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1. Association between left ventricular systolic function parameters and myocardial injury, organ failure and mortality in patients with septic shock

Author: Blixt, Patrik Johansson, Nguyen, Maxime, Cholley, Bernard, Hammarskjöld, Fredrik, Toiron, Alois, Bouhemad, Belaid, Lee, Shaun, De Geer, Lina, Andersson, Henrik, Aneq, Meriam Åström, Engvall, Jan, and Chew, Michelle S.
Published: 2024
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2. The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data

Author: Bruno, Raphael Romano, Wernly, Bernhard, Bagshaw, Sean M., van den Boogaard, Mark, Darvall, Jai N., De Geer, Lina, de Gopegui Miguelena, Pablo Ruiz, Heyland, Daren K., Hewitt, David, Hope, Aluko A., Langlais, Emilie, Le Maguet, Pascale, Montgomery, Carmel L., Papageorgiou, Dimitrios, Seguin, Philippe, Geense, Wytske W., Silva-Obregón, J. Alberto, Wolff, Georg, Polzin, Amin, Dannenberg, Lisa, Kelm, Malte, Flaatten, Hans, Beil, Michael, Franz, Marcus, Sviri, Sigal, Leaver, Susannah, Guidet, Bertrand, Boumendil, Ariane, and Jung, Christian
Published: 2023
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3. Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study

Author: Tabah, Alexis, Lipman, Jeffrey, Pollock, Hamish, Ben Margetts, Udy, Andrew, Young, Meredith, Bhadange, Neeraj, Tyler, Steven, Ledtischke, Anne, Finnis, Mackenzie, Dwivedi, Jyotsna, Saxena, Manoj, Biradar, Vishwanath, Soar, Natalie, Sarode, Vineet, Brewster, David, Regli, Adrian, Weeda, Elizabeth, Ahmed, Samiul, Fourie, Cheryl, Laupland, Kevin, Ramanan, Mahesh, Walsham, James, Meyer, Jason, Litton, Edward, Maria Palermo, Anna, Yap, Timothy, Eroglu, Ege, George Attokaran, Antony, Jaramillo, C'havala, Nafees, Khalid Mk, Nafees, Khalid Mahmood Khan, Aqilah Haji Abd Rashid, Nurhikmahtul, Adi Muhamad Ibnu Walid, Haji, Mon, Tomas, Dhakshina Moorthi, P., Sudhirchandra, Shah, Sridharan, Dhadappa Damodar, Haibo, Qiu, Xie, Jianfeng, Jianfeng, Xie, Wei-Hua, Lu, Zhen, Wang, Qian, Chuanyun, Luo, Jili, Chen, Xiaomei, Wang, Hao, Zhao, Peng, Zhao, Juan, Wusi, Qiu, Mingmin, Chen, Xu, Lei, Yin, Chengfen, Wang, Ruilan, Wang, Jinfeng, Yin, Yongjie, Zhang, Min, Ye, Jilu, Hu, Chungfang, Zhou, Suming, Huang, Min, Yan, Jing, Wang, Yan, Qin, Bingyu, Ye, Ling, Weifeng, Xie, Peije, Li, Geng, Nan, Ling, Lowell, Hayashi, Yoshiro, Karumai, Toshiyuki, Yamasaki, Masaki, Hashimoto, Satoru, Hosokawa, Koji, Makino, Jun, Matsuyoshi, Takeo, Kuriyama, Akira, Shigemitsu, Hidenobu, Mishima, Yuka, Nagashima, Michio, Yoshida, Hideki, Fujitani, Shigeki, Omori, Koichiro, Rinka, Hiroshi, Saito, Hiroki, Atobe, Kaori, Kato, Hideaki, Takaki, Shunsuke, Sulaiman, Helmi, Shahnaz Hasan, M., Fadhil Hadi Jamaluddin, Muhamad, Pheng, Lee See, Visvalingam, Sheshendrasurian, Thing Liew, Mun, Ling Danny Wong, Siong, Khang Fong, Kean, Bt Abdul Rahman, Hamizah, Md Noor, Zuraini, Lee, Kok Tong, Hamid Azman, Abd., Zulfakar Mazlan, Mohd, Ali, Saedah, Hernandez, Aaron Mark, Abello, Anton, Jeon, Kyeongman, Lee, Sang-Min, Park, Sunghoon, Park, Seung Yong, Yoon Lim, Sung, Kwa, Andrea Lay Hoon, Yuan Goh, Qing, Ng, Shin Yi, An Lie, Sui, Junyang Goh, Ken, Yunkai Li, Andrew, Ong, Caroline Yu Ming, Yan Lim, Jia, Lishan Quah, Jessica, Ng, Kangqi, Xiang Long Ng, Louis, Yeh, Tony Yu-Chang, Chang Yeh, Yu, Chou, Nai-Kuan, Cia, Cong-Tat, Hu, Ting-Yu, Kuo, Li-Kuo, Ku, Shih-Chi, Wongsurakiat, Phunsup, Apichatbutr, Yutthana, Chiewroongroj, Supattra, Alsisi, Adel, Nadeem, Rashid, El Houfi, Ashraf, Elhadidy, Amr, Barsoum, Mina, Osman, Nermin, Mostafa, Tarek, Elbahnasawy, Mohamed, Saber, Ahmed, Aldhalia, Amer, Elmandouh, Omar, Elsayed, Ahmed, Elbadawy, Merihan A., Awad, Ahmed K., Hemead, Hanan M., Zand, Farid, Ouhadian, Maryam, Hamid Borsi, Seyed, Mehraban, Zahra, Kashipazha, Davood, Ahmadi, Fatemeh, Savaie, Mohsen, Soltani, Farhad, Rashidi, Mahboobeh, Baghbanian, Reza, Javaherforoosh, Fatemeh, Amiri, Fereshteh, Kiani, Arash, Amin Zargar, Mohammad, Mahmoodpoor, Ata, Aalinezhad, Fatemeh, Dabiri, Gholamreza, Sabetian, Golnar, Sarshad, Hakimeh, Masjedi, Mansoor, Tajvidi, Ramin, Nasirodin (S.M.N.) Tabatabaei, Dr Seyed Mohammad, Ahmed, Abdullah Khudhur, Singer, Pierre, Kagan, Ilya, Rigler, Merav, Belman, Daniel, Levin, Phillip, Harara, Belal, Diab, Adei, Abillama, Fayez, Abilama, Fayez, Ibrahim, Rebecca, Fares, Aya, Elhadi, Muhammed, Buimsaedah, Ahmad, Gamra, Marwa, Aqeelah, Ahmed, Ali Mohammed Ali, Almajdoub, Gaber Sadik Homaidan, Ahmed, Almiqlash, Bushray, Bilkhayr, Hala, Bouhuwaish, Ahmad, Sa Taher, Ahmed, Abdulwahed, Eman, Abousnina, Fathi A., Khaled Hdada, Aisha, Jobran, Rania, Ben Hasan, Hayat, Shaban Ben Hasan, Rabab, Khalid Abidi, Serghini, Issam, Seddiki, Rachid, Boukatta, Brahim, Kanjaa, Nabil, Mouhssine, Doumiri, Ahmed Wajdi, Maazouzi, Dendane, Tarek, Ali Zeggwagh, Amine, Housni, Brahim, Younes, Oujidi, Hachimi, Abdelhamid, Ghannam, A., Belkhadir, Z., Abu Jayyab, Mustafa, Aithssain, Ali, Lance, Marcus, Nissar, Shaikh, Sallam, Hend, Elrabi, Omar, Almekhlafi, Ghaleb A., Awad, Maher, Aljabbary, Ahmed, Karam Chaaban, Mohammad, Abu-Sayf, Natalia, Al-Jadaan, Mohammad, Bakr, Lubna, Mounir Bouaziz, Bouaziz, Mounir, Turki, Olfa, Sellami, Walid, Vidal, Gabriela, Centeno, Pablo, Morvillo, Natalia, Oscar Acevedo, José, Mabel Lopez, Patricia, Fernández, Rubén, Segura, Matías, Aparicio, Marta, Alonzo, Irene, Nuccetelli, Yanina, Montefiore, Pablo, Arias, Mario, Felipe Reyes, Luis, Ñamendys-Silva, Silvio A., Romero-Gonzalez, Juan P., Hermosillo, Mariana, Alejandro Castillo, Roberto, Nicolás Pantoja Leal, Jesús, Garcia Aguilar, Candy, Ocotlan Gonzalez Herrera, Mara, Vladimir Espinoza Villafuerte, Missael, Lomeli-Teran, Manuel, Dominguez-Cherit, Jose G., Davalos-Alvarez, Adrian, Sánchez-Hurtado, Luis, Tejeda-Huezo, Brigitte, Perez-Nieto, Orlando R., Deloya Tomas, Ernesto, De Bus, Liesbet, De Waele, Jan, Francois, Guy, Hollevoet, Isabelle, Denys, Wouter, Bourgeois, Marc, Vanderhaeghen, Sofie F.M., Mesland, Jean-Baptiste, Henin, Pierre, Haentjens, Lionel, Biston, Patrick, Noel, Cindérella, Layos, Nathalie, Misset, Benoît, De Schryver, Nicolas, Serck, Nicolas, Wittebole, Xavier, De Waele, Elisabeth, Opdenacker, Godelive, Kovacevic, Pedja, Zlojutro, Biljana, Ina, Filipovic-Grcic, Custovic, Aida, Filipovic-Grcic, Ina, Radonic, Radovan, Vujaklija Brajkovic, Ana, Persec, Jasminka, Sakan, Sanja, Nikolic, Mario, Lasic, Hrvoje, Leone, Marc, Timsit, Jean-François, Ruppe, Etienne, Ruckly, Stephane, Montravers, Philippe, Arbelot, Charlotte, Patrier, Juliette, Zappela, N., Montravers, P., Dulac, Thierry, Castanera, Jérémy, Auchabie, Johann, Le Meur, Anthony, Marchalot, A., Beuzelin, M., Massri, Alexandre, Guesdon, Charlotte, Escudier, Etienne, Mateu, Philippe, Rosman, Jérémy, Leroy, Olivier, Alfandari, Serge, Nica, Alexandru, Souweine, Bertrand, Coupez, Elisabeth, Duburcq, Thibault, Kipnis, Eric, Bortolotti, Perrine, Le Souhaitier, Mathieu, Mira, Jean-Paul, Garcon, Pierre, Duprey, Matthieu, Thyrault, Martial, Paulet, Rémi, Philippart, François, Tran, Marc, Bruel, Cédric, Weiss, Emmanuel, Janny, Sylvie, Foucrier, Arnaud, Perrigault, Pierre-François, Djanikian, Flora, Barbier, François, Gainnier, Marc, Bourenne, Jérémy, Louis, Guillaume, Smonig, Roland, Argaud, Laurent, Baudry, Thomas, Mekonted Dessap, Armand, Razazi, Keyvan, Kalfon, Pierre, Badre, Gaëtan, Larcher, Romaric, Lefrant, Jean-Yves, Roger, Claire, Sarton, Benjamine, Silva, Stein, Demeret, Sophie, Le Guennec, Loïc, Siami, Shidasp, Aparicio, Christelle, Voiriot, Guillaume, Fartoukh, Muriel, Dahyot-Fizelier, Claire, Imzi, Nadia, Klouche, Kada, Bracht, Hendrik, Hoheisen, Sandra, Bloos, Frank, Thomas-Rueddel, Daniel, Petros, Sirak, Pasieka, Bastian, Dubler, Simon, Schmidt, Karsten, Gottschalk, Antje, Wempe, Carola, Lepper, Philippe, Metz, Carlos, Viderman, Dmitriy, Umbetzhanov, Yerlan, Mugazov, Miras, Bazhykayeva, Yelena, Kaligozhin, Zhannur, Babashev, Baurzhan, Merenkov, Yevgeniy, Temirov, Talgat, Arvaniti, Kostoula, Smyrniotis, Dimitrios, Psallida, Vasiliki, Fildisis, Georgios, Soulountsi, Vasiliki, Kaimakamis, Evangelos, Iasonidou, Cristina, Papoti, Sofia, Renta, Foteini, Vasileiou, Maria, Romanou, Vasiliki, Koutsoukou, Vasiliki, Kristina Matei, Mariana, Moldovan, Leora, Karaiskos, Ilias, Paskalis, Harry, Marmanidou, Kyriaki, Papanikolaou, M., Kampolis, C., Oikonomou, Marina, Kogkopoulos, Evangelos, Nikolaou, Charikleia, Sakkalis, Anastasios, Chatzis, Marinos, Georgopoulou, Maria, Efthymiou, Anna, Chantziara, Vasiliki, Sakagianni, Aikaterini, Athanasa (Athanassa), Zoi (Zoe), Papageorgiou, Eirini, Ali, Fadi, Dimopoulos, Georges, Panagiota Almiroudi, Mariota, Malliotakis, Polychronis, Marouli, Diamantina, Theodorou, Vasiliki, Retselas, Ioannis, Kouroulas, Vasilios, Papathanakos, Georgios, Bassetti, Matteo, Giacobbe, Daniele, Montrucchio, Giorgia, Sales, Gabriele, De Pascale, Gennaro, Maria Montini, Luca, Carelli, Simone, Vargas, Joel, Di Gravio, Valentina, Roberto Giacobbe, Daniele, Gratarola, Angelo, Porcile, Elisa, Mirabella, Michele, Daroui, Ivan, Lodi, Giovanni, Zuccaro, Francesco, Grazia Schlevenin, Maria, Pelosi, Paolo, Battaglini, Denise, Cortegiani, Andrea, Ippolito, Mariachiara, Bellina, Davide, Di Guardo, Andrea, Pelagalli, Lorella, Covotta, Marco, Rocco, Monica, Fiorelli, Silvia, Cotoia, Antonella, Chiara Rizzo, Anna, Adam Mikstacki, Mikstacki, Adam, Tamowicz, Barbara, Kaptur Komorowska, Irmina, Szczesniak, Anna, Bojko, Jozef, Kotkowska, Anna, Walczak-Wieteska, Paulina, Wasowska, Dominika, Nowakowski, Tomasz, Broda, Hanna, Mariusz Peichota, Assoc, Pietraszek-Grzywaczewska, Iwona, Martin-Loeches, Ignacio, Bisanti, Alessandra, Paiva, José Artur, Póvoa, Pedro, Cartoze, Nuno, Pereira, Tiago, Guimarães, Nádia, Alves, Madalena, Josefina Pinheiro Marques, Ana, Rios Pinto, Ana, Krystopchuk, Andriy, Teresa, Ana, Manuel Pereira de Figueiredo, António, Botelho, Isabel, Duarte, Tiago, Costa, Vasco, Pedro Cunha, Rui, Molinos, Elena, Tito da Costa, Ledo, Sara, Queiró, Joana, Pascoalinho, Dulce, Nunes, Cristina, Pedro Moura, José, Pereira, Énio, Carvalho Mendes, António, Valeanu, Liana, Bubenek-Turconi, Serban, Marina Grintescu, Ioana, Cobilinschi, Cristian, Carmen Filipescu, Daniela, Elena Predoi, Cornelia, Tomescu, Dana, Popescu, Mihai, Marcu, Alexandra, Grigoras, Ioana, Lungu, Olguta, Gritsan, Alexey, Anderzhanova, Anastasia, Meleshkina, Yulia, Magomedov, Marat, Zubareva, Nadezhda, Tribulev, Maksim, Gaigolnik, Denis, Eremenko, Aleksandr, Vistovskaya, Natala, Chukina, Maria, Belskiy, Vladislav, Furman, Mikhail, Ferrer Rocca, Ricard, Martinez, Maria, Casares, Vanessa, Mellado Artigas, Ricard, Vera, Paula, Flores, Matias, Amador Amerigo, Joaquin, Gracia Arnillas, Maria Pilar, Munoz Bermudez, Rosana, Armestar, Fernando, Catalan, Beatriz, Roig, Regina, Raguer, Laura, Dolores Quesada, María, Diaz Santos, Emilio, Gomà, Gemma, Ubeda, Alejandro, Salgado, Maria, Forcelledo Espina, Lorena, Garcia Prieto, Emilio, Asensio, Mj, Rodriguez, M., Maseda, Dr Emilio, Suarez De La Rica, Alejandro, Ignacio Ayestaran, J., Novo, Mariana, Blasco-Navalpotro, Miguel Angel, Orejas Gallego, Alberto, Sjovall, Fredrik, Sjövall, Fredrik, Spahic, Dzana, Johan Svensson, Carl, Haney, Michael, Edin, Alicia, Åkerlund, Joyce, De Geer, Lina, Prazak, Josef, Buetti, Niccolò, Jakob, Stephan, Pagani, Jl, Abed-Maillard, S., Akova, Murat, Tarık Aslan, Abdullah, Tarik Aslan, Abdullah, Timuroglu, Arif, Kocagoz, Sesin, Kusoglu, Hulya, Mehtap, Selcuk, Ceyhun, Solakoğlu, Altintas, Dr. Neriman Defne, Talan, Leyla, Kayaaslan, Bircan, Kaya Kalem, Ayşe, Kurt, Dr. Ibrahim, Telli, Murat, Ozturk, Barcin, Erol, Çiğdem, Dindar Demiray, Emine Kubra, Çolak, Sait, Akbas, Türkay, Dr. Kursat Gundogan, Sari, Ali, Agalar, Canan, Çolak, Onur, Baykam, Nurcan (N), Akdogan, Ozlem (O), Yilmaz, Mesut, Tunay, Burcu, Cakmak, Rumeysa, Saltoglu, Nese, Karaali, Ridvan, Iftihar Koksal, Firdevs Aksoy, Eroglu, Ahmet, Tolga Saracoglu, Kemal, Bilir, Yeliz, Guzeldag, Seda, Ersoz, Gulden, Evik, Guliz, Sungurtekin, Hulya, Ozgen, Cansu, Erdoğan, Cem, Gürbüz, Yunus, Altin, Nilgün, Bayindir, Yasar, Ersoy, Yasemin, Goksu, Senay, Akyol, Ahmet, Dr, Kartal, Batirel, Ayse, Cagan Aktas, Sabahat, Morris, Andrew Conway, Conway Morris, Andrew, Routledge, Matthew, Ercole, Ari, Antcliffe, David, Rojo, Roceld, Tizard, Kate, Faulkner, Maria, Cowton, Amanda, Kent, Melanie, Raj, Ashok, Zormpa, Artemis, Tinaslanidis, George, Khade, Reena, Torlinski, Tomasz, Mulhi, Randeep, Goyal, Shraddha, Bajaj, Manan, Soltan, Marina, Yonan, Aimee, Dolan, Rachael, Johnson, Aimee, Macfie, Caroline, Lennard, James, Templeton, Maie, Sousa Arias, Sonia, Franke, Uwe, Hugill, Keith, Angell, Hollie, Benjamin J Parcell, Cobb, Katherine, Cole, Stephen, Smith, Tim, Graham, Clive, Cerman, Jaroslav, Keegan, Allison, Ritzema, Jenny, Sanderson, Amanda, Roshdy, Ashraf, Szakmany, Tamas, Baumer, Tom, Longbottom, Rebecca, Hall, Daniel, Tatham, Kate, Loftus, S., Husain, A., Black, E., Jhanji, S., Rao Baikady, R., Mcguigan, Peter, Mckee, Rachel, Kannan, Santhana, Antrolikar, Supriya, Marsden, Nicholas, Della Torre, Valentina, Banach, Dorota, Zaki, Ahmed, Jackson, Matthew, Chikungwa, Moses, Attwood, Ben, Patel, Jamie, Rebecca E Tilley, Humphreys, Sally K., Jean Renaud, Paul, Sokhan, Anton, Burma, Yaroslava, Sligl, Wendy, Baig, Nadia, McCoshen, Lorena, Kutsogiannis, Demetrios J., Thompson, Patricia, Hewer, Tayne, Rabbani, Raihan, Huq, Shihan Mahmud Redwanul, Hasan, Rajib, Motiul Islam, Mohammad, Gurjar, Mohan, Baronia, Arvind, Kothari, Nikhil, Sharma, Ankur, Karmakar, Saurabh, Sharma, Priya, Nimbolkar, Janardan, Samdani, Pratit, Vaidyanathan, R., Ahmedi Rubina, Noor, Jain, Nikhilesh, Pahuja, Madhumati, Singh, Ritu, Shekhar, Saurav, Syed, Nabeel Muzaffar, Ozair, Ahmad, Sarwar Siddiqui, Suhail, Bose, Payel, Datta, Avijatri, Rathod, Darshana, Patel, Mayur, MK, Renuka, Sailaja, K Baby, Dsilva, Carol, Chandran, Jagadish, Ghosh, Pralay, Mukherjee, Sudipta, Sheshala, Kaladhar, Chandra Misra, Krushna, Adekola, Oyebola O., Yusuf Yakubu, Saidu, Mgbosoro Ugwu, Euphemia, Olatosi, John (O), Desalu, Ibironke, Asiyanbi, Gabriel, Oladimeji, Motunrayo, Idowu, Olusola, Adeola, Fowotade, Mer, Mervyn, Mc Cree, Melanie, El Sanousi, Dr. Bashir, Adil Ali Karar, Ali, Saidahmed, Elfayadh, Hamid, Hytham K.S., Loiodice, Ambre, Bailly, Sébastien, Ruckly, Stéphane, and Staiquly, Quentin
Published: 2024
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4. Frailty is a stronger predictor of death in younger intensive care patients than in older patients: a prospective observational study

Author: De Geer, Lina, Fredrikson, Mats, and Chew, Michelle S.
Published: 2022
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5. Identification of myocardial injury using perioperative troponin surveillance in major noncardiac surgery and net benefit over the Revised Cardiac Risk Index

Author: Chew, Michelle S., Puelacher, Christian, Patel, Akshaykumar, Hammarskjöld, Fredrik, Lyckner, Sara, Kollind, Malin, Jawad, Monir, Andersson, Ulrika, Fredrikson, Mats, Sperber, Jesper, Johnsson, Patrik, Elander, Louise, Zeuchner, Jakob, Linhardt, Michael, De Geer, Lina, Rolander, Wictor Gääw, Gagnö, Gunilla, Didriksson, Helén, Pearse, Rupert, Mueller, Christian, and Andersson, Henrik
Published: 2022
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6. Association between left ventricular systolic function parameters and myocardial injury, organ failure and mortality in patients with septic shock

Author: Johansson Blixt, Patrik, Nguyen, Maxime, Cholley, Bernard, Hammarskjold, Fredrik, Toiron, Alois, Bouhemad, Belaid, Lee, Shaun, de Geer, Lina, Andersson, Henrik, Åström, Meriam, Engvall, Jan, Chew, Michelle, Johansson Blixt, Patrik, Nguyen, Maxime, Cholley, Bernard, Hammarskjold, Fredrik, Toiron, Alois, Bouhemad, Belaid, Lee, Shaun, de Geer, Lina, Andersson, Henrik, Åström, Meriam, Engvall, Jan, and Chew, Michelle
Abstract: BackgroundLeft ventricular ejection fraction (LVEF) is inconsistently associated with poor outcomes in patients with sepsis. Newer parameters such as LV longitudinal strain (LVLS), mitral annular plane systolic excursion (MAPSE) and LV longitudinal wall fractional shortening (LV-LWFS) may be more sensitive indicators of LV dysfunction, but are sparsely investigated. Our objective was to evaluate the association between five traditional and novel echocardiographic parameters of LV systolic function (LVEF, peak tissue Doppler velocity at the mitral valve (s '), LVLS, MAPSE and LV-LWFS) and outcomes in patients admitted to the Intensive Care Unit (ICU) with septic shock.MethodsA total of 152 patients admitted to the ICU with septic shock from two data repositories were included. Transthoracic echocardiograms were performed within 24 h of ICU admission. The primary outcome was myocardial injury, defined as high-sensitivity troponin T >= 45 ng/L on ICU admission. Secondary outcomes were organ support-free days (OSFD) and 30-day mortality. We also tested for the prognostic value of the systolic function parameters using multivariable analysis.ResultsLVLS, MAPSE and LV-LWFS, but not LVEF and s ', differed between patients with and without myocardial injury. After adjustment for age, pre-existing cardiac disease, Simplified Acute Physiology (SAPS3) score, Sequential Organ Failure Assessment (SOFA) score, plasma creatinine and presence of right ventricular dysfunction, only MAPSE and LV-LWFS were independently associated with myocardial injury. None of the systolic function parameters were associated with OSFD or 30-day mortality.ConclusionsMAPSE and LV-LWFS are independently associated with myocardial injury and outperform LVEF, s ' and LVLS. Whether these parameters are associated with clinical outcomes such as the need for organ support and short-term mortality is still unclear.Trial registration NCT01747187 and NCT04695119.ConclusionsMAPSE and LV-LWFS are independ, Funding Agencies|Region stergtland
Published: 2024
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7. Left ventricular longitudinal wall fractional shortening accurately predicts longitudinal strain in critically ill patients with septic shock

Author: Johansson Blixt, Patrik, Chew, Michelle S., Åhman, Rasmus, de Geer, Lina, Blomqwist, Lill, Åström Aneq, Meriam, Engvall, Jan, and Andersson, Henrik
Published: 2021
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8. Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden: a prospective multicentre cohort study

Author: Krifors, Anders, primary, Blennow, Ola, additional, Påhlman, Lisa I., additional, Gille-Johnson, Patrik, additional, Janols, Helena, additional, Lipcsey, Miklos, additional, Källman, Jan, additional, Tham, Johan, additional, Stjärne Aspelund, Anna, additional, Ljungquist, Oskar, additional, Hammarskjöld, Fredrik, additional, Hällgren, Anita, additional, De Geer, Lina, additional, Lemberg, Marie, additional, Petersson, Johan, additional, and Castegren, Markus, additional
Published: 2023
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9. Endotoxin Removal in Septic Shock with the Alteco® LPS Adsorber was Safe But Showed No Benefit Compared to Placebo in the Double-Blind Randomized Controlled Trial – the Asset Study

Author: Lipcsey, Miklos, Tenhunen, Jyrki, Pischke, Soeren E., Kuitunen, Anne, Flaatten, Hans, De Geer, Lina, Sjölin, Jan, Frithiof, Robert, Chew, Michelle S., Bendel, Stepani, Kawati, Rafael, Larsson, Anders, Mollnes, Tom Eirik, Tønnessen, Tor Inge, and Rubertsson, Sten
Published: 2019
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10. Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden: a prospective multicentre cohort study.

Author: Krifors, Anders, Blennow, Ola, Påhlman, Lisa I., Gille-Johnson, Patrik, Janols, Helena, Lipcsey, Miklos, Källman, Jan, Tham, Johan, Stjärne Aspelund, Anna, Ljungquist, Oskar, Hammarskjöld, Fredrik, Hällgren, Anita, De Geer, Lina, Lemberg, Marie, Petersson, Johan, and Castegren, Markus
Subjects: PULMONARY aspergillosis, INTENSIVE care patients, ASPERGILLOSIS, INTENSIVE care units, COHORT analysis
Abstract: The purpose of this study was to prospectively investigate the incidence of influenza-associated pulmonary aspergillosis (IAPA) in influenza patients admitted to intensive care units in Sweden. The study included consecutive adult patients with PCR-verified influenza A or B in 12 Swedish intensive care units (ICUs) over four influenza seasons (2019-2023). Patients were screened using serum galactomannan and β-d-glucan tests and fungal culture of a respiratory sample at inclusion and weekly during the ICU stay. Bronchoalveolar lavage was performed if clinically feasible. IAPA was classified according to recently proposed case definitions. The cohort included 55 patients; 42% were female, and the median age was 59 (IQR 48-71) years. All patients had at least one galactomannan test, β-d-glucan test and respiratory culture performed. Bronchoalveolar lavage was performed in 24 (44%) of the patients. Five (9%, 95% CI 3.8% − 20.4%) patients were classified as probable IAPA, of which four lacked classical risk factors. The overall ICU mortality was significantly higher among IAPA patients than non-IAPA patients (60% vs 8%, p = 0.01). The study represents the first prospective investigation of IAPA incidence. The 9% incidence of IAPA confirms the increased risk of invasive pulmonary aspergillosis among influenza patients admitted to the ICU. Therefore, it appears reasonable to implement a screening protocol for the early diagnosis and treatment of IAPA in influenza patients receiving intensive care. ClinicalTrials.gov NCT04172610, registered November 21, 2019 [ABSTRACT FROM AUTHOR]
Published: 2024
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11. Frailty predicts 30-day mortality in intensive care patients: A prospective prediction study

Author: De Geer, Lina, Fredrikson, Mats, and Tibblin, Anna O.
Published: 2020
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12. Nonadherence to antibiotic guidelines in patients admitted to ICU with sepsis is associated with increased mortality: A registry-based, retrospective cohort study

Author: Lindberg, Oscar, De Geer, Lina, and Chew, Michelle S.
Published: 2020
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13. New‐onset atrial fibrillation in critically ill adult patients—an SSAI clinical practice guideline

Author: Andreasen, Anne Sofie, primary, Wetterslev, Mik, additional, Sigurdsson, Martin Ingi, additional, Bove, Jeppe, additional, Kjærgaard, Jesper, additional, Aslam, Tayyba Naz, additional, Järvelä, Kati, additional, Poulsen, Mette, additional, De Geer, Lina, additional, Agarwal, Arnav, additional, Kjær, Maj‐Brit Nørregaard, additional, and Møller, Morten Hylander, additional
Published: 2023
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14. New-onset atrial fibrillation in critically ill adult patients-an SSAI clinical practice guideline

Author: Andreasen, Anne Sofie, Wetterslev, Mik, Sigurdsson, Martin Ingi, Bove, Jeppe, Kjaergaard, Jesper, Aslam, Tayyba Naz, Jarvela, Kati, Poulsen, Mette, de Geer, Lina, Agarwal, Arnav, Kjaer, Maj-Brit Norregaard, Moller, Morten Hylander, Andreasen, Anne Sofie, Wetterslev, Mik, Sigurdsson, Martin Ingi, Bove, Jeppe, Kjaergaard, Jesper, Aslam, Tayyba Naz, Jarvela, Kati, Poulsen, Mette, de Geer, Lina, Agarwal, Arnav, Kjaer, Maj-Brit Norregaard, and Moller, Morten Hylander
Abstract: Background: Acute or new-onset atrial fibrillation (NOAF) is the most common cardiac arrhythmia in critically ill adult patients, and observational data suggests that NOAF is associated to adverse outcomes. Methods: We prepared this guideline according to the Grading of Recommendations Assessment, Development and Evaluation methodology. We posed the following clinical questions: (1) what is the better first-line pharmacological agent for the treatment of NOAF in critically ill adult patients?, (2) should we use direct current (DC) cardioversion in critically ill adult patients with NOAF and hemodynamic instability caused by atrial fibrillation?, (3) should we use anticoagulant therapy in critically ill adult patients with NOAF?, and (4) should critically ill adult patients with NOAF receive follow-up after discharge from hospital? We assessed patient-important outcomes, including mortality, thromboembolic events, and adverse events. Patients and relatives were part of the guideline panel. Results: The quantity and quality of evidence on the management of NOAF in critically ill adults was very limited, and we did not identify any relevant direct or indirect evidence from randomized clinical trials for the prespecified PICO questions. We were able to propose one weak recommendation against routine use of therapeutic dose anticoagulant therapy, and one best practice statement for routine follow-up by a cardiologist after hospital discharge. We were not able to propose any recommendations on the better first-line pharmacological agent or whether to use DC cardioversion in critically ill patients with hemodynamic instability induced by NOAF. An electronic version of this guideline in layered and interactive format is available in MAGIC: https://app.magicapp.org/#/guideline/7197. Conclusions: The body of evidence on the management of NOAF in critically ill adults is very limited and not informed by direct evidence from randomized clinical trials. Practice variation appear, Funding Agencies|Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI)
Published: 2023
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15. Influenza-associated invasive aspergillosis in patients admitted to the intensive care unit in Sweden: a prospective multicentre cohort study

Author: Krifors, Anders, Blennow, Ola, Pahlman, Lisa I., Gille-Johnson, Patrik, Janols, Helena, Lipcsey, Miklos, Kallman, Jan, Tham, Johan, Stjarne Aspelund, Anna, Ljungquist, Oskar, Hammarskjöld, Fredrik, Hällgren, Anita, de Geer, Lina, Lemberg, Marie, Petersson, Johan, Castegren, Markus, Krifors, Anders, Blennow, Ola, Pahlman, Lisa I., Gille-Johnson, Patrik, Janols, Helena, Lipcsey, Miklos, Kallman, Jan, Tham, Johan, Stjarne Aspelund, Anna, Ljungquist, Oskar, Hammarskjöld, Fredrik, Hällgren, Anita, de Geer, Lina, Lemberg, Marie, Petersson, Johan, and Castegren, Markus
Abstract: BackgroundThe purpose of this study was to prospectively investigate the incidence of influenza-associated pulmonary aspergillosis (IAPA) in influenza patients admitted to intensive care units in Sweden.MethodsThe study included consecutive adult patients with PCR-verified influenza A or B in 12 Swedish intensive care units (ICUs) over four influenza seasons (2019-2023). Patients were screened using serum galactomannan and beta-d-glucan tests and fungal culture of a respiratory sample at inclusion and weekly during the ICU stay. Bronchoalveolar lavage was performed if clinically feasible. IAPA was classified according to recently proposed case definitions.ResultsThe cohort included 55 patients; 42% were female, and the median age was 59 (IQR 48-71) years. All patients had at least one galactomannan test, beta-d-glucan test and respiratory culture performed. Bronchoalveolar lavage was performed in 24 (44%) of the patients. Five (9%, 95% CI 3.8% - 20.4%) patients were classified as probable IAPA, of which four lacked classical risk factors. The overall ICU mortality was significantly higher among IAPA patients than non-IAPA patients (60% vs 8%, p = 0.01).ConclusionsThe study represents the first prospective investigation of IAPA incidence. The 9% incidence of IAPA confirms the increased risk of invasive pulmonary aspergillosis among influenza patients admitted to the ICU. Therefore, it appears reasonable to implement a screening protocol for the early diagnosis and treatment of IAPA in influenza patients receiving intensive care.Trial registrationClinicalTrials.gov NCT04172610, registered November 21, 2019, Funding Agencies|Regional research council Uppsala-Orebro; Centre for Clinical Research Vastmanland
Published: 2023
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16. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Author: Rashidi, Mahboobeh, Hamid, Hytham K S, Saidahmed, Elfayadh, Karar, Ali Adil Ali, Mc Cree, Melanie, Adeola, Fowotade, Idowu, Olusola, Oladimeji, Motunrayo, Asiyanbi, Gabriel, Desalu, Ibironke, Olatosi, John O, Ugwu, Euphemia Mgbosoro, Yakubu, Saidu Yusuf, Misra, Krushna Chandra, Sheshala, Kaladhar, Mukherjee, Sudipta, Ghosh, Pralay, Chandran, Jagadish, Dsilva, Carol, Baby, Sailaja K, Renuka, M K, Patel, Mayur, Rathod, Darshana, Datta, Avijatri, Bose, Payel, Siddiqui, Suhail Sarwar, Ozair, Ahmad, Muzaffar, Syed Nabeel, Shekhar, Saurav, Singh, Ritu, Pahuja, Madhumati, Jain, Nikhilesh, Rubina, Noor Ahmedi, Vaidyanathan, R, Samdani, Pratit, Nimbolkar, Janardan, Sharma, Priya, Karmakar, Saurabh, Sharma, Ankur, Kothari, Nikhil, Baronia, Arvind, Gurjar, Mohan, Islam, Mohammad Motiul, Hasan, Rajib, Huq, Shihan Mahmud Redwanul, Rabbani, Raihan, Hewer, Tayne, Thompson, Patricia, Sligl, Wendy, Kutsogiannis, Demetrios J, McCoshen, Lorena, Baig, Nadia, Burma, Yaroslava, Sokhan, Anton, Renaud, Paul Jean, Humphreys, Miss Sally K, Tilley, Rebecca E, Patel, Jamie, Attwood, Ben, Chikungwa, Moses, Jackson, Matthew, Zaki, Ahmed, Banach, Dorota, Torre, Valentina Della, Marsden, Nicholas, Antrolikar, Supriya, Kannan, Santhana, Mckee, Rachel, Mcguigan, Peter, Baikady, R Rao, Jhanji, S, Black, E, Husain, A, Loftus, S, Tatham, Kate, Hall, Daniel, Longbottom, Rebecca, Baumer, Tom, Szakmany, Tamas, Roshdy, Ashraf, Sanderson, Amanda, Ritzema, Jenny, Keegan, Allison, Cerman, Jaroslav, Graham, Clive, Smith, Tim, Cole, Stephen, Cobb, Katherine, Parcell, Benjamin J, Angell, Hollie, Hugill, Keith, Franke, Uwe, Arias, Sonia Sousa, Templeton, Maie, Lennard, James, Macfie, Caroline, Johnson, Aimee, Dolan, Rachael, Yonan, Aimee, Soltan, Marina, Bajaj, Manan, Goyal, Shraddha, Mulhi, Randeep, Torlinski, Tomasz, Khade, Reena, Tinaslanidis, George, Zormpa, Artemis, Raj, Ashok, Kent, Melanie, Cowton, Amanda, Faulkner, Maria, Tizard, Kate, Rojo, Roceld, Antcliffe, David, Ercole, Ari, Morris, Andrew Conway, Routledge, Matthew, Aktas, Sabahat Cagan, Batirel, Ayse, Akyol, Ahmet, Goksu, Senay, Ersoy, Yasemin, Bayindir, Yasar, Altin, Nilgün, Gürbüz, Yunus, Erdoğan, Cem, Ozgen, Cansu, Sungurtekin, Hulya, Evik, Guliz, Ersoz, Gulden, Guzeldag, Seda, Bilir, Yeliz, Saracoglu, Kemal Tolga, Eroglu, Ahmet, Aksoy, Firdevs, Koksal, Iftihar, Karaali, Ridvan, Saltoglu, Nese, Cakmak, Rumeysa, Tunay, Burcu, Yilmaz, Mesut, Akdogan, Ozlem O, Baykam, Nurcan N, Çolak, Onur, Agalar, Canan, Sari, Ali, Gundogan, KÜRŞAT, Akbas, Türkay, Çolak, Sait, Demiray, Emine Kubra Dindar, Erol, Çiğdem, Ozturk, Barcin, Telli, Murat, Kurt, Ibrahim, Kalem, Ayşe Kaya, Kayaaslan, Bircan, Talan, Leyla, Altintas, Neriman Defne, Ceyhun, Solakoğlu, Mehtap, Selcuk, Kusoglu, Hulya, Kocagoz, Sesin, Timuroglu, Arif, Aslan, Abdullah Tarik, Akova, Murat, Abed-Maillard, S, Pagani, Jl, Jakob, Stephan, Prazak, Josef, De Geer, Lina, Åkerlund, Joyce, Edin, Alicia, Haney, Michael, Svensson, Carl Johan, Spahic, Dzana, Sjövall, Fredrik, Gallego, Alberto Orejas, Blasco-Navalpotro, Miguel Angel, Novo, Mariana, Ayestaran, J Ignacio, De La Rica, Alejandro Suarez, Maseda, Emilio, Rodriguez, Dra M, Asensio, Dra Mj, Prieto, Emilio Garcia, Espina, Lorena Forcelledo, Salgado, Dra Maria, Ubeda, Alejandro, Gomà, Gemma, Santos, Emilio Diaz, Quesada, María Dolores, Raguer, Laura, Roig, Regina, Catalan, Beatriz, Armestar, Fernando, Bermudez, Rosana Munoz, Arnillas, Maria Pilar Gracia, Amerigo, Joaquin Amador, Flores, Matias, Vera, Paula, Casares, Vanessa, Martinez, Maria, Rocca, Ricard Ferrer, Furman, Mikhail, Belskiy, Vladislav, Chukina, Maria, Vistovskaya, Natala, Eremenko, Aleksandr, Gaigolnik, Denis, Tribulev, Maksim, Zubareva, Nadezhda, Magomedov, Marat, Meleshkina, Yulia, Anderzhanova, Anastasia, Gritsan, Alexey, Lungu, Olguta, Grigoras, Ioana, Marcu, Alexandra, Popescu, Mihai, Tomescu, Dana, Predoi, Cornelia Elena, Filipescu, Daniela Carmen, Cobilinschi, Cristian, Grintescu, Ioana Marina, Bubenek-Turconi, Serban, Valeanu, Liana, Mendes, António Carvalho, Pereira, Énio, Moura, José Pedro, Nunes, Cristina, Pascoalinho, Dulce, Queiró, Joana, Ledo, Sara, da Costa, Tito, Molinos, Elena, Cunha, Rui Pedro, Costa, Vasco, Duarte, Tiago, Botelho, Isabel, de Figueiredo, António Manuel Pereira, Teresa, Ana, Krystopchuk, Andriy, Pinto, Ana Rios, Marques, Ana Josefina Pinheiro, Alves, Madalena, Guimarães, Nádia, Pereira, Tiago, Cartoze, Nuno, Bisanti, Alessandra, Martin-Loeches, Ignacio, Pietraszek-Grzywaczewska, Iwona, Peichota, Mariusz, Broda, Hanna, Nowakowski, Tomasz, Wasowska, Dominika, Walczak-Wieteska, Paulina, Kotkowska, Anna, Bojko, Jozef, Szczesniak, Anna, Komorowska, Irmina Kaptur, Tamowicz, Barbara, Mikstacki, Adam, Rizzo, Anna Chiara, Cotoia, Antonella, Fiorelli, Silvia, Rocco, Monica, Covotta, Marco, Pelagalli, Lorella, Di Guardo, Andrea, Bellina, Davide, Ippolito, Mariachiara, Cortegiani, Andrea, Battaglini, Denise, Pelosi, Paolo, Schlevenin, Maria Grazia, Zuccaro, Francesco, Lodi, Giovanni, Daroui, Ivan, Mirabella, Michele, Porcile, Elisa, Gratarola, Angelo, Giacobbe, Daniele Roberto, Di Gravio, Valentina, Vargas, Joel, Carelli, Simone, Montini, Luca Maria, De Pascale, Gennaro, Sales, Gabriele, Montrucchio, Giorgia, Papathanakos, Georgios, Kouroulas, Vasilios, Retselas, Ioannis, Theodorou, Vasiliki, Marouli, Diamantina, Malliotakis, Polychronis, Almiroudi, Mariota Panagiota, Dimopoulos, Georges, Ali, Fadi, Papageorgiou, Eirini, Athanasa, Zoi, Sakagianni, Aikaterini, Chantziara, Vasiliki, Efthymiou, Anna, Georgopoulou, Maria, Chatzis, Marinos, Sakkalis, Anastasios, Nikolaou, Charikleia, Kogkopoulos, Evangelos, Oikonomou, Marina, Kampolis, C, Papanikolaou, M, Marmanidou, Kyriaki, Paskalis, Harry, Karaiskos, Ilias, Moldovan, Leora, Matei, Mariana Kristina, Koutsoukou, Vasiliki, Romanou, Vasiliki, Vasileiou, Maria, Renta, Foteini, Papoti, Sofia, Iasonidou, Cristina, Kaimakamis, Evangelos, Soulountsi, Vasiliki, Fildisis, Georgios, Psallida, Vasiliki, Smyrniotis, Dimitrios, Arvaniti, Kostoula, Temirov, Talgat, Merenkov, Yevgeniy, Babashev, Baurzhan, Kaligozhin, Zhannur, Bazhykayeva, Yelena, Mugazov, Miras, Ymbetzhanov, Yerlan, Viderman, Dmitriy, Metz, Carlos, Lepper, Philippe, Wempe, Carola, Gottschalk, Antje, Schmidt, Karsten, Dubler, Simon, Pasieka, Bastian, Petros, Sirak, Thomas-Rueddel, Daniel, Bloos, Frank, Hoheisen, Sandra, Bracht, Hendrik, Klouche, Kada, Imzi, Nadia, Dahyot-Fizelier, Claire, Fartoukh, Muriel, Voiriot, Guillaume, Aparicio, Christelle, Siami, Shidasp, Le Guennec, Loïc, Demeret, Sophie, Silva, Stein, Sarton, Benjamine, Roger, Claire, Lefrant, Jean-Yves, Larcher, Romaric, Badre, Gaëtan, Kalfon, Pierre, Razazi, Keyvan, Dessap, Armand Mekonted, Baudry, Thomas, Argaud, Laurent, Smonig, Roland, Louis, Guillaume, Bourenne, Jérémy, Gainnier, Marc, Barbier, François, Djanikian, Flora, Perrigault, Pierre-François, Foucrier, Arnaud, Janny, Sylvie, Weiss, Emmanuel, Bruel, Cédric, Tran, Marc, Philippart, François, Paulet, Rémi, Thyrault, Martial, Duprey, Matthieu, Garcon, Pierre, Mira, Jean-Paul, Le Souhaitier, Mathieu, Bortolotti, Perrine, Kipnis, Eric, Duburcq, Thibault, Coupez, Elisabeth, Souweine, Bertrand, Nica, Alexandru, Alfandari, Serge, Leroy, Olivier, Rosman, Jérémy, Mateu, Philippe, Escudier, Etienne, Guesdon, Charlotte, Massri, Alexandre, Beuzelin, M, Marchalot, A, Le Meur, Anthony, Auchabie, Johann, Castanera, Jérémy, Dulac, Thierry, Montravers, P, Zappela, N, Patrier, Juliette, Timsit, Jean-François, Arbelot, Charlotte, Leone, Marc, Lasic, Hrvoje, Nikolic, Mario, Sakan, Sanja, Persec, Jasminka, Brajkovic, Ana Vujaklija, Radonic, Radovan, Filipovic-Grcic, Ina, Custovic, Aida, Zlojutro, Biljana, Kovacevic, Pedja, Opdenacker, Godelive, De Waele, Elisabeth, Wittebole, Xavier, Serck, Nicolas, De Schryver, Nicolas, Misset, Benoît, Layos, Nathalie, Noel, Cindérella, Biston, Patrick, Haentjens, Lionel, Henin, Pierre, Mesland, Jean-Baptiste, Vanderhaeghen, Sofie F M, Bourgeois, Marc, Denys, Wouter, Hollevoet, Isabelle, De Waele, Jan, De Bus, Liesbet, Tomas, Ernesto Deloya, Perez-Nieto, Orlando R, Tejeda-Huezo, Brigitte, Sánchez-Hurtado, Luis, Ñamendys-Silva, Silvio A, Davalos-Alvarez, Adrian, Dominguez-Cherit, Jose G, Lomeli-Teran, Manuel, Villafuerte, Missael Vladimir Espinoza, Herrera, Mara Ocotlan Gonzalez, Aguilar, Candy Garcia, Leal, Jesús Nicolás Pantoja, Castillo, Roberto Alejandro, Hermosillo, Mariana, Romero-Gonzalez, Juan P, Reyes, Luis Felipe, Montefiore, Pablo, Nuccetelli, Yanina, Alonzo, Microbiologa Irene, Aparicio, Dra Marta, Segura, Matías, Fernández, Rubén, Lopez, Patricia Mabel, Acevedo, José Oscar, Morvillo, Lic Natalia, Centeno, Pablo, Sellami, Walid, Turki, Olfa, Bouaziz, Mounir, Bakr, Lubna, Al-Jadaan, Mohammad, Abu-Sayf, Natalia, Chaaban, Mohammad Karam, Aljabbary, Ahmed, Awad, Maher, Almekhlafi, Ghaleb A, Elrabi, Omar, Sallam, Hend, Nissar, Shaikh, Lance, Marcus, Karic, Edin, Elbuzidi, Abdurahaman, Hssain, Ali Ait, Jayyab, Mustafa Abu, Amro, Sarah, Belkhadir, Z, Ghannam, A, Hachimi, Abdelhamid, Younes, Oujidi, Housni, Brahim, Zeggwagh, Amine Ali, Dendane, Tarek, Wajdi, Maazouzi Ahmed, Mouhssine, Doumiri, Kanjaa, Nabil, Boukatta, Brahim, Seddiki, Rachid, Serghini, Issam, Hasan, Rabab Shaban Ben, Hasan, Hayat Ben, Jobran, Rania, Hdada, Aisha Khaled, Abousnina, Fathi A, Abdulwahed, Eman, Taher, Ahmed Sa, Bouhuwaish, Ahmad, Bilkhayr, Hala, Almiqlash, Bushray, Homaidan, Ahmed Gaber Sadik, AliAli, Almajdoub Mohammed, Aqeelah, Ahmed, Gamra, Marwa, Buimsaedah, Ahmad, Fares, Aya, Ibrahim, Rebecca, Abilama, Fayez, Diab, Adei, Harara, Belal, Levin, Phillip, Belman, Daniel, Rigler, Merav, Kagan, Ilya, Singer, Pierre, Ahmed, Abdullah Khudhur, Tabatabaei, Seyed Mohammad Nasirodin, Tajvidi, Ramin, Masjedi, Mansoor, Sarshad, Hakimeh, Sabetian, Golnar, Dabiri, Gholamreza, Aalinezhad, Fatemeh, Mahmoodpoor, Ata, Zargar, Mohammad Amin, Kiani, Arash, Amiri, Fereshteh, Javaherforoosh, Fatemeh, Baghbanian, Reza, Soltani, Farhad, Savaie, Mohsen, Ahmadi, Fatemeh, Kashipazha, Davood, Mehraban, Zahra, Borsi, Seyed Hamid, Ouhadian, Maryam, Zand, Farid, Hemead, Hanan M, Awad, Ahmed K, Elbadawy, Merihan A, Elsayed, Ahmed, Elmandouh, Omar, Aldhalia, Amer, Saber, Ahmed, Elbahnasawy, Mohamed, Mostafa, Tarek, Osman, Nermin, Barsoum, Mina, Elhadidy, Amr, Alsisi, Adel, Houfi, Ashraf El, Nadeem, Rashid, Chiewroongroj, Supattra, Apichatbutr, Yutthana, Wongsurakiat, Phunsup, Ku, Shih-Chi, Kuo, Li-Kuo, Hu, Ting-Yu, Cia, Cong-Tat, Chou, Nai-Kuan, Yeh, Yu Chang, Ng, Louis Xiang Long, Ng, Kangqi, Quah, Jessica Lishan, Lim, Jia Yan, Ong, Caroline Yu Ming, Li, Andrew Yunkai, Goh, Ken Junyang, Kwa, Andrea Lay Hoon, Lie, Sui An, Ng, Shin Yi, Goh, Qing Yuan, Lim, Sung Yoon, Park, Seung Yong, Park, Sunghoon, Lee, Sang-Min, Jeon, Kyeongman, Ali, Saedah, Mazlan, Mohd Zulfakar, Azman, Abd Hamid, Tong, Lee Kok, Noor, Zuraini Md, Rahman, Hamizah Bt Abdul, Fong, Kean Khang, Wong, Siong Ling Danny, Liew, Mun Thing, Visvalingam, Sheshendrasurian, Pheng, Lee See, Jamaluddin, Muhamad Fadhil Hadi, Hasan, M Shahnaz, Takaki, Shunsuke, Kato, Hideaki, Atobe, Kaori, Saito, Hiroki, Rinka, Hiroshi, Omori, Koichiro, Fujitani, Shigeki, Yoshida, Hideki, Nagashima, Michio, Mishima, Yuka, Shigemitsu, Hidenobu, Kuriyama, Akira, Matsuyoshi, Takeo, Makino, Jun, Hosokawa, Koji, Hashimoto, Satoru, Yamasaki, Masaki, Karumai, Toshiyuki, Hayashi, Yoshiro, Geng, Nan, Peije, Li, Weifeng, Xie, Ye, Ling, Qin, Bingyu, Wang, Yan, Yan, Jing, Huang, Min, Zhou, Suming, Hu, Chungfang, Ye, Jilu, Zhang, Min, Yin, Yongjie, Wang, Jinfeng, Wang, Ruilan, Yin, Chengfen, Xu, Lei, Mingmin, Chen, Wusi, Qiu, Zhao, Juan, Zhao, Peng, Wang, Hao, Chen, Xiaomei, Luo, Jili, Qian, Chuanyun, Zhen, Wang, Wei-Hua, Lu, Jianfeng, Xie, Haibo, Qiu, Sridharan, Dhadappa Damodar, Sudhirchandra, Shah, Moorthi, P Dhakshina, Mon, Tomas, Walid, Haji Adi Muhamad Ibnu, Tabah, Alexis, Buetti, Niccolò, Staiquly, Quentin, Ruckly, Stéphane, Conway Morris, Andrew, Bassetti, Matteo, Lipman, Jeffrey, Ferrer, Ricard, Qiu, Haibo, Paiva, José-Artur, Povoa, Pedro, Abidi, Khalid, Elhadi, Muhammed, Pollock, Hamish, Margetts, Ben, Young, Meredith, Bhadange, Neeraj, Tyler, Steven, Ledtischke, Anne, Finnis, Mackenzie, Dwivedi, Jyotsna, Saxena, Manoj, Biradar, Vishwanath, Soar, Natalie, Sarode, Vineet, Brewster, David, Regli, Adrian, Weeda, Elizabeth, Ahmed, Samiul, Fourie, Cheryl, Laupland, Kevin, Ramanan, Mahesh, Walsham, James, Meyer, Jason, Litton, Edward, Palermo, Anna Maria, Yap, Timothy, Eroglu, Ege, Attokaran, Antony George, Jaramillo, C'havala, Nafees, Khalid Mahmood Khan, Rashid, Nurhikmahtul Aqilah Haji Abd, Tabah, Alexi, Buetti, Niccolò, Staiquly, Quentin, Ruckly, Stéphane, Akova, Murat, Aslan, Abdullah Tarik, Leone, Marc, Conway Morris, Andrew, Bassetti, Matteo, Arvaniti, Kostoula, Lipman, Jeffrey, Ferrer, Ricard, Qiu, Haibo, Paiva, José-Artur, Povoa, Pedro, De Bus, Liesbet, De Waele, Jan, Zand, Farid, Gurjar, Mohan, Alsisi, Adel, Abidi, Khalid, Bracht, Hendrik, Hayashi, Yoshiro, Jeon, Kyeongman, Elhadi, Muhammed, Barbier, Françoi, Timsit, Jean-Françoi, EUROBACT-2 Study Group, ESICM, ESCMID ESGCIP and the OUTCOMEREA Network including, Andrea Cortegiani, and Mariachiara Ippolito
Subjects: antibiotic resistance, bloodstream infection, hospital-acquired, bacteremia, Critical Care and Intensive Care Medicine
Abstract: Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) waspresent in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alivefrom hospital by day-28. Conclusions: HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.
Published: 2023

17. Identification of myocardial injury using perioperative troponin surveillance in major noncardiac surgery and net benefit over the Revised Cardiac Risk Index

Author: Chew, Michelle, Puelacher, Christian, Patel, Akshaykumar, Hammarskjöld, Fredrik, Lyckner, Sara, Kollind, Malin, Jawad, Monir, Andersson, Ulrika, Fredrikson, Mats, Sperber, Jesper, Johnsson, Patrik, Elander, Louise, Zeuchner, Jakob, Linhardt, Michael, de Geer, Lina, Rolander, Wictor Gääw, Gagnö, Gunilla, Didriksson, Helen, Pearse, Rupert, Mueller, Christian, Andersson, Henrik, Chew, Michelle, Puelacher, Christian, Patel, Akshaykumar, Hammarskjöld, Fredrik, Lyckner, Sara, Kollind, Malin, Jawad, Monir, Andersson, Ulrika, Fredrikson, Mats, Sperber, Jesper, Johnsson, Patrik, Elander, Louise, Zeuchner, Jakob, Linhardt, Michael, de Geer, Lina, Rolander, Wictor Gääw, Gagnö, Gunilla, Didriksson, Helen, Pearse, Rupert, Mueller, Christian, and Andersson, Henrik
Abstract: Background: Patients with perioperative myocardial injury are at risk of death and major adverse cardiovascular and cerebrovascular events (MACCE). The primary aim of this study was to determine optimal thresholds of preoperative and perioperative changes in high-sensitivity cardiac troponin T (hs-cTnT) to predict MACCE and mortality. Methods: Prospective, observational, cohort study in patients >= 50 yr of age undergoing elective major noncardiac surgery at seven hospitals in Sweden. The exposures were hs-cTnT measured before and days 0-3 after surgery. Two previously published thresholds for myocardial injury and two thresholds identified using receiver operating characteristic analyses were evaluated using multivariable logistic regression models and externally validated. The weighted comparison net benefit method was applied to determine the additional value of hs-cTnT thresholds when compared with the Revised Cardiac Risk Index (RCRI). The primary outcome was a composite of 30-day all-cause mortality and MACCE. Results: We included 1291 patients between April 2017 and December 2020. The primary outcome occurred in 124 patients (9.6%). Perioperative increase in hs-cTnT >= 14 ng L-1 above preoperative values provided statistically optimal model performance and was associated with the highest risk for the primary outcome (adjusted odds ratio 2.9, 95% confidence interval 1.8-4.7). Validation in an independent, external cohort confirmed these findings. A net benefit over RCRI was demonstrated across a range of clinical thresholds. Conclusions: Perioperative increases in hsTnT >= 14 ng L-1 above baseline values identifies acute perioperative myocardial injury and provides a net prognostic benefit when added to RCRI for the identification of patients at high risk of death and MACCE., Funding Agencies|Swedish Research CouncilSwedish Research CouncilEuropean Commission [2019-02833]; South Eastern Sweden Research Council [746981, 712291]; Linkoping University-Region Ostergotland ALF [687681, 792291]; Swiss National Science FoundationSwiss National Science Foundation (SNSF)European Commission [320030-179362]; Swiss Heart Foundation; University Hospital of Basel; Roche Diagnostics; University of Basel; AstraZenecaAstraZeneca
Published: 2022
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18. Clinical frailty scale – skörhet ärett sätt att skatta biologisk ålder : [Clinical Frailty Scale - a proxy estimate of biological age]

Author: Ekerstad, Niklas, Cederholm, Tommy, Boström, Anne-Marie, de Geer, Lina, Ekdahl, Anne, Guidetti, Susanne, Janzon, Magnus, Alfredsson, Joakim, Ekerstad, Niklas, Cederholm, Tommy, Boström, Anne-Marie, de Geer, Lina, Ekdahl, Anne, Guidetti, Susanne, Janzon, Magnus, and Alfredsson, Joakim
Abstract: The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis., Skörhet (frailty) är ett kliniskt syndrom med sviktandefysiologiska reserver och ökad sårbarhet för påfrestningar.b Clinical frailty scale (CFS) är ett av de vanligaste skattningsinstrumentenför skörhet.b CFS är en markör för biologisk ålder, och skalanbygger på klinisk bedömning av samsjuklighet, ADL ochkognitiv förmåga.b CFS kan användas som stöd för riskstratifiering ochför att göra ett första urval av vilka personer som kangagnas av övergripande geriatrisk handläggning (comprehensivegeriatric assessment, CGA).b CFS kan användas på klinisk nivå som ett av flera stödför individualiserad behandling.b CFS kan bidra till att individer med hög kronologiskålder inte slentrianmässigt ges låg prioritet beträffandeolika interventioner.
Published: 2022

19. Strain echocardiography in septic shock – a comparison with systolic and diastolic function parameters, cardiac biomarkers and outcome

Author: De Geer, Lina, Engvall, Jan, and Oscarsson, Anna
Published: 2015
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20. Sustainment of a patient flow intervention in an intensive care unit in a regional hospital in Australia: a mixed-method, 5-year follow-up study

Author: Ros, Eva, primary, Ros, Axel, additional, Austin, Elizabeth E, additional, De Geer, Lina, additional, Lane, Paul, additional, Johnson, Andrew, additional, and Clay-Williams, Robyn, additional
Published: 2021
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21. Management and outcomes in critically ill nonagenarian versus octogenarian patients

Author: Bruno, Raphael Romano, Wernly, Bernhard, Kelm, Malte, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Finazzi, Stefano, Cecconi, Maurizio, Christensen, Steffen, Faraldi, Loredana, Lichtenauer, Michael, Muessig, Johanna M., Marsh, Brian, Moreno, Rui, Oeyen, Sandra, Öhman, Christina Agvald, Pinto, Bernardo Bollen, Soliman, Ivo W., Szczeklik, Wojciech, Valentin, Andreas, Watson, Ximena, Leaver, Susannah, Boulanger, Carole, Walther, Sten, Schefold, Joerg C., Joannidis, Michael, Nalapko, Yuriy, Elhadi, Muhammed, Fjølner, Jesper, Zafeiridis, Tilemachos, De Lange, Dylan W., Guidet, Bertrand, Flaatten, Hans, Jung, Christian, Eller, Philipp, Helbok, Raimund, Schmutz, René, Nollet, Joke, de Neve, Nikolaas, Buysscher, Pieter De, Swinnen, Walter, Mikačić, Marijana, Bastiansen, Anders, Husted, Andreas, Dahle, Bård E. S., Cramer, Christine, Sølling, Christoffer, Ørsnes, Dorthe, Thomsen, Jakob Edelberg, Pedersen, Jonas Juul, Enevoldsen, Mathilde Hummelmose, Elkmann, Thomas, Kubisz-Pudelko, Agnieszka, Pope, Alan, Collins, Amy, Raj, Ashok S., Frey, Christian, Hart, Ciaran, Bolger, Clare, Spray, Dominic, Randell, Georgina, Filipe, Helder, Welters, Ingeborg D., Grecu, Irina, Evans, Jane, Cupitt, Jason, Lord, Jenny, Henning, Jeremy, Jones, Joanne, Ball, Jonathan, North, Julie, Salaunkey, Kiran, De Gordoa, Laura Ortiz-Ruiz, Bell, Louise, Balasubramaniam, Madhu, Vizcaychipi, Marcela, Faulkner, Maria, Mupudzi, Mc Donald, Lea-Hagerty, Megan, Reay, Michael, Spivey, Michael, Love, Nicholas, Spittle, Nick Spittle Nick, White, Nigel, Williams, Patricia, Morgan, Patrick, Wakefield, Phillipa, Savine, Rachel, Jacob, Reni, Innes, Richard, Kapoor, Ritoo, Humphreys, Sally, Rose, Steve, Dowling, Susan, Mane, Tarkeshwari, Lawton, Tom, Ogbeide, Vongayi, Khaliq, Waqas, Baird, Yolanda, Romen, Antoine, Galbois, Arnaud, Vinsonneau, Christophe, Charron, Cyril, Thevenin, Didier, Guerot, Emmanuel, Besch, Guillaume, Savary, Guillaume, Mentec, Hervé, Chagnon, Jean-Luc, Rigaud, Jean-Philippe, Quenot, Jean-Pierre, Castanera, Jeremy, Rosman, Jérémy, Maizel, Julien, Tiercelet, Kelly, Vettoretti, Lucie, Hovaere, Maud Mousset, Messika, Messika, Djibré, Michel, Rolin, Nathalie, Burtin, Philippe, Garcon, Pierre, Nseir, Saad, Valette, Xavier, Rabe, Christian, Barth, Eberhard, Ebelt, Henning, Fuest, Kristina, Franz, Marcus, Horacek, Michael, Schuster, Michael, Meybohm, Patrick, Allgäuer, Sebastian, Dubler, Simon, Schaller, Stefan J., Schering, Stefan, Steiner, Stephan, Dieck, Thorben, Rahmel, Tim, Graf, Tobias, Koutsikou, Anastasia, Vakalos, Aristeidis, Raitsiou, Bogdan, Flioni, Elli Niki, Neou, Evangelia, Tsimpoukas, Fotios, Papathanakos, Georgios, Marinakis, Giorgos, Koutsodimitropoulos, Ioannis, Aikaterini, Kounougeri, Rovina, Nikoletta, Kourelea, Stylliani, Tasioudis, Polychronis, Zidianakis, Vasiiios, Konstantinia, Vryza, Aidoni, Zoi, Motherway, Catherine, Read, Chris, Martin-Loeches, Ignacio, Cracchiolo, Andrea Neville, Morigi, Aristide, Calamai, Italo, Brusa, Stefania, Elhadi, Ahmed, Tarek, Ahmed, Khaled, Ala, Ahmed, Hazem, Belkhair, Wesal Ali, Cornet, Alexander D., Gommers, Diederik, van Boven, Eva, Haringman, Jasper, Haas, Lenneke, van den Berg, Lettie, Hoiting, Oscar, de Jager, Peter, Gerritsen, Rik T., Dormans, Tom, Dieperink, Willem, Breidablik, Alena Breidablik Alena, Slapgard, Anita, Rime, Anne-Karin, Jannestad, Bente, Sjøbøe, Britt, Rice, Eva, Strietzel, Hans Frank, Jensen, Jan Peter, Langørgen, Jørund, Tøien, Kirsti, Strand, Kristian, Hahn, Michael, Klepstad, Pål, Biernacka, Aleksandra, Kluzik, Anna, Kudlinski, Bartosz, Maciejewski, Dariusz, Studzińska, Dorota, Hymczak, Hubert, Stefaniak, Jan, Solek-Pastuszka, Joanna, Zorska, Joanna, Cwyl, Katarzyna, Krzych, Lukasz J., Zukowski, Maciej, Lipińska-Gediga, Małgorzata, Pietruszko, Marek, Piechota, Mariusz, Serwa, Marta, Czuczwar, Miroslaw, Ziętkiewicz, Mirosław, Kozera, Natalia, Nasiłowski, Paweł, Sendur, Paweł, Zatorski, Paweł, Galkin, Piotr, Gawda, Ryszard, Kościuczuk, Urszula, Cyrankiewicz, Waldemar, Gola, Wojciech, Fernandes Pinto, Alexandre, Fernandes, Ana Margarida, Santos, Ana Rita, Sousa, Cristina, Barros, Inês, Ferreira, Isabel Amorim, Blanco, Jacobo Bacariza, Carvalho, João Teles, Maia, Jose, Candeias, Nuno, Catorze, Nuno, Belskiy, Vladislav, Lores, Africa, Mira, Angela Prado, Cilloniz, Catia, Perez-Torres, David, Maseda, Emilio, Rodriguez, Enver, Prol-Silva, Estefania, Eixarch, Gaspar, Gomà, Gemma, Aguilar, Gerardo, Velasco, Gonzalo Navarro, Jaimes, Marián Irazábal, Villamayor, Mercedes Ibarz, Fernández, Noemí Llamas, Cubero, Patricia Jimeno, López-Cuenca, Sonia, Tomasa, Teresa, Sjöqvist, Anders, Brorsson, Camilla, Schiöler, Fredrik, Westberg, Henrik, Nauska, Jessica, Sivik, Joakim, Berkius, Johan, Thiringer, Karin Kleiven, De Geer, Lina, Boroli, Filippo, Hergafi, Leila, Eckert, Philippe, Yıldız, Ismail, Yovenko, Ihor, Pugh, Richard, and on behalf of the VIP2 study group, [missing]
Subjects: Octogenarians, INTENSIVE-CARE-UNIT, Frailty, PREDICTION, SURGERY, MORTALITY, Nonagenarians, ICU, Medicine and Health Sciences, OLD PATIENTS, SHORT-TERM, Intensive care medicine, Geriatrics and Gerontology, ELDERLY-PATIENTS, Outcome
Abstract: Background: Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. Methods: We included 7900 acutely admitted older critically ill patients from two large, multinational studies. The primary outcome was 30-day-mortality, and the secondary outcome was ICU-mortality. Baseline characteristics consisted of frailty assessed by the Clinical Frailty Scale (CFS), ICU-management, and outcomes were compared between octogenarian (80-89.9 years) and nonagenarian (>= 90 years) patients. We used multilevel logistic regression to evaluate differences between octogenarians and nonagenarians. Results: The nonagenarians were 10% of the entire cohort. They experienced a higher percentage of frailty (58% vs 42%; p < 0.001), but lower SOFA scores at admission (6 +/- 5 vs. 7 +/- 6; p < 0.001). ICU-management strategies were different. Octogenarians required higher rates of organ support and nonagenarians received higher rates of life-sustaining treatment limitations (40% vs. 33%; p < 0.001). ICU mortality was comparable (27% vs. 27%; p = 0.973) but a higher 30-day-mortality (45% vs. 40%; p = 0.029) was seen in the nonagenarians. After multivariable adjustment nonagenarians had no significantly increased risk for 30-day-mortality (aOR 1.25 (95% CI 0.90-1.74; p = 0.19)). Conclusion: After adjustment for confounders, nonagenarians demonstrated no higher 30-day mortality than octogenarian patients. In this study, being age 90 years or more is no particular risk factor for an adverse outcome. This should be considered- together with illness severity and pre-existing functional capacity - to effectively guide triage decisions.
Published: 2021

22. Sustainment of a patient flow intervention in an intensive care unit in a regional hospital in Australia : a mixed-method, 5-year follow-up study

Author: Ros, Eva, Ros, Axel, Austin, Elizabeth E., de Geer, Lina, Lane, Paul, Johnson, Andrew, Clay-Williams, Robyn, Ros, Eva, Ros, Axel, Austin, Elizabeth E., de Geer, Lina, Lane, Paul, Johnson, Andrew, and Clay-Williams, Robyn
Abstract: Objective In 2014, an escalation plan and morning handover meetings were implemented in an intensive care unit (ICU) to reduce access block for post-operative care. In this study, the improvement intervention is revisited 5 years on with the objective to see if the changes are sustained and to understand factors contributing to sustainability. Design A mixed-method approach was used, with quantitative analysis of ICU administrative data and qualitative analysis of interviews with hospital management and ICU staff. Setting ICU with mixed surgical and non-surgical cases in a regional hospital in Australia. Participants Interview participants: ICU nurses (four), ICU doctors (four) and hospital management (four). Main outcome measures Monthly number of elective surgeries were cancelled due to unavailability of ICU beds. Staff perceptions of the interventions and factors contributed to sustainability. Results After a decline in elective surgeries being cancelled in the first year after the intervention, there was an increase in cancellations in the following years (chi(2)=16.38, p=0.003). Lack of knowledge about the intervention and competitive interests in the management of patient flow were believed to be obstacles for sustained effects of the original intervention. So were communication deficiencies that were reported within the ICU and between ICU and other departments. There are discrepancies between how nurses and doctors use the escalation plan and regard the availability of ICU beds. Conclusion Improvement interventions in healthcare that appear initially to be successful are not necessarily sustained over time, as was the case in this study. In healthcare, there is no such thing as a fix and forget solution for interventions. Management commitment to support communication within and between microsystems, and to support healthcare staff understanding of the underlying reasons for intervention, are important implications for change and change management across hea
Published: 2021
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23. Left ventricular longitudinal wall fractional shortening accurately predicts longitudinal strain in critically ill patients with septic shock

Author: Blixt Johansson, Patrik, Chew, Michelle, Åhman, Rasmus, de Geer, Lina, Blomqwist, Lill, Åström, Meriam, Engvall, Jan, Andersson, Henrik, Blixt Johansson, Patrik, Chew, Michelle, Åhman, Rasmus, de Geer, Lina, Blomqwist, Lill, Åström, Meriam, Engvall, Jan, and Andersson, Henrik
Abstract: Background Left ventricular longitudinal strain (LVLS) may be a sensitive indicator of left ventricular (LV) systolic function in patients with sepsis, but is dependent on high image quality and analysis software. Mitral annular plane systolic excursion (MAPSE) and the novel left ventricular longitudinal wall fractional shortening (LV-LWFS) are bedside echocardiographic indicators of LV systolic function that are less dependent on image quality. Both are sparsely investigated in the critically ill population, and may potentially be used as surrogates for LVLS. We assessed if LVLS may be predicted by LV-LWFS and MAPSE in patients with septic shock. We also assessed the repeatability and inter-rater agreement of LVLS, LV-LWFS and MAPSE measurements. Results 122 TTE studies from 3 echocardiographic data repositories of patients admitted to ICU with septic shock were retrospectively assessed, of which 73 were suitable for LVLS analysis using speckle tracking. The correlations between LVLS vs. LV-LWFS and LVLS vs. MAPSE were 0.89 (p < 0.001) and 0.81 (p < 0.001) with mean squared errors of 5.8% and 9.1%, respectively. Using the generated regression equation, LV-LWFS predicted LVLS with a high degree of accuracy and precision, with bias and limits of agreement of -0.044 +/- 4.7% and mean squared prediction error of 5.8%. Interobserver repeatability was good, with high intraclass correlation coefficients (0.96-0.97), small bias and tight limits of agreement (<= 4.1% for all analyses) between observers for all measurements. Conclusions LV-LWFS may be used to estimate LVLS in patients with septic shock. MAPSE also performed well, but was slightly inferior compared to LV-LWFS in estimating LVLS. Feasibility of MAPSE and LV-LWFS was excellent, as was interobserver repeatability., Funding Agencies|Linkoping University; Region Ostergotland ALF; Linkoping University [SC-2019-00155-12, LIO-935252, LIO-900161]
Published: 2021
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24. 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

25. Causes of late mortality among ICU-treated patients with sepsis

Author: Wilhelms, Susanne, Walther, Sten M., Sjöberg, Folke, de Geer, Lina, Wilhelms, Susanne, Walther, Sten M., Sjöberg, Folke, and de Geer, Lina
Abstract: Background Patients with sepsis may have an increased risk of late mortality, but the causes of late death are unclear. This retrospective matched cohort study aimed to determine the causes of late death (>= 1 year) among patients with sepsis compared to patients without sepsis. Methods 8760 patients with severe sepsis or septic shock (2001 consensus criteria) registered in the Swedish Intensive Care Registry (2008-2013) were compared with a 1:1 matched (gender, age, SAPS3 probability for death, ICU length of stay) control group consisting of non-septic ICU patients. Causes of death (International Classification of Diseases codes) were obtained from the Swedish Cause of Death Register (2008-2014). Results During 2008-2014, 903 patients with sepsis died at >= 365 days after their initial septic event, compared to 884 patients in the control group. Median time of follow-up was 313 days (sepsis group, interquartile range 11-838 days) vs 288 days (control group, 9-836 days). The most common causes of death were heart diseases (sepsis: 50.2%, non-septic: 48.6%) and cancer (sepsis: 33.7%, non-septic: 31.7%). Infectious diseases were significantly more common cause of death in the sepsis group (24.3% vs 19.6%, respectively; P < .05). Pneumonia was a common infectious cause of death in both groups, whereas sepsis was more common in the sepsis group. Conclusions The most common causes of late death after ICU admission among patients with and without sepsis were heart diseases and cancer. However, patients with sepsis more frequently had infectious diseases as a cause of late death, compared to non-septic patients., Funding Agencies|Region Ostergotland
Published: 2020
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26. Endotoxin removal in septic shock with the Alteco LPS adsorber was safe but showed no benefit compared to placebo in the double-blind randomized controlled trial-the asset study

Author: Lipcsey, Miklós, Tenhunen, Jyrki, Pischke, Soeren E., Kuitunen, Anne, Flaatten, Hans, De Geer, Lina, Sjölin, Jan, Frithiof, Robert, Chew, Michelle S., Bendel, Stepani, Kawati, Rafael, Larsson, Anders, Mollnes, Tom Eirik, Tonnessen, Tor Inge, Rubertsson, Sten, Lipcsey, Miklós, Tenhunen, Jyrki, Pischke, Soeren E., Kuitunen, Anne, Flaatten, Hans, De Geer, Lina, Sjölin, Jan, Frithiof, Robert, Chew, Michelle S., Bendel, Stepani, Kawati, Rafael, Larsson, Anders, Mollnes, Tom Eirik, Tonnessen, Tor Inge, and Rubertsson, Sten
Abstract: Purpose: Lipopolysaccharides (LPS) are presumed to contribute to the inflammatory response in sepsis. We investigated if extracorporeal Alteco LPS Adsorber for LPS removal in early gram-negative septic shock was feasible and safe. Also, effects on endotoxin level, inflammatory response, and organ function were assessed. Methods: A pilot, double-blinded, randomized, Phase IIa, feasibility clinical investigation was undertaken in six Scandinavian intensive care units aiming to allocate 32 septic shock patients with abdominal or urogenital focus on LPS Adsorber therapy or a Sham Adsorber, therapy without active LPS binding. The study treatment was initiated within 12 h of inclusion and given for 6 h daily on first 2 days. LPS was measured in all patients. Results: The investigation was terminated after 527 days with eight patients included in the LPS Adsorber group and seven in the Sham group. Twenty-one adverse effects, judged not to be related to the device, were reported in three patients in the LPS Adsorber group and two in the Sham group. Two patients in the Sham group and no patients in the LPS Adsorber group died within 28 days. Plasma LPS levels were low without groups differences during or after adsorber therapy. The changes in inflammatory markers and organ function were similar in the groups. Conclusions: In a small cohort of patients with presumed gram-negative septic shock, levels of circulating endotoxin were low and no adverse effects within 28 days after LPS adsorber-treatment were observed. No benefit compared with a sham device was seen when using a LPS adsorber in addition to standard care.
Published: 2020
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27. Causes of late mortality among ICU‐treated patients with sepsis

Author: Wilhelms, Susanne B., primary, Walther, Sten M., additional, Sjöberg, Folke, additional, and De Geer, Lina, additional
Published: 2020
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28. 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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29. No association with cardiac death after sepsis : A nationwide observational cohort study

Author: de Geer, Lina, Oscarsson Tibblin, Anna, Fredrikson, Mats, Walther, Sten M., de Geer, Lina, Oscarsson Tibblin, Anna, Fredrikson, Mats, and Walther, Sten M.
Abstract: BACKGROUND: Cardiac dysfunction is a well-known complication of sepsis, but its long-term consequences and implications for patients remain unclear. The aim of this study was to investigate cardiac outcome in sepsis by assessing causes of death up to 2 years after treatment in an Intensive Care Unit (ICU) in a nationwide register-based cohort collected from the Swedish Intensive Care Registry. METHODS: A cohort of 13 669 sepsis and septic shock ICU patients from 2008 to 2014 was collected together with a non-septic control group, matched regarding age, sex and severity of illness (n = 6582), and all without preceding severe cardiac disease. For a large proportion of the severe sepsis and septic shock patients (n = 7087), no matches were found. Information on causes of death up to 2 years after ICU admission was sought in the Swedish National Board of Health and Welfare's Cause of Death Registry. RESULTS: Intensive Care Unit mortality was nearly identical in a matched comparison of sepsis patients to controls (24% in both groups) but higher in more severely ill sepsis patients for whom no matches were found (33% vs 24%, P < 0.001). There was no association of sepsis to cardiac deaths in the first month (OR 1.03, 95%CI 0.87 to 1.20, P = 0.76) nor up to 2 years after ICU admission (OR 1.01, 95%CI 0.82 to 1.25, P = 0.94) in an adjusted between-group comparison. CONCLUSIONS: There was no association with an increased risk of death related to cardiac disease in patients with severe sepsis or septic shock when compared to other ICU patients with similar severity of illness.
Published: 2019
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30. No association with cardiac death after sepsis: A nationwide observational cohort study

Author: De Geer, Lina, primary, Oscarsson Tibblin, Anna, additional, Fredrikson, Mats, additional, and Walther, Sten M., additional
Published: 2018
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31. Cardiac dysfunction in septic shock : Observational studies on characteristics and outcome

Author: De Geer, Lina
Subjects: Anestesi och intensivvård, Kardiologi, Anesthesiology and Intensive Care, Klinisk medicin, Cardiac and Cardiovascular Systems, Clinical Medicine
Abstract: Background: Cardiac dysfunction is a well-known complication of sepsis, but its characteristics and consequences, especially on a longer term, remain unclear. The aim of this thesis was to study the characteristics and the implications of cardiac dysfunction for outcome in intensive care unit (ICU) patients with septic shock. Purpose: First, to assess the ability of a cardiac biomarker to predict outcome in ICU patients. Second, to characterise cardiac dysfunction in septic shock using speckle tracking echocardiography. Third, to investigate the reliability of echocardiographic methods used to describe cardiac dysfunction in septic shock. Fourth, to study long-term cardiac outcome in severe sepsis and septic shock patients. Materials and methods: The cardiac biomarker amino-terminal pro-brain natriuretic peptide (NTproBNP) was collected in 481 patients on ICU admission and its ability to predict death was assessed. In 50 patients with septic shock, echocardiography was performed on ICU admission and was repeated during and after ICU stay. Measurements of cardiac strain using speckle tracking echocardiography were assessed in relation to other echocardiographic function parameters, NT-proBNP and severity of illness scores, and their change over time was analysed. Echocardiograms from patients with septic shock were independently evaluated by two physicians and the results analysed regarding measurement variability. A nationwide-registry-based open cohort of 9,520 severe sepsis and septic shock ICU patients discharged alive from the ICU was analysed together with a non-septic control group matched for age, sex and severity of illness. In patients who died after ICU discharge, information on causes of death was collected. Results: A discriminatory level of significance of NT-proBNP on ICU admission was identified at ≥1,380 ng/L, above which NT-proBNP was an independent predictor of death. With increasing levels of NT-proBNP, patients were more severely ill, had a longer ICU stay and were more often admitted with septic shock. Cardiac strain was frequently impaired in septic shock patients but was not superior to other echocardiographic measurements in detecting cardiac dysfunction. Cardiac strain correlated with other echocardiographic function parameters and with NT-proBNP, and was the least user-dependent echocardiographic parameter in septic shock patients. Cardiac strain remained unchanged over time, did not differ between survivors and non-survivors and could not predict an increased risk of death. During a follow-up of up to nearly 6 years after ICU discharge, 3,954 (42%) of sepsis patients died, 654 (17%) with cardiac failure as the cause of death. With increasing severity of illness on admission, the risk of death with cardiac failure as the cause of death after ICU discharge increased. In comparison to other ICU patients with similar severity of illness, however, the risk of death due to cardiac was not increased in patients with severe sepsis or septic shock. Conclusions: Laboratory or echocardiographic signs of cardiac dysfunction are commonly seen in ICU patients in general and in septic shock patients in particular. The assessment of cardiac dysfunction in patients with septic shock is, however, complicated by pre-existing comorbidities, by treatment given in the ICU and by critical illness in itself. Signs of cardiac dysfunction, and the increasing risk of death related to cardiac failure seen after remission of sepsis, may therefore be reflections of critical illness per se, rather than of sepsis.
Published: 2016

32. Cardiac dysfunction in septic shock : Observational studies on characteristics and outcome

Author: De Geer, Lina, primary
Published: 2016
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33. Variability in echocardiographic measurements of left ventricular function in septic shock patients

Author: de Geer, Lina, Oscarsson, Anna, Engvall, Jan, de Geer, Lina, Oscarsson, Anna, and Engvall, Jan
Abstract: BACKGROUND: Echocardiography is increasingly used for haemodynamic evaluation and titration of therapy in intensive care, warranting reliable and reproducible measurements. The aim of this study was to evaluate the observer dependence of echocardiographic findings of left ventricular (LV) diastolic and systolic dysfunction in patients with septic shock. METHODS: Echocardiograms performed in 47 adult patients admitted with septic shock to a general intensive care unit (ICU) were independently evaluated by one cardiologist and one intensivist for the following signs: decreased diastolic tissue velocity of the base of the LV septum (e), increased early mitral inflow (E) to e ratio (E/e), decreased LV ejection fraction (EF) and decreased LV global longitudinal peak strain (GLPS). Diastolic dysfunction was defined as e <8.0cm/s and/or E/e [greater than or equal to]15 and systolic dysfunction as EF <50% and/or GLPS>15%. Ten randomly selected examinations were re-analysed two months later. Pearson’s r was used to test the correlation and Bland-Altman plots to assess the agreement between observers. Kappa statistics were used to test the consistency between readers and intraclass correlation coefficients (ICC) for inter- and intraobserver variability. RESULTS: In 44 patients (94%), image quality was sufficient for echocardiographic measurements. The agreement between observers was moderate (k=0.60 for e, k=0.50 for E/e and k=0.60 for EF) to good (k=0.71 for GLPS). Pearson’s r was 0.76 for e, 0.85 for E/e, 0.78 for EF and 0.84 for GLPS (p<0.001 for all four). The ICC between observers for e was very good (0.85; 95% confidence interval (CI) 0.73-0.92), good for E/e (0.70; 95% CI 0.45 - 0.84), very good for EF (0.87; 95% CI 0.77 - 0.93), excellent for GLPS (0.91; 95% CI 0.74 - 0.95), and very good for all measures repeated by one of the observers. On Bland-Altman analysis, the mean differences and 95% limits of agreement for e, E/e, EF and GLPS were 0.01 (0.04 - 0.
Published: 2015
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34. Risk prediction of ICU readmission in a mixed surgical and medical population

Author: Kareliusson, Frida, de Geer, Lina, Oscarsson Tibblin, Anna, Kareliusson, Frida, de Geer, Lina, and Oscarsson Tibblin, Anna
Abstract: Background Readmission to intensive care units (ICU) is accompanied with longer ICU stay as well as higher ICU, in-hospital and 30-day mortality. Different scoring systems have been used in order to predict and reduce readmission rates. Methods The purpose of this study was to evaluate the Stability and Workload Index for Transfer (SWIFT) score as a predictor of readmission. Further, we wanted to study steps and measures taken at the ward prior to readmission. Results This was a retrospective study conducted at the mixed surgical and medical ICU at Linköping University Hospital. One thousand sixty-seven patients >18 years were admitted to the ICU during 2 years and were included in the study. During the study period, 27 patients were readmitted to the ICU. Readmitted patients had a higher SWIFT score than the non-readmitted (16.1 ± 6.8 vs. 13.0 ± 7.5, p = 0.03) at discharge. The total ICU length of stay was longer (7.5 ± 7.5 vs. 2.9 ± 5.1, p = 0.004), and the 30-day mortality was higher (26 vs. 7 %, p < 0.001) for readmitted patients. Fifty-six percent of readmitted patients were assessed by the critical care outreach service (CCOS) at the ward prior to ICU readmission. A SWIFT score of 15 or more was associated with a significantly higher readmission rate (p = 0.03) as well as 30-day mortality (p < 0.001) compared to a score of ≤14. Conclusions A SWIFT score of 15 or more is associated with higher readmission rate and 30-day mortality. The SWIFT score could therefore be used for risk prediction for readmission and mortality at ICU discharge.
Published: 2015
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35. Cardiac mortality after severe sepsis and septic shock : A nationwide observational cohort study

Author: De Geer, Lina, Oscarsson, Anna, Fredrikson, Mats, Walther, Sten M., De Geer, Lina, Oscarsson, Anna, Fredrikson, Mats, and Walther, Sten M.
Abstract: Introduction: Cardiac dysfunction is a well-known complication of sepsis, but its long-term consequences remain unclear. The aim of this study was to investigate cardiac outcome after sepsis by assessing causes of death in a nationwide register-based cohort. Methods: A cohort of 9,520 severe sepsis and septic shock intensive care (ICU) patients without preceding severe cardiac failure and discharged alive from the ICU was collected from the Swedish Intensive Care Registry (SIR) from 2008 to 2013, together with a nonseptic control group (n = 4,577). Patients were matched according to age, sex and severity of illness. Information on cause of death after ICU discharge was sought in the Swedish National Board of Health and Welfare’s Cause of Death Registry. Results: After ICU discharge, 3,954 (42%) of severe sepsis or septic shock patients died. In 654 (16%) of these, cardiac failure was registered as the cause of death. The follow-up time was 17,693 person-years (median 583 days/person; maximum 5.7 years) and the median (IQR) time from ICU discharge to cardiac failure-related death 81 (17 - 379) days. With increasing severity of illness (quartiles of SAPS3), the hazard rate for cardiac failure-related death increased (hazard ratio (HR) 1.58 (95% CI 1.19 - 2.09, p <0.001) in the highest quartile compared to the lowest). In a matched comparison between severe sepsis or septic shock patients and controls, survival was similar, and the hazard rate for cardiac failurerelated death did not differ between groups (HR 0.97, 95% CI 0.88 – 1.10, p = 0.62). Conclusions: The risk of death with cardiac failure as the cause of death after severe sepsis or septic shock increases with severity of illness on admission. Patients with severe sepsis or septic shock are not, however, at an increased risk of death with cardiac failure as the cause of death when compared to other ICU patients with similar severity of illness.
Published: 2015

36. Cardiac mortality after septic shock.

Author: De Geer, Lina, Oscarsson, Anna, Fredrikson, Mats, Walther, Sten, De Geer, Lina, Oscarsson, Anna, Fredrikson, Mats, and Walther, Sten
Published: 2015

37. Lung ultrasound in quantifying lung water in septic shock patients

Author: de Geer, Lina, Oscarsson, Anna, Gustafsson, Mikael, de Geer, Lina, Oscarsson, Anna, and Gustafsson, Mikael
Abstract: Quantification of lung ultrasound (LUS) artifacts (B-lines) is used to assess pulmonary congestion in emergency medicine and cardiology [1,2]. We investigated B-lines in relation to extravascular lung-water index (EVLWI) from invasive transpulmonary thermodilution in septic shock patients. Our aim was to evaluate the role of LUS in an intensive care setting.
Published: 2015
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38. Risk prediction of ICU readmission in a mixed surgical and medical population

Author: Kareliusson, Frida, primary, De Geer, Lina, additional, and Tibblin, Anna Oscarsson, additional
Published: 2015
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39. Variability in echocardiographic measurements of left ventricular function in septic shock patients

Author: De Geer, Lina, primary, Oscarsson, Anna, additional, and Engvall, Jan, additional
Published: 2015
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40. Amino-terminal pro-brain natriuretic peptide as a predictor of outcome in patients admitted to intensive care. A prospective observational study

Author: De Geer, Lina, Fredrikson, Mats, Oscarsson Tibblin, Anna, De Geer, Lina, Fredrikson, Mats, and Oscarsson Tibblin, Anna
Abstract: Context: Amino-terminal pro-brain-type natriuretic peptide is known to predict outcome in patients with heart failure, but its role in an intensive care setting is not yet fully established. Objective: To assess the incidence of elevated amino-terminal pro-brain natriuretic peptide (NT-pro-BNP) on admission to intensive care and its relation to death in the ICU and within 30 days. Design: Prospective, observational cohort study. Setting: A mixed noncardiothoracic tertiary ICU in Sweden. Patients and main outcome measures NT-pro-BNP was collected from 481 consecutive patients on admission to intensive care, in addition to data on patient characteristics and outcome. A receiver-operating characteristic curve was used to identify a discriminatory level of significance, a stepwise logistic regression analysis to correct for other clinical factors and a Kaplan-Meier analysis to assess survival. The correlation between Simplified Acute Physiology Score (SAPS) 3, Sequential Organ Failure Assessment score (SOFA) and NT-pro-BNP was analysed using Spearmans correlation test. Quartiles of NT-pro-BNP elevation were compared for baseline data and outcome using a logistic regression model. Results: An NT-pro-BNP more than 1380 ng l(-1) on admission was an independent predictor of death in the ICU and within 30 days [odds ratio (OR) 2.6; 95% confidence interval (CI), 1.5 to 4.4] and was present in 44% of patients. Thirty-three percent of patients with NT-pro-BNP more than 1380 ng l(-1), and 14.6% of patients below that threshold died within 30 days (log rank P 0.005). NT-pro-BNP correlated moderately with SAPS 3 and with SOFA on admission (Spearmans rho 0.5552 and 0.5129, respectively). In quartiles of NT-pro-BNP elevation on admission, severity of illness and mortality increased significantly (30-day mortality 36.1%; OR 3.9; 95% CI, 2.0 to 7.3 in the quartile with the highest values, vs. 12.8% in the lowest quartile). Conclusion: We conclude that NT-pro-BNP is commonly elevated o
Published: 2012
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41. Amino-terminal pro-brain natriuretic peptide as a predictor of outcome in patients admitted to intensive care. A prospective observational study

Author: De Geer, Lina, primary, Fredrikson, Mats, additional, and Oscarsson, Anna, additional
Published: 2012
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42. Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit

Author: Guidet B., Flaatten H., Boumendil A., Morandi A., Andersen F. H., Artigas A., Bertolini G., Cecconi M., Christensen S., Faraldi L., Fjolner J., Jung C., Marsh B., Moreno R., Oeyen S., Ohman C. A., Pinto B. B., Soliman I. W., Szczeklik W., Valentin A., Watson X., Zafeiridis T., De Lange D. W., Schmutz R., Wimmer F., Eller P., Zotter K., De Buysscher P., De Neve N., Swinnen W., Abraham P., Hergafi L., Schefold J. C., Biskup E., Taliadoros I., Piza P., Lauten A., Sacher A. L., Brenner T., Franz M., Bloos F., Ebelt H., Schaller S. J., Fuest K., Rabe C., Dieck T., Steiner S., Graf T., Nia A. M., Janosi R. A., Simon P., Utzolino S., Rahmel T., Barth E., Schuster M., Dey N., Solling C., Rasmussen B. S., Rodriguez E., Rebollo S., Aguilar G., Masdeu G., Jaimes M. I., Mira A. P., Bodi M. A., Barea Mendoza J. A., Lopez-Cuenca S., Guzman M. H., Rico-Feijoo J., Ibarz M., Alvarez J. T., 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. J., Raj A. S., 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., 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., 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., Ravani I., Pagaki E., Antoniou A., Katsoulas T. A., Kounougeri A., Marinakis G., Tsimpoukas F., Spyropoulou A., Zygoulis P., Kyparissi A., Hayes I., Kelly Y., Westbrook A., Fitzpatrick G., Maheshwari D., Motherway C., Gupta M., Gurjar M., Maji I. M., Negri G., Spadaro S., Nattino G., Pedeferri M., Boscolo A., Rossi S., 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. A., 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., Adorni A., Bocci M. G., Cortegiani A., Casalicchio T., Mellea S., Graziani E., Barattini M., Brizio E., Rossi M., van Dijk I., van Lelyveld-Haas L. E. M., Ramnarain D., Jansen T., Nooteboom F., van der Voort P. H., de Lange D., Dieperink W., de Waard M. C., de Smet A. G. E., Bormans L., Dormans T., Hahn M., Kemmerer N., Strietzel H. F., Dybwik K., Legernaes T., Klepstad P., Olaussen E. B., Olsen K. I., Brresen O. M., Bjorsvik G., Maini S., Fehrle L., Czuczwar M., Krawczyk P., Zietkiewicz M., Nowak L. R., Kotfis K., Cwyl K., Gajdosz R., Biernawska J., Bohatyrewicz R., Gawda R., Grudzien P., Nasilowski P., Popek N., Cyrankiewicz W., Wawrzyniak K., Wnuk M., Maciejewski D., Studzinska D., Zukowski M., Bernas S., Piechota M., Nowak I., Fronczek J., Serwa M., Machala W., Stefaniak J., Wujtewicz M., Maciejewski P., Szymkowiak M., Adamik B., Catorze N., Branco M. C., Barros I., Barros N., Krystopchuk A., Honrado T., Sousa C., Munoz F., Rebelo M., Gomes R., Nunes J., Dias C., Fernandes A. M., 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., Nalapko Y., 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), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Bergen (UiB), Haukeland University Hospital, Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona (UAB), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), St George's, University of London, Aarhus University Hospital, Ghent University Hospital, Karolinska University Hospital [Stockholm], Hôpitaux Universitaires de Genève (HUG), University Medical Center [Utrecht], Utrecht University [Utrecht], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Guidet, B, Flaatten, H, Boumendil, A, Morandi, A, Andersen, F, Artigas, A, Bertolini, G, 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, Zafeiridis, T, De Lange, D, Schmutz, R, Wimmer, F, Eller, P, Zotter, K, De Buysscher, P, De Neve, N, Swinnen, W, Abraham, P, Hergafi, L, 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, 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, Mira, A, Bodi, M, Barea Mendoza, J, Lopez-Cuenca, S, Guzman, M, Rico-Feijoo, J, Ibarz, M, 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, 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, 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, Ravani, I, Pagaki, E, Antoniou, A, Katsoulas, T, Kounougeri, A, Marinakis, G, Tsimpoukas, F, Spyropoulou, A, Zygoulis, P, Kyparissi, A, 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, 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, Adorni, A, Bocci, M, Cortegiani, A, Casalicchio, T, Mellea, S, Graziani, E, Barattini, M, Brizio, E, Rossi, M, van Dijk, I, van Lelyveld-Haas, L, Ramnarain, D, Jansen, T, Nooteboom, F, van der Voort, P, de Lange, D, Dieperink, W, de Waard, M, de Smet, A, Bormans, L, Dormans, T, Hahn, M, Kemmerer, N, Strietzel, H, Dybwik, K, Legernaes, T, Klepstad, P, Olaussen, E, Olsen, K, Brresen, O, Bjorsvik, G, Maini, S, Fehrle, L, Czuczwar, M, Krawczyk, P, Zietkiewicz, M, Nowak, L, Kotfis, K, Cwyl, K, Gajdosz, R, Biernawska, J, Bohatyrewicz, R, Gawda, R, Grudzien, P, Nasilowski, P, Popek, N, Cyrankiewicz, W, Wawrzyniak, K, Wnuk, M, Maciejewski, D, Studzinska, D, Zukowski, M, Bernas, S, Piechota, M, Nowak, I, Fronczek, J, Serwa, M, Machala, W, Stefaniak, J, Wujtewicz, M, Maciejewski, P, Szymkowiak, M, Adamik, B, Catorze, N, 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, Nalapko, Y, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Guidet, Bertrand, Flaatten, Han, Boumendil, Ariane, Morandi, Alessandro, Andersen, Finn H., Artigas, Antonio, Bertolini, Guido, 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, Zafeiridis, Tilemacho, de Lange, Dylan W., Schmutz, René, Wimmer, Franz, Eller, Philipp, Zotter, Klemen, de Buysscher, Pieter, de Neve, Nikolaa, Swinnen, Walter, Abraham, Paul, Hergafi, Leila, 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, 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, Mira, Ángela Prado, Bodi, Maria A., Barea Mendoza, Jesus A., López-Cuenca, Sonia, Guzman, Marcela Homez, Rico-Feijoo, Jesú, Ibarz, Mercede, Alvarez, Josep Trenado, 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, 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, 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, Ravani, Ifigenia, Pagaki, Eumorfia, Antoniou, Angela, Katsoulas, Theodoros A., Kounougeri, Aikaterini, Marinakis, George, Tsimpoukas, Fotio, Spyropoulou, Anastasia, Zygoulis, Pari, Kyparissi, Aikaterini, 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, 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, van Dijk, I., van Lelyveld-Haas, L.E.M., Ramnarain, D., Jansen, Tim, Nooteboom, Fleur, van der Voort, Peter HJ, de Lange, Dylan, Dieperink, Willem, de Waard, Monique C., de Smet, Annemarie G. E., Bormans, Laura, Dormans, Tom, Hahn, Michael, Kemmerer, Nicolai, Strietzel, Hans Frank, Dybwik, Knut, Legernaes, Terje, Klepstad, Pål, Olaussen, Even Braut, Olsen, Knut Inge, Brresen, Ole Mariu, Bjorsvik, Geir, Maini, Sameer, Fehrle, Lutz, Czuczwar, Miroslaw, Krawczyk, Pawel, Ziętkiewicz, Mirosław, Nowak, Łukasz R., Kotfis, Katarzyna, Cwyl, Katarzyna, Gajdosz, Ryszard, Biernawska, Jowita, Bohatyrewicz, Romuald, Gawda, Ryszard, Grudzień, Paweł, Nasiłowski, Paweł, Popek, Natalia, Cyrankiewicz, Waldemar, Wawrzyniak, Katarzyna, Wnuk, Marek, Maciejewski, Dariusz, Studzińska, Dorota, Żukowski, Maciej, Bernas, Szymon, Piechota, Mariusz, Nowak, Ilona, Fronczek, Jakub, Serwa, Marta, Machała, Waldemar, Stefaniak, Jan, Wujtewicz, Maria, Maciejewski, Paweł, Szymkowiak, Małgorzata, Adamik, Barbara, Catorze, Nuno, Branco, Miguel Castelo, 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, Nalapko, Yuiry, and Critical Care
Subjects: Male, medicine.medical_treatment, HSJ UCI, Critical Care and Intensive Care Medicine, law.invention, Life sustaining treatment, 0302 clinical medicine, Elderly, law, 80 and over, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, 80 and over, education.field_of_study, Withholding Treatment, ddc:617, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Withholding, Intensive care unit, 3. Good health, Europe, aged, Intensive Care Units, Withdrawal, SOFA score, Human, medicine.medical_specialty, ethical aspects, Population, Intensive Care Unit, Decision Making, Ethics, Intensive care, life-sustaining therapy, NO, 03 medical and health sciences, Anesthesiology, Humans, Ethic, education, Mechanical ventilation, business.industry, 030208 emergency & critical care medicine, critical care, Life Support Care, Prospective Studie, Emergency medicine, business
Abstract: PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries. CONCLUSIONS: The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NTC03134807). info:eu-repo/semantics/publishedVersion
Published: 2018

43. [Clinical Frailty Scale - a proxy estimate of biological age].

Author: Ekerstad N, Cederholm T, Boström AM, De Geer L, Ekdahl A, Guidetti S, Janzon M, and Alfredsson J
Subjects: Humans, Aged, Frail Elderly, Geriatric Assessment methods, Aging, Frailty diagnosis
Abstract: The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis.
Published: 2022

44. Endotoxin Removal in Septic Shock with the Alteco LPS Adsorber Was Safe But Showed no Benefit Compared to Placebo in the Double-Blind Randomized Controlled Trial-the Asset Study.

Author: Lipcsey M, Tenhunen J, Pischke SE, Kuitunen A, Flaatten H, De Geer L, Sjölin J, Frithiof R, Chew MS, Bendel S, Kawati R, Larsson A, Mollnes TE, Tønnessen TI, and Rubertsson S
Subjects: Aged, Double-Blind Method, Female, Humans, Intensive Care Units statistics & numerical data, Male, Middle Aged, Placebos, Endotoxins blood, Lipopolysaccharides metabolism, Shock, Septic blood
Abstract: Purpose: Lipopolysaccharides (LPS) are presumed to contribute to the inflammatory response in sepsis. We investigated if extracorporeal Alteco LPS Adsorber for LPS removal in early gram-negative septic shock was feasible and safe. Also, effects on endotoxin level, inflammatory response, and organ function were assessed., Methods: A pilot, double-blinded, randomized, Phase IIa, feasibility clinical investigation was undertaken in six Scandinavian intensive care units aiming to allocate 32 septic shock patients with abdominal or urogenital focus on LPS Adsorber therapy or a Sham Adsorber, therapy without active LPS binding. The study treatment was initiated within 12 h of inclusion and given for 6 h daily on first 2 days. LPS was measured in all patients., Results: The investigation was terminated after 527 days with eight patients included in the LPS Adsorber group and seven in the Sham group. Twenty-one adverse effects, judged not to be related to the device, were reported in three patients in the LPS Adsorber group and two in the Sham group. Two patients in the Sham group and no patients in the LPS Adsorber group died within 28 days. Plasma LPS levels were low without groups differences during or after adsorber therapy. The changes in inflammatory markers and organ function were similar in the groups., Conclusions: In a small cohort of patients with presumed gram-negative septic shock, levels of circulating endotoxin were low and no adverse effects within 28 days after LPS adsorber-treatment were observed. No benefit compared with a sham device was seen when using a LPS adsorber in addition to standard care., Trial Registration: Clinicaltrials.gov NCT02335723. Registered: November 28, 2014.
Published: 2020
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45. No association with cardiac death after sepsis: A nationwide observational cohort study.

Author: De Geer L, Oscarsson Tibblin A, Fredrikson M, and Walther SM
Subjects: APACHE, Adult, Aged, Aged, 80 and over, Cohort Studies, Critical Care, Female, Heart Diseases complications, Heart Diseases mortality, Hospital Mortality, Humans, Male, Middle Aged, Prospective Studies, Registries, Risk Assessment, Shock, Septic mortality, Shock, Septic therapy, Sweden epidemiology, Death, Sepsis complications, Sepsis mortality
Abstract: Background: Cardiac dysfunction is a well-known complication of sepsis, but its long-term consequences and implications for patients remain unclear. The aim of this study was to investigate cardiac outcome in sepsis by assessing causes of death up to 2 years after treatment in an Intensive Care Unit (ICU) in a nationwide register-based cohort collected from the Swedish Intensive Care Registry., Methods: A cohort of 13 669 sepsis and septic shock ICU patients from 2008 to 2014 was collected together with a non-septic control group, matched regarding age, sex and severity of illness (n = 6582), and all without preceding severe cardiac disease. For a large proportion of the severe sepsis and septic shock patients (n = 7087), no matches were found. Information on causes of death up to 2 years after ICU admission was sought in the Swedish National Board of Health and Welfare's Cause of Death Registry., Results: Intensive Care Unit mortality was nearly identical in a matched comparison of sepsis patients to controls (24% in both groups) but higher in more severely ill sepsis patients for whom no matches were found (33% vs 24%, P < 0.001). There was no association of sepsis to cardiac deaths in the first month (OR 1.03, 95%CI 0.87 to 1.20, P = 0.76) nor up to 2 years after ICU admission (OR 1.01, 95%CI 0.82 to 1.25, P = 0.94) in an adjusted between-group comparison., Conclusions: There was no association with an increased risk of death related to cardiac disease in patients with severe sepsis or septic shock when compared to other ICU patients with similar severity of illness., (© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Published: 2019
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