Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-... more Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-pharmacological population based infection control measures known as “lockdowns”. Our study sought to compare disease severity measures for patients in Ireland hospitalised with COVID-19 against those hospitalised with seasonal influenza. Study Design Retrospective population-based cohort study. Methods COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes in the Irish national hospitalisation dataset. Occurrence of key metrics of disease severity, length of stay, intensive care admission, ventilatory support, haemodialysis and in-hospital mortality were measured and compared between the two groups using odds ratios with 95% confidence intervals, stratified by age. Results Hospitalised COVID-19 episodes had a mean length of stay more than twice as long as hospitalised influenza episodes (17.7 days vs. 8.3 days). The likelihood of all measures of disease severity were greater in COVID-19 episodes, and the odds of in-hospital mortality were five-fold higher in this group compared with seasonal influenza episodes (OR 5.07, 95% C.I. 4.29-5.99, p<0.001). Greater likelihood of increased disease severity was observed for COVID-19 episodes in most age groups. Conclusions COVID-19 is a more severe illness than seasonal influenza in hospitalised cohorts. It is imperative that public health professionals ensure evidence-based advocacy is part of the response to COVID-19 to tackle a dangerous “infodemic” which can undermine public health control measures.
Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-... more Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-pharmacological population based infection control measures known as “lockdowns”. Our study sought to compare disease severity measures for patients in Ireland hospitalised with COVID-19 against those hospitalised with seasonal influenza. Study Design Retrospective population-based cohort study. Methods COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes in the Irish national hospitalisation dataset. Occurrence of key metrics of disease severity, length of stay, intensive care admission, ventilatory support, haemodialysis and in-hospital mortality were measured and compared between the two groups using odds ratios with 95% confidence intervals, stratified by age. Results Hospitalised COVID-19 episodes had a mean length of stay more than twice as long as hospitalised influenza episodes (17.7 days vs. 8.3 days). The likelihood of all measures of disease severity were greater in COVID-19 episodes, and the odds of in-hospital mortality were five-fold higher in this group compared with seasonal influenza episodes (OR 5.07, 95% C.I. 4.29-5.99, p<0.001). Greater likelihood of increased disease severity was observed for COVID-19 episodes in most age groups. Conclusions COVID-19 is a more severe illness than seasonal influenza in hospitalised cohorts. It is imperative that public health professionals ensure evidence-based advocacy is part of the response to COVID-19 to tackle a dangerous “infodemic” which can undermine public health control measures.
Background: Sepsis can lead to significant morbidity and mortality if not recognised and managed ... more Background: Sepsis can lead to significant morbidity and mortality if not recognised and managed early. On the basis of national mortality reports, Irish guidelines recommend that patients at risk of neutropenia, patients with sepsis or those with a systemic inflammatory response (SIRS) with one plus co-morbidity should receive Sepsis Six. We assessed the implementation of the Sepsis Six on a surgical ward in our institution. Methods: All inpatients on a surgical ward in July 2018 were prospectively assessed for the presence of infection and sepsis. If the Sepsis Six was required, implementation of each of the Sepsis Six elements was recorded. Results: Of 164 patients, 40.2% (66/164) developed an infection of whom 47% (31/66), met the criteria for requiring Sepsis Six. Of these, 7.3% (12/164) patients had sepsis, with 3% (5/164) developing septic shock. Patients required Sepsis Six for the following reasons: ³1 co-morbidity and ³2 SIRS criteria(n=19); new onset organ failure (n=12) and neutropenic risk(n=0).Only 12.9% (4/31) patients received all of the Sepsis Six elements within one hour; 77.4% (24/31) received some and 9.67% (3/31) did not receive any elements. Blood cultures were taken in 54.8% (17/31) of cases but only 32.3% (10/31) patients had their lactate level checked. Conclusion: Further research action is required to better understand and improve Sepsis Six implementation. This should facilitate improved sepsis recognition and enhance patient care.
Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2007
To assess the efficacy of the CathRite system as a tool to guide clinicians in placement of perip... more To assess the efficacy of the CathRite system as a tool to guide clinicians in placement of peripherally inserted central catheters (PICCs) into the superior vena cava (SVC) in critically ill patients. Prospective, randomised, parallel controlled trial. three8 critically ill patients (mean APACHE II score, 16.6) in a mixed medical and surgical intensive care unit from 200four to 2006. Participants were randomised to receive PICC placement using either the CathRite system or a standard "blind" technique (control). Peripheral vein cannulation was performed for both groups under ultrasound monitoring, and the PICC was placed using the modified Seldinger technique, with position confirmed using standard chest x-ray. Proportion of PICCs guided into the SVC; placement into the lower third of the SVC; and time to complete placement. There was no significant difference between groups in sex distribution or age (CathRite: 12 men, 7 women; mean age +/- SEM, 61.1 +/- 3.4 years; contr...
Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-... more Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-pharmacological population based infection control measures known as “lockdowns”. Our study sought to compare disease severity measures for patients in Ireland hospitalised with COVID-19 against those hospitalised with seasonal influenza. Study Design Retrospective population-based cohort study. Methods COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes in the Irish national hospitalisation dataset. Occurrence of key metrics of disease severity, length of stay, intensive care admission, ventilatory support, haemodialysis and in-hospital mortality were measured and compared between the two groups using odds ratios with 95% confidence intervals, stratified by age. Results Hospitalised COVID-19 episodes had a mean length of stay more than twice as long as hospitalised influenza episodes (17.7 days vs. 8.3 days). The likelihood of all measures of disease severity were greater in COVID-19 episodes, and the odds of in-hospital mortality were five-fold higher in this group compared with seasonal influenza episodes (OR 5.07, 95% C.I. 4.29-5.99, p<0.001). Greater likelihood of increased disease severity was observed for COVID-19 episodes in most age groups. Conclusions COVID-19 is a more severe illness than seasonal influenza in hospitalised cohorts. It is imperative that public health professionals ensure evidence-based advocacy is part of the response to COVID-19 to tackle a dangerous “infodemic” which can undermine public health control measures.
Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-... more Objectives COVID-19 infection has been compared to seasonal influenza as an argument against non-pharmacological population based infection control measures known as “lockdowns”. Our study sought to compare disease severity measures for patients in Ireland hospitalised with COVID-19 against those hospitalised with seasonal influenza. Study Design Retrospective population-based cohort study. Methods COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes in the Irish national hospitalisation dataset. Occurrence of key metrics of disease severity, length of stay, intensive care admission, ventilatory support, haemodialysis and in-hospital mortality were measured and compared between the two groups using odds ratios with 95% confidence intervals, stratified by age. Results Hospitalised COVID-19 episodes had a mean length of stay more than twice as long as hospitalised influenza episodes (17.7 days vs. 8.3 days). The likelihood of all measures of disease severity were greater in COVID-19 episodes, and the odds of in-hospital mortality were five-fold higher in this group compared with seasonal influenza episodes (OR 5.07, 95% C.I. 4.29-5.99, p<0.001). Greater likelihood of increased disease severity was observed for COVID-19 episodes in most age groups. Conclusions COVID-19 is a more severe illness than seasonal influenza in hospitalised cohorts. It is imperative that public health professionals ensure evidence-based advocacy is part of the response to COVID-19 to tackle a dangerous “infodemic” which can undermine public health control measures.
Background: Sepsis can lead to significant morbidity and mortality if not recognised and managed ... more Background: Sepsis can lead to significant morbidity and mortality if not recognised and managed early. On the basis of national mortality reports, Irish guidelines recommend that patients at risk of neutropenia, patients with sepsis or those with a systemic inflammatory response (SIRS) with one plus co-morbidity should receive Sepsis Six. We assessed the implementation of the Sepsis Six on a surgical ward in our institution. Methods: All inpatients on a surgical ward in July 2018 were prospectively assessed for the presence of infection and sepsis. If the Sepsis Six was required, implementation of each of the Sepsis Six elements was recorded. Results: Of 164 patients, 40.2% (66/164) developed an infection of whom 47% (31/66), met the criteria for requiring Sepsis Six. Of these, 7.3% (12/164) patients had sepsis, with 3% (5/164) developing septic shock. Patients required Sepsis Six for the following reasons: ³1 co-morbidity and ³2 SIRS criteria(n=19); new onset organ failure (n=12) and neutropenic risk(n=0).Only 12.9% (4/31) patients received all of the Sepsis Six elements within one hour; 77.4% (24/31) received some and 9.67% (3/31) did not receive any elements. Blood cultures were taken in 54.8% (17/31) of cases but only 32.3% (10/31) patients had their lactate level checked. Conclusion: Further research action is required to better understand and improve Sepsis Six implementation. This should facilitate improved sepsis recognition and enhance patient care.
Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2007
To assess the efficacy of the CathRite system as a tool to guide clinicians in placement of perip... more To assess the efficacy of the CathRite system as a tool to guide clinicians in placement of peripherally inserted central catheters (PICCs) into the superior vena cava (SVC) in critically ill patients. Prospective, randomised, parallel controlled trial. three8 critically ill patients (mean APACHE II score, 16.6) in a mixed medical and surgical intensive care unit from 200four to 2006. Participants were randomised to receive PICC placement using either the CathRite system or a standard "blind" technique (control). Peripheral vein cannulation was performed for both groups under ultrasound monitoring, and the PICC was placed using the modified Seldinger technique, with position confirmed using standard chest x-ray. Proportion of PICCs guided into the SVC; placement into the lower third of the SVC; and time to complete placement. There was no significant difference between groups in sex distribution or age (CathRite: 12 men, 7 women; mean age +/- SEM, 61.1 +/- 3.4 years; contr...
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