, Valentina, additional, De Candia, Erica, additional, Bianchi, Maria, additional, Maresca, Maddalena, additional, Barelli, Roberta, additional, Tersali, Alessandra, additional, Dell’Anna, Antonio Maria, additional, De Pascale, Gennaro, additional, Cutuli, Salvatore Lucio, additional, Mercurio, Giovanna, additional, Caricato, Anselmo, additional, Grieco, Domenico Luca, additional, Antonelli, Massimo, additional, and Cingolani, Emiliano, additional

Published
2019
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36. A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention

Author

Jung, Christian, Wernly, Bernhard, Muessig, Johanna M., Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjolner, Jesper, Lichtenauer, Michael, Bruno, Raphael Romano, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Ohman, Christina Agvald, Pinto, Bernadro Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Schmutz, Rene, Wimmer, Franz, Eller, Philipp, Joannidis, Michael, De Buysscher, Pieter, De Neve, Nikolaas, Swinnen, Walter, Abraham, Paul, Hergafi, Leila, Schefold, Joerg C., Biskup, Ewelina, Piza, Petr, Taliadoros, Ioannis, Dey, Nilanjan, Solling, Christoffer, Rasmussen, Bodil Steen, Forceville, Xavier, Besch, Guillaume, Mentec, Herve, Michel, Philippe, Mateu, Philippe, Vettoretti, Lucie, Bourenne, Jeremy, Marin, Nathalie, Guillot, Max, Aissaoui, Naida, Goulenok, Cyril, Thieulot-Rolin, Nathalie, Messika, Jonathan, Lamhaut, Lionel, Charron, Cyril, Lauten, Alexander, Sacher, Anna Lena, Brenner, Thorsten, Franz, Marcus, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobias, Nia, Amir M., Janosi, Rolf Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Aidoni, Zoi, Aloizos, Stavros, Tasioudis, Polychronis, Lampiri, Kleri, Zisopoulou, Vasiliki, Ravani, Ifigenia, Pagaki, Eumorfia, Antoniou, Angela, Katsoulas, Theodoros A., Kounougeri, Aikaterini, Marinakis, George, Tsimpoukas, Fotios, Spyropoulou, Anastasia, Zygoulis, Paris, Kyparissi, Aikaterini, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M., Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, Calicchio, Giuseppe, Cubattoli, Lucia, Di Lascio, Gabriella, Barbagallo, Maria, Berruto, Francesco, Codazzi, Daniela, Bottazzi, Andrea, Fumagalli, Paolo, Negro, Giancarlo, Lupi, Giuseppe, Savelli, Flavia, Vulcano, Giuseppe A., Fumagalli, Roberto, Marudi, Andrea, Lefons, Ugo, Lembo, Rita, Babini, Maria, Paggioro, Alessandra, Parrini, Vieri, Zaccaria, Maria, Clementi, Stefano, Gigliuto, Carmelo, Facondini, Francesca, Pastorini, Simonetta, Munaron, Susanna, Calamai, Italo, Bocchi, Anna, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, Brizio, Elisabetta, Rossi, Maurizio, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Dybwik, Knut, Legernaes, Terje, Klepstad, Pal, Olaussen, Even Braut, Olsen, Knut Inge, Brresen, Ole Marius, Bjorsvik, Geir, Maini, Sameer, Fehrle, Lutz, Czuczwar, Miroslaw, Krawczyk, Pawel, Zietkiewicz, Miroslaw, Nowak, Lukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Bohatyrewicz, Romuald, Gawda, Ryszard, Grudzien, Pawel, Nasilowski, Pawel, Popek, Natalia, Cyrankiewicz, Waldemar, Wawrzyniak, Katarzyna, Wnuk, Marek, Maciejewski, Dariusz, Studzinska, Dorota, Zukowski, Maciej, Bernas, Szymon, Piechota, Mariusz, Nowak, Ilona, Fronczek, Jakub, Serwa, Marta, Machala, Waldemar, Stefaniak, Jan, Wujtewicz, Maria, Maciejewski, Pawel, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Branco, Miguel Castelo, Barros, Ines, Barros, Nelson, Krystopchuk, Andriy, Honrado, Teresa, Sousa, Cristina, Munoz, Francisco, Rebelo, Marta, Gomes, Rui, Nunes, Jorge, Dias, Celeste, Fernandes, Ana Margarida, Petrisor, Cristina, Constantin, Bodolea, Belskiy, Vladislav, Boskholov, Boris, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Irazabal Jaimes, Marian, Prado Mira, Angela, Bodi, Maria A., Barea Mendoza, Jesus A., Lopez-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesus, Ibarz, Mercedes, Trenado Alvarez, Josep, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyren, Johanna, Rockstroh, Katalin, Ryden, Sara, Spangfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Palsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Marten, Bark, Bjorn, Nordling, Berit, Skold, Hans, Brorsson, Camilla, Persson, Stefan, Bergstrom, Anna, Berkius, Johan, Holmstrom, Johanna, van Dijk, I, van Lelyveld-Haas, L. E. M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H. J., de Lange, Dylan, Dieperink, Willem, de Waard, Monique C., de Smet, Annemarie G. E., Bormans, Laura, Dormans, Tom, Dempsey, Ged, Mathew, Shiju J., Raj, Ashok S., Grecu, Irina, Cupitt, Jason, Lawton, Tom, Clark, Richard, Popescu, Monica, Spittle, Nick, Faulkner, Maria, Cowton, Amanda, Elloway, Esme, Williams, Patricia, Reay, Michael, Chukkambotla, Srikanth, Kumar, Ravi, Al-Subaie, Nawaf, Kent, Linda, Tamm, Tiina, Kajtor, Istvan, Burns, Karen, Pugh, Richard, Ostermann, Marlies, Kam, Elisa, Bowyer, Helen, Smith, Neil, Templeton, Maie, Henning, Jeremy, Goffin, Kelly, Kapoor, Ritoo, Laha, Shondipon, Chilton, Phil, Khaliq, Waqas, Crayford, Alison, Coetzee, Samantha, Tait, Moira, Stoker, Wendy, Gimenez, Marc, Pope, Alan, Camsooksai, Julie, Pogson, David, Quigley, Kate, Ritzema, Jenny, Hormis, Anil, Boulanger, Carole, Balasubramaniam, M., Vamplew, Luke, Burt, Karen, Martin, Daniel, Craig, Jayne, Prowle, John, Doyle, Nanci, Shelton, Jonathon, Scott, Carmen, Donnison, Phil, Shelton, Sarah, Frey, Christian, Ryan, Christine, Spray, Dominic, Barnes, Veronica, Barnes, Kerry, Ridgway, Stephanie, Saha, Rajnish, Clark, Thomas, Wood, James, Bolger, Clare, Bassford, Christopher, Lewandowski, John, Zhao, Xiaobei, Humphreys, Sally, Dowling, Susan, Richardson, Neil, Burtenshaw, Andrew, Stevenson, Carl, Wilcock, Danielle, Nalapko, Yuiry, Jung, Christian, Wernly, Bernhard, Muessig, Johanna M., Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Fjolner, Jesper, Lichtenauer, Michael, Bruno, Raphael Romano, Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Ohman, Christina Agvald, Pinto, Bernadro Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Schmutz, Rene, Wimmer, Franz, Eller, Philipp, Joannidis, Michael, De Buysscher, Pieter, De Neve, Nikolaas, Swinnen, Walter, Abraham, Paul, Hergafi, Leila, Schefold, Joerg C., Biskup, Ewelina, Piza, Petr, Taliadoros, Ioannis, Dey, Nilanjan, Solling, Christoffer, Rasmussen, Bodil Steen, Forceville, Xavier, Besch, Guillaume, Mentec, Herve, Michel, Philippe, Mateu, Philippe, Vettoretti, Lucie, Bourenne, Jeremy, Marin, Nathalie, Guillot, Max, Aissaoui, Naida, Goulenok, Cyril, Thieulot-Rolin, Nathalie, Messika, Jonathan, Lamhaut, Lionel, Charron, Cyril, Lauten, Alexander, Sacher, Anna Lena, Brenner, Thorsten, Franz, Marcus, Bloos, Frank, Ebelt, Henning, Schaller, Stefan J., Fuest, Kristina, Rabe, Christian, Dieck, Thorben, Steiner, Stephan, Graf, Tobias, Nia, Amir M., Janosi, Rolf Alexander, Meybohm, Patrick, Simon, Philipp, Utzolino, Stefan, Rahmel, Tim, Barth, Eberhard, Schuster, Michael, Aidoni, Zoi, Aloizos, Stavros, Tasioudis, Polychronis, Lampiri, Kleri, Zisopoulou, Vasiliki, Ravani, Ifigenia, Pagaki, Eumorfia, Antoniou, Angela, Katsoulas, Theodoros A., Kounougeri, Aikaterini, Marinakis, George, Tsimpoukas, Fotios, Spyropoulou, Anastasia, Zygoulis, Paris, Kyparissi, Aikaterini, Gupta, Manish, Gurjar, Mohan, Maji, Ismail M., Hayes, Ivan, Kelly, Yvelynne, Westbrook, Andrew, Fitzpatrick, Gerry, Maheshwari, Darshana, Motherway, Catherine, Negri, Giovanni, Spadaro, Savino, Nattino, Giuseppe, Pedeferri, Matteo, Boscolo, Annalisa, Rossi, Simona, Calicchio, Giuseppe, Cubattoli, Lucia, Di Lascio, Gabriella, Barbagallo, Maria, Berruto, Francesco, Codazzi, Daniela, Bottazzi, Andrea, Fumagalli, Paolo, Negro, Giancarlo, Lupi, Giuseppe, Savelli, Flavia, Vulcano, Giuseppe A., Fumagalli, Roberto, Marudi, Andrea, Lefons, Ugo, Lembo, Rita, Babini, Maria, Paggioro, Alessandra, Parrini, Vieri, Zaccaria, Maria, Clementi, Stefano, Gigliuto, Carmelo, Facondini, Francesca, Pastorini, Simonetta, Munaron, Susanna, Calamai, Italo, Bocchi, Anna, Adorni, Adele, Bocci, Maria Grazia, Cortegiani, Andrea, Casalicchio, Tiziana, Mellea, Serena, Graziani, Elia, Barattini, Massimo, Brizio, Elisabetta, Rossi, Maurizio, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Dybwik, Knut, Legernaes, Terje, Klepstad, Pal, Olaussen, Even Braut, Olsen, Knut Inge, Brresen, Ole Marius, Bjorsvik, Geir, Maini, Sameer, Fehrle, Lutz, Czuczwar, Miroslaw, Krawczyk, Pawel, Zietkiewicz, Miroslaw, Nowak, Lukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Bohatyrewicz, Romuald, Gawda, Ryszard, Grudzien, Pawel, Nasilowski, Pawel, Popek, Natalia, Cyrankiewicz, Waldemar, Wawrzyniak, Katarzyna, Wnuk, Marek, Maciejewski, Dariusz, Studzinska, Dorota, Zukowski, Maciej, Bernas, Szymon, Piechota, Mariusz, Nowak, Ilona, Fronczek, Jakub, Serwa, Marta, Machala, Waldemar, Stefaniak, Jan, Wujtewicz, Maria, Maciejewski, Pawel, Szymkowiak, Malgorzata, Adamik, Barbara, Catorze, Nuno, Branco, Miguel Castelo, Barros, Ines, Barros, Nelson, Krystopchuk, Andriy, Honrado, Teresa, Sousa, Cristina, Munoz, Francisco, Rebelo, Marta, Gomes, Rui, Nunes, Jorge, Dias, Celeste, Fernandes, Ana Margarida, Petrisor, Cristina, Constantin, Bodolea, Belskiy, Vladislav, Boskholov, Boris, Rodriguez, Enver, Rebollo, Sergio, Aguilar, Gerardo, Masdeu, Gaspar, Irazabal Jaimes, Marian, Prado Mira, Angela, Bodi, Maria A., Barea Mendoza, Jesus A., Lopez-Cuenca, Sonia, Homez Guzman, Marcela, Rico-Feijoo, Jesus, Ibarz, Mercedes, Trenado Alvarez, Josep, Kawati, Rafael, Sivik, Joakim, Nauska, Jessica, Smole, Daniel, Parenmark, Fredric, Lyren, Johanna, Rockstroh, Katalin, Ryden, Sara, Spangfors, Martin, Strinnholm, Morten, Walther, Sten, De Geer, Lina, Nordlund, Peter, Palsson, Staffan, Zetterquist, Harald, Nilsson, Annika, Thiringer, Karin, Jungner, Marten, Bark, Bjorn, Nordling, Berit, Skold, Hans, Brorsson, Camilla, Persson, Stefan, Bergstrom, Anna, Berkius, Johan, Holmstrom, Johanna, van Dijk, I, van Lelyveld-Haas, L. E. M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter H. J., de Lange, Dylan, Dieperink, Willem, de Waard, Monique C., de Smet, Annemarie G. E., Bormans, Laura, Dormans, Tom, Dempsey, Ged, Mathew, Shiju J., Raj, Ashok S., Grecu, Irina, Cupitt, Jason, Lawton, Tom, Clark, Richard, Popescu, Monica, Spittle, Nick, Faulkner, Maria, Cowton, Amanda, Elloway, Esme, Williams, Patricia, Reay, Michael, Chukkambotla, Srikanth, Kumar, Ravi, Al-Subaie, Nawaf, Kent, Linda, Tamm, Tiina, Kajtor, Istvan, Burns, Karen, Pugh, Richard, Ostermann, Marlies, Kam, Elisa, Bowyer, Helen, Smith, Neil, Templeton, Maie, Henning, Jeremy, Goffin, Kelly, Kapoor, Ritoo, Laha, Shondipon, Chilton, Phil, Khaliq, Waqas, Crayford, Alison, Coetzee, Samantha, Tait, Moira, Stoker, Wendy, Gimenez, Marc, Pope, Alan, Camsooksai, Julie, Pogson, David, Quigley, Kate, Ritzema, Jenny, Hormis, Anil, Boulanger, Carole, Balasubramaniam, M., Vamplew, Luke, Burt, Karen, Martin, Daniel, Craig, Jayne, Prowle, John, Doyle, Nanci, Shelton, Jonathon, Scott, Carmen, Donnison, Phil, Shelton, Sarah, Frey, Christian, Ryan, Christine, Spray, Dominic, Barnes, Veronica, Barnes, Kerry, Ridgway, Stephanie, Saha, Rajnish, Clark, Thomas, Wood, James, Bolger, Clare, Bassford, Christopher, Lewandowski, John, Zhao, Xiaobei, Humphreys, Sally, Dowling, Susan, Richardson, Neil, Burtenshaw, Andrew, Stevenson, Carl, Wilcock, Danielle, and Nalapko, Yuiry

Abstract

Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed. Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality. Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02). Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.

Published
2019
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37. Improving communication toward ICU families to facilitate understanding and reduce stress. Protocol for a multicenter randomized and controlled Italian study

Author

Mistraletti, G., Mezzetti, A., Anania, S., Ionescu Maddalena, A., Del Negro, S., Giusti, G. D., Gili, A., Iacobone, E., Pulitano', Silvia Maria, Conti, Giorgio, Bocci, Maria Grazia, Pulitano S. M. (ORCID:0000-0002-8496-379X), Conti G. (ORCID:0000-0002-8566-9365), Bocci M. G., Mistraletti, G., Mezzetti, A., Anania, S., Ionescu Maddalena, A., Del Negro, S., Giusti, G. D., Gili, A., Iacobone, E., Pulitano', Silvia Maria, Conti, Giorgio, Bocci, Maria Grazia, Pulitano S. M. (ORCID:0000-0002-8496-379X), Conti G. (ORCID:0000-0002-8566-9365), and Bocci M. G.

Abstract

Objective: Families of ICU patients have a pressing need for information: they find themselves suddenly in a complex technical environment often because of a life-threatening illness of a loved one. Some evidence suggests that specific communication tools (like websites or brochures) could improve the experience of ICU families. Design: Randomized, multicenter, stepped wedge trial for large-scale assessment of the effectiveness of a multitasking intervention to improve communication with families of critically ill patients. Main outcome: correct understanding of the prognosis. Secondary outcomes: correct understanding of medical treatments, prevalence of anxiety, depression and post-traumatic stress symptoms in the first ICU week. Prevalence of PTSD 6 months from ICU discharge. Empathy and burnout among ICU staff. Prevalence of refusals for tissues/organ donation, and medical claims. Subjects: 2100 ICU relatives of critically ill patients. Interventions: The intervention employs specific tools especially designed to raise the correctness of information and to improve the quality of communication: a website presenting the ICU world and justifying the relatives' emotions, with a webpage specifically dedicated to each participating ICU; a standard brochure; eight posters for the families' waiting room and a signboard for the ICU door. Measurements and main results: The study plans to assess these materials in up to 300 Italian ICUs that will participate, according to a five waves program, each one with randomized starting order. This way the effect of the intervention will be evaluated simultaneously. Conclusion: This is an educational study, aiming to spread good medical practices, while also verifying their real effectiveness in a large number of ICUs. Trial registration number: NCT03438175.

Published
2019

38. Data on the application of early coagulation support protocol in the management of major trauma patients

Author

Bocci, Maria Grazia, Nardi, G., Veronesi, G., Rondinelli, M. B., Palma, Angelomaria, Fiore, V., De Candia, Erica, Bianchi, Maria, Maresca, Maddalena, Barelli, R., Tersali, A., Dell'Anna, Antonio Maria, De Pascale, Gennaro, Cutuli, S. L., Mercurio, Giovanna, Caricato, Anselmo, Grieco, D. L., Antonelli, Massimo, Cingolani, E., Bocci M. G., Palma A., De Candia E. (ORCID:0000-0003-0942-2819), Bianchi M., Maresca M., Dell'Anna A. M., De Pascale G. (ORCID:0000-0002-8255-0676), Mercurio G., Caricato A. (ORCID:0000-0001-5929-120X), Antonelli M. (ORCID:0000-0003-3007-1670), Bocci, Maria Grazia, Nardi, G., Veronesi, G., Rondinelli, M. B., Palma, Angelomaria, Fiore, V., De Candia, Erica, Bianchi, Maria, Maresca, Maddalena, Barelli, R., Tersali, A., Dell'Anna, Antonio Maria, De Pascale, Gennaro, Cutuli, S. L., Mercurio, Giovanna, Caricato, Anselmo, Grieco, D. L., Antonelli, Massimo, Cingolani, E., Bocci M. G., Palma A., De Candia E. (ORCID:0000-0003-0942-2819), Bianchi M., Maresca M., Dell'Anna A. M., De Pascale G. (ORCID:0000-0002-8255-0676), Mercurio G., Caricato A. (ORCID:0000-0001-5929-120X), and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

This article provides additional data on the application of early coagulation support protocol in the management of major trauma patients. Data come from a retrospective analysis reported in the article “Early coagulation support protocol: a valid approach in real-life management of major trauma patients. Results from two Italian centres” [1]. Data contain information about the relationship between differences in resource use and mortality outcomes, and patient demographic and clinical features at presentation. Furthermore, a comparison between resource consumption, the probability of multiple transfusions and the mortality outcomes among propensity-score matched patients is reported.

Published
2019

39. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: 'AbSeS', a multinational observational cohort study and ESICM Trials Group Project

Author

Carelli, Simone, De Pascale, Gennaro, Filetici, Nicoletta, Bocci, Maria Grazia, Maresca, Gian Marco, Cutuli, S. L., Pizzo, Cecilia Maria, Bello, Giuseppe, Montini, Luca, Caricato, Anselmo, Conti, Giorgio, Antonelli, Massimo, Carelli S., De Pascale G. (ORCID:0000-0002-8255-0676), Filetici N., Bocci M. G., Maresca G. M., Pizzo C. M., Bello G. (ORCID:0000-0003-2648-7235), Montini L. (ORCID:0000-0003-4602-5134), Caricato A. (ORCID:0000-0001-5929-120X), Conti G. (ORCID:0000-0002-8566-9365), Antonelli M. (ORCID:0000-0003-3007-1670), Carelli, Simone, De Pascale, Gennaro, Filetici, Nicoletta, Bocci, Maria Grazia, Maresca, Gian Marco, Cutuli, S. L., Pizzo, Cecilia Maria, Bello, Giuseppe, Montini, Luca, Caricato, Anselmo, Conti, Giorgio, Antonelli, Massimo, Carelli S., De Pascale G. (ORCID:0000-0002-8255-0676), Filetici N., Bocci M. G., Maresca G. M., Pizzo C. M., Bello G. (ORCID:0000-0003-2648-7235), Montini L. (ORCID:0000-0003-4602-5134), Caricato A. (ORCID:0000-0001-5929-120X), Conti G. (ORCID:0000-0002-8566-9365), and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

PURPOSE: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). METHODS: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. RESULTS: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. CONCLUSION: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outco

Published
2019

40. Early coagulation support protocol: A valid approach in real-life management of major trauma patients. Results from two Italian centres

Author

Bocci, Maria Grazia, Nardi, G., Veronesi, G., Rondinelli, M. B., Palma, A., Fiore, V., De Candia, Erica, Bianchi, M., Maresca, M., Barelli, R., Tersali, A., Dell'Anna, Antonio Maria, De Pascale, Gennaro, Cutuli, S. L., Mercurio, Giovanna, Caricato, Anselmo, Grieco, D. L., Antonelli, Massimo, Cingolani, E., Bocci M. G., De Candia E. (ORCID:0000-0003-0942-2819), Dell'Anna A. M., De Pascale G. (ORCID:0000-0002-8255-0676), Mercurio G., Caricato A. (ORCID:0000-0001-5929-120X), Antonelli M. (ORCID:0000-0003-3007-1670), Bocci, Maria Grazia, Nardi, G., Veronesi, G., Rondinelli, M. B., Palma, A., Fiore, V., De Candia, Erica, Bianchi, M., Maresca, M., Barelli, R., Tersali, A., Dell'Anna, Antonio Maria, De Pascale, Gennaro, Cutuli, S. L., Mercurio, Giovanna, Caricato, Anselmo, Grieco, D. L., Antonelli, Massimo, Cingolani, E., Bocci M. G., De Candia E. (ORCID:0000-0003-0942-2819), Dell'Anna A. M., De Pascale G. (ORCID:0000-0002-8255-0676), Mercurio G., Caricato A. (ORCID:0000-0001-5929-120X), and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

Introduction: Early coagulation support (ECS) includes prompt infusion of tranexamic acid, fibrinogen concentrate, and packed red blood cells for initial resuscitation of major trauma patients. The aim of this study was to determine the effects, in terms of blood product consumption, length of stay, and in-hospital mortality, of the ECS protocol, compared to the massive transfusion protocol (MTP) in the treatment of major trauma patients. Patients and methods: A retrospective analysis was conducted using the registry data of two Italian trauma centres. Adult major trauma patients with, or at risk of, active bleeding who were managed according to the MTP during the years 2011–2012, or the ECS protocol during the years 2013–2014 and were considered at risk of multiple transfusions, were enrolled. The primary endpoint was to determine whether the ECS protocol reduces the use of blood products in the acute management of trauma patients. Secondary endpoints were the outcome measures of length of stay in ICU, length of stay in hospital, and mortality at 24-hours and 28-days after hospital admission. Results: Among the 518 major trauma patients admitted to the trauma centres during the study period, 235 patients (118 in the pre-ECS period and 117 in the ECS period) matched one of the inclusion criteria and were enrolled in the study. Compared with the pre-ECS period, the ECS period showed a reduction in the average consumption of packed red blood cells (−1.87 units, 95% confidence interval [CI], −2.40, −1.34), platelets (−1.28 units; 95% CI, −1.64, −0.91), and fresh frozen plasma (−1.69; 95% CI, −2.14, −1.25) in the first 24-hours. Furthermore, during the ECS period, we recorded a 10-day reduction in the hospital length of stay (−10 days, 95% CI, −11.6, −8.4) and a non-significant 28-day mortality increase. Conclusions: The ECS protocol was effective in reducing blood product consumption compared to the MTP and confirmed the importance of early fibrinogen administration as

Published
2019

41. Family-Centered Care to Improve Family Consent for Organ Donation

Author

Bocci, Maria Grazia

Subjects
Medical / Surgery
Abstract

The need for organ donation has increased over time, but the shortage of available donors is the major limiting factor in transplantation. Organ donation refusal from relatives of potential donors with brain death significantly reduces organ availability. We report a brief analysis about family conflicts in decision-making and causes for refusing donation; moreover, we describe new family-centered strategies in the intensive care unit (ICU) and our systematic communication approach between medical staff and patients’ relatives. In 2016 we conducted a single-center, non-randomized, controlled and before and after study in our ICU, an 18-bed intensive care unit (ICU) of a university hospital. We compared the rate of consent for organ donation before and after the introduction of the new communication approach. The application of a new communication approach between medical staff and relatives of brain-dead patients was associated with a significant increase in the rate of consent to donation. The positive results of the 3-year period 2013–2015 have been confirmed in the 2-year period 2016–2017. Our results highlight the importance of empathy and counselor support of relatives in the ICU.

Published
2018

42. Lice, rodents, and many hopes: a rare disease in a young refugee

Author

Cutuli, Salvatore Lucio, De Pascale, Gennaro, Spanu, Teresa, Dell'Anna, Antonio Maria, Bocci, Maria Grazia, Pallavicini, Federico, Mancini, F, Ciervo, A, Antonelli, Massimo, De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Spanu, Teresa (ORCID:0000-0003-1864-5184), Pallavicini, Federico (ORCID:0000-0001-6874-0302), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Cutuli, Salvatore Lucio, De Pascale, Gennaro, Spanu, Teresa, Dell'Anna, Antonio Maria, Bocci, Maria Grazia, Pallavicini, Federico, Mancini, F, Ciervo, A, Antonelli, Massimo, De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Spanu, Teresa (ORCID:0000-0003-1864-5184), Pallavicini, Federico (ORCID:0000-0001-6874-0302), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

Borrelia recurrentis infection is a louse-borne disease and Leptospirosis is a rat-borne zoonosis, both endemic in areas characterized by a low hygiene condition. This is the first case of life-threatening Borrelia recurrentis and Leptospira species co-infection

Published
2017

43. Defining needs and goals of post-ICU care for trauma patients: preliminary study

Author

Bocci, Maria Grazia, Grieco, Domenico Luca, Lochi, Serena, Minguell Del Lungo, Laura, Pintaudi, Gabriele, Caricato, Anselmo, Murri, Rita, Calabrese, Claudia, Avolio, Maria, Sandroni, Claudio, Antonelli, Massimo, De Belvis, Ag, Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Lochi, S, Caricato, Anselmo (ORCID:0000-0001-5929-120X), Murri, Rita (ORCID:0000-0003-4263-7854), Sandroni, Claudio (ORCID:0000-0002-8878-2611), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Bocci, Maria Grazia, Grieco, Domenico Luca, Lochi, Serena, Minguell Del Lungo, Laura, Pintaudi, Gabriele, Caricato, Anselmo, Murri, Rita, Calabrese, Claudia, Avolio, Maria, Sandroni, Claudio, Antonelli, Massimo, De Belvis, Ag, Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Lochi, S, Caricato, Anselmo (ORCID:0000-0001-5929-120X), Murri, Rita (ORCID:0000-0003-4263-7854), Sandroni, Claudio (ORCID:0000-0002-8878-2611), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

Background: The aim of this study was to assess the long-term physical and psychological disabilities and their economic impact in severe trauma survivors. Methods: adult patients with injury severity score >15 and Abbreviated Injury Scale ≤3 admitted to the ICU of a level 1 trauma centre in the lazio region and discharged alive from hospital underwent a structured interview 12-24 months after the event. self-reported somatic symptoms, autonomy, anxiety and depression were evaluated using a Likert-type Scale, Barthel Index and Hospital Anxiety and Depression Score (HADS), respectively. Patients’ working and economic status were also investigated. Results: A total of 32/58 patients matching the inclusion criteria were included in the final analysis. eighteen patients (56%) reported at least a partial restriction in daily activities. Most common symptoms included muscle or joint pain, fatigue, and headache. All patients were receiving rehabilitation 1-2 years after the event. Fifty-eight percent of the patients spent more than €3600/year from their family budget for rehabilitation and medical care, however only 25% were receiving financial support from regional social services and 44% were unemployed at the time of the interview. thirty patients (94%) had HADS Depression Score≥11. Conclusion: Survivors of severe trauma in our cohort had limited autonomy and need long-term rehabilitation. Most of them rely on private healthcare services with a significant financial impact on their family budget. Almost all patients had moderate to severe depression. Future post-ICU counseling services should facilitate access to rehabilitation and psychological support for these patients

Published
2015

44. Linear and Nonlinear Heart Rate Variability Indexes in Clinical Practice

Author

Maviglia Riccardo, Bocci Maria Grazia, Calcinaro Sara, Buccelletti Francesco, Fiore Valentina, Fragnoli Chiara, Gilardi Emanuele, and Franceschi Francesco

Subjects
Male, medicine.medical_specialty, Pathology, Biological organism, Review Article, lcsh:Computer applications to medicine. Medical informatics, General Biochemistry, Genetics and Molecular Biology, Electrocardiography, Heart Rate, Internal medicine, Heart rate, medicine, Homeostasis, Humans, Heart rate variability, General Immunology and Microbiology, medicine.diagnostic_test, business.industry, Applied Mathematics, Linear model, Human heart, General Medicine, Clinical Practice, Nonlinear system, Nonlinear Dynamics, Modeling and Simulation, Linear Models, Cardiology, lcsh:R858-859.7, Female, Clinical Medicine, business
Abstract

Biological organisms have intrinsic control systems that act in response to internal and external stimuli maintaining homeostasis. Human heart rate is not regular and varies in time and such variability, also known as heart rate variability (HRV), is not random. HRV depends upon organism's physiologic and/or pathologic state. Physicians are always interested in predicting patient's risk of developing major and life-threatening complications. Understanding biological signals behavior helps to characterize patient's state and might represent a step toward a better care. The main advantage of signals such as HRV indexes is that it can be calculated in real time in noninvasive manner, while all current biomarkers used in clinical practice are discrete and imply blood sample analysis. In this paper HRV linear and nonlinear indexes are reviewed and data from real patients are provided to show how these indexes might be used in clinical practice.

Published
2012

45. Echography in brain imaging in intensive care unit: State of the art

Author

Caricato, Anselmo, Pitoni, Sara, Montini, Luca, Bocci, Maria Grazia, Annetta, Pina, Antonelli, Massimo, Caricato, Anselmo (ORCID:0000-0001-5929-120X), Montini, Luca (ORCID:0000-0003-4602-5134), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Caricato, Anselmo, Pitoni, Sara, Montini, Luca, Bocci, Maria Grazia, Annetta, Pina, Antonelli, Massimo, Caricato, Anselmo (ORCID:0000-0001-5929-120X), Montini, Luca (ORCID:0000-0003-4602-5134), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

Transcranial sonography (TCS) is an ultrasound-based imaging technique, which allows the identification of several structures within the brain parenchyma. In the past it has been applied for bedside assessment of different intracranial pathologies in children. Presently, TCS is also used on adult patients to diagnose intracranial space occupying lesions of various origins, intracranial hemorrhage, hydrocephalus, midline shift and neurodegenerative movement disorders, in both acute and chronic clinical settings. In comparison with conventional neuroimaging methods (such as computed tomography or magnetic resonance), TCS has the advantages of low costs, short investigation times, repeatability, and bedside availability. These noninvasive characteristics, together with the possibility of offering a continuous patient neuro-monitoring system, determine its applicability in the monitoring of multiple emergency and non-emergency settings. Currently, TCS is a still underestimated imaging modality that requires a wider diffusion and a qualified training process. In this review we focused on the main indications of TCS for the assessment of acute neurologic disorders in intensive care unit. KEYWORDS: Brain imaging; Brain sonography; Cerebral hemorrhage; Cerebral sonography; Hydrocephalus; Transcranial sonography; Ultrasounds PMID: 25276307 PMCID: PMC4176781 DOI: 10.4329/wjr.v6.i9.636

Published
2014

46. Pulmonary embolism in a stroke patient after systemic thrombolysis: clinical decisions and literature review

Author

Pilato, Fabio, Calandrelli, Rosalinda, Profice, Paolo, Della Marca, Giacomo, Broccolini, Aldobrando, Bello, Giuseppe, Bocci, Maria Grazia, Distefano, Marisa, Colosimo, Cesare, Rossini, Paolo Maria, Pilato, Fabio (ORCID:0000-0002-7248-3916), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Rossini, Paolo Maria (ORCID:0000-0003-2665-534X), Pilato, Fabio, Calandrelli, Rosalinda, Profice, Paolo, Della Marca, Giacomo, Broccolini, Aldobrando, Bello, Giuseppe, Bocci, Maria Grazia, Distefano, Marisa, Colosimo, Cesare, Rossini, Paolo Maria, Pilato, Fabio (ORCID:0000-0002-7248-3916), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Colosimo, Cesare (ORCID:0000-0003-3800-3648), and Rossini, Paolo Maria (ORCID:0000-0003-2665-534X)

Abstract

Pulmonary embolism can be a catastrophic event that can result in early death or serious hemodynamic dysfunction. The dehydration, immobility, and infections occurring in acute stroke patients puts these patients at risk of developing deep vein thrombosis and pulmonary embolism. Recombinant tissue-type plasminogen activator (rt-PA) is the established therapy for acute ischemic stroke, and its prompt administration results in a better outcome in stroke patients. We describe a 73-year-old man who arrived at the emergency room within 2 hours of acute onset of left hemiparesis who was treated with rt-PA and suffered a pulmonary embolism 3 days after acute stroke therapy. rt-PA is also a current therapy for pulmonary embolism, but an ischemic stroke in the previous 3 months is an absolute contraindication to thrombolysis because of the high risk of intracranial hemorrhage. We discuss clinical and therapeutic decisions and review the current literature.

Published
2013

47. Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients.

Author

Antonelli, Massimo, Caricato, Anselmo, Montini, Luca, Bello, Giuseppe, Michetti, Vincenzo, Maviglia, Riccardo, Bocci, Maria Grazia, Mercurio, Giovanna, Maggiore, Salvatore Maurizio, Antonelli, Massimo (ORCID:0000-0003-3007-1670), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Montini, Luca (ORCID:0000-0003-4602-5134), Michetti, Vincenzo (ORCID:0000-0002-6076-6118), Antonelli, Massimo, Caricato, Anselmo, Montini, Luca, Bello, Giuseppe, Michetti, Vincenzo, Maviglia, Riccardo, Bocci, Maria Grazia, Mercurio, Giovanna, Maggiore, Salvatore Maurizio, Antonelli, Massimo (ORCID:0000-0003-3007-1670), Caricato, Anselmo (ORCID:0000-0001-5929-120X), Montini, Luca (ORCID:0000-0003-4602-5134), and Michetti, Vincenzo (ORCID:0000-0002-6076-6118)

Abstract

OBJECTIVE: To investigate incidence, risk factors and outcome of Acinetobacter baumanii infection in trauma patients. DESIGN AND SETTING: A retrospective analysis of prospectively collected data of all trauma patients admitted to a general intensive care unit (ICU) of a 1,500-bed university hospital over 3 years. PATIENTS: Three hundred thirty trauma patients were included in the study. RESULTS: Thirty-six (10.9%) cases of A. baumanii infection were observed; 29 of them were late onset pneumonia. Patients with A. baumanii infection had a significantly higher Injury Severity Score (ISS) (p = 0.02), a lower Glasgow Coma Scale (GCS) on ICU admission (p = 0.03), stayed longer in the ICU (p = 0.00001), were mechanically ventilated for a longer period of time (p = 0.00001), were more frequently admitted to the emergency department with hypotension (p = 0.02), and had trans-skeletal traction for more than 3 days (p = 0.003) in comparison to the 294 patients who did not develop A. baumanii infection. At multivariate analysis the time spent on mechanical ventilation (p = 0.02) and the presence of long-term trans-skeletal traction (p = 0.04) were the only independent risk factors for A. baumanii infection. Patients with A. baumanii infection had a high mortality rate (9 out of 36; 25.0%). ISS (p = 0.003), GCS (p = 0.001) and older age (p = 0.00001), but not A. baumanii infection (p = 0.15), were independently correlated with mortality. CONCLUSIONS: In trauma patients prolonged mechanical ventilation and delayed fracture fixation with the persistence of trans-skeletal traction were major risk factors for A. baumanii infection. The presence of this infection was not correlated with mortality.

Published
2009

48. Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients

Author

Caricato, Anselmo, Montini, Luca, Bello, Giuseppe, Michetti, Vincenzo, Maviglia, Riccardo, Bocci, Maria Grazia, Mercurio, Giovanna, Maggiore, Salvatore Maurizio, Antonelli, Massimo, Caricato, Anselmo (ORCID:0000-0001-5929-120X), Montini, Luca (ORCID:0000-0003-4602-5134), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Michetti, Vincenzo (ORCID:0000-0002-6076-6118), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Caricato, Anselmo, Montini, Luca, Bello, Giuseppe, Michetti, Vincenzo, Maviglia, Riccardo, Bocci, Maria Grazia, Mercurio, Giovanna, Maggiore, Salvatore Maurizio, Antonelli, Massimo, Caricato, Anselmo (ORCID:0000-0001-5929-120X), Montini, Luca (ORCID:0000-0003-4602-5134), Bello, Giuseppe (ORCID:0000-0003-2648-7235), Michetti, Vincenzo (ORCID:0000-0002-6076-6118), and Antonelli, Massimo (ORCID:0000-0003-3007-1670)

Abstract

OBJECTIVE: To investigate incidence, risk factors and outcome of Acinetobacter baumanii infection in trauma patients. DESIGN AND SETTING: A retrospective analysis of prospectively collected data of all trauma patients admitted to a general intensive care unit (ICU) of a 1,500-bed university hospital over 3 years. PATIENTS: Three hundred thirty trauma patients were included in the study. RESULTS: Thirty-six (10.9%) cases of A. baumanii infection were observed; 29 of them were late onset pneumonia. Patients with A. baumanii infection had a significantly higher Injury Severity Score (ISS) (p = 0.02), a lower Glasgow Coma Scale (GCS) on ICU admission (p = 0.03), stayed longer in the ICU (p = 0.00001), were mechanically ventilated for a longer period of time (p = 0.00001), were more frequently admitted to the emergency department with hypotension (p = 0.02), and had trans-skeletal traction for more than 3 days (p = 0.003) in comparison to the 294 patients who did not develop A. baumanii infection. At multivariate analysis the time spent on mechanical ventilation (p = 0.02) and the presence of long-term trans-skeletal traction (p = 0.04) were the only independent risk factors for A. baumanii infection. Patients with A. baumanii infection had a high mortality rate (9 out of 36; 25.0%). ISS (p = 0.003), GCS (p = 0.001) and older age (p = 0.00001), but not A. baumanii infection (p = 0.15), were independently correlated with mortality. CONCLUSIONS: In trauma patients prolonged mechanical ventilation and delayed fracture fixation with the persistence of trans-skeletal traction were major risk factors for A. baumanii infection. The presence of this infection was not correlated with mortality. PMID: 19652951 DOI: 10.1007/s00134-009-1582-5

Published
2009

49. Good neurological recovery after cardiopulmonary resuscitation and thrombolysis in two old patients with pulmonary embolism

Author

Sandroni, Claudio, Cavallaro, Fabio, Bocci, Maria Grazia, Marano, Cristina, Sandroni, Claudio (ORCID:0000-0002-8878-2611), Sandroni, Claudio, Cavallaro, Fabio, Bocci, Maria Grazia, Marano, Cristina, and Sandroni, Claudio (ORCID:0000-0002-8878-2611)

Abstract

The use of thrombolysis as an emergency treatment for cardiac arrest (CA) due to massive pulmonary embolism (MPE) has been described. However, there are no reports of successful treatment of MPE-associated CA in patients over 77 years of age. We report two cases of successful cardiopulmonary resuscitation for an MPE-associated CA in two very old women (87 and 86 years of age). In both cases, typical signs of MPE were documented using emergency echocardiography, which showed an acute right ventricle enlargement and a paradoxical movement of the interventricular septum. Emergency thrombolysis was administered during resuscitation, which lasted 45 and 21 min, respectively. Despite old age and prolonged resuscitation efforts, both patients had good neurological recovery and one of them was alive and neurologically intact 1 year later. Thrombolysis is a potentially useful therapy in MPE-associated CA. A good neurological outcome can be obtained even in very old patients and after prolonged resuscitation.

Published
2009

50. Multitrauma, Including Peripheral Compartment Syndrome

Author

Richard Albert, Arthur Slutski, Marco Ranieri, Antoni Torres, Jukka Takala, Antonelli, Massimo, Arcangeli, Andrea, Bocci, Maria Grazia, Caricato, Anselmo, Antonelli M. (ORCID:0000-0003-3007-1670), Arcangeli A. (ORCID:0000-0001-6755-5981), Bocci M. G., Caricato A. (ORCID:0000-0001-5929-120X), Richard Albert, Arthur Slutski, Marco Ranieri, Antoni Torres, Jukka Takala, Antonelli, Massimo, Arcangeli, Andrea, Bocci, Maria Grazia, Caricato, Anselmo, Antonelli M. (ORCID:0000-0003-3007-1670), Arcangeli A. (ORCID:0000-0001-6755-5981), Bocci M. G., and Caricato A. (ORCID:0000-0001-5929-120X)

Published
2006

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