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Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs

Patients who develop persistent critical illness remain in the ICU predominately because they develop new late-onset organ failure(s), which may render them at risk of acquiring a new medical device. The epidemiology and short-term outcomes of patients with persistent critical illness who acquire a...

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Autores principales: Viglianti, Elizabeth M., Carlton, Erin F., McPeake, Joanne, Wang, Xiao Qing, Seelye, Sarah, Iwashyna, Theodore J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259166/
https://www.ncbi.nlm.nih.gov/pubmed/35801748
http://dx.doi.org/10.1097/MD.0000000000029821
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author Viglianti, Elizabeth M.
Carlton, Erin F.
McPeake, Joanne
Wang, Xiao Qing
Seelye, Sarah
Iwashyna, Theodore J.
author_facet Viglianti, Elizabeth M.
Carlton, Erin F.
McPeake, Joanne
Wang, Xiao Qing
Seelye, Sarah
Iwashyna, Theodore J.
author_sort Viglianti, Elizabeth M.
collection PubMed
description Patients who develop persistent critical illness remain in the ICU predominately because they develop new late-onset organ failure(s), which may render them at risk of acquiring a new medical device. The epidemiology and short-term outcomes of patients with persistent critical illness who acquire a new medical device are unknown. We retrospectively studied a cohort admitted to the Veterans Affairs (VA) ICUs from 2014 to 2019. Persistent critical illness was defined as an ICU length of stay of at least 14 days. Receipt of new devices was defined as acquisition of a new tracheostomy, feeding tube (including gastrostomy and jejunostomy tubes), implantable cardiac device, or ostomy. Logistic regression models were fit to identify patient factors associated with the acquisition of each new medical device. Among hospitalized survivors, 90-day posthospitalization discharge location and mortality were identified. From 2014 to 2019, there were 13,184 ICU hospitalizations in the VA which developed persistent critical illness. In total, 30.4% of patients (N = 3998/13,184) acquired at least 1 medical device during their persistent critical illness period. Patients with an initial higher severity of illness and prolonged hospital stay preICU admission had higher odds of acquiring each medical device. Among patients who survived their hospitalization, discharge location and mortality did not significantly differ among those who acquired a new medical device as compared to those who did not. Less than one-third of patients with persistent critical illness acquire a new medical device and no significant difference in short-term outcomes was identified. Future work is needed to understand if the acquisition of new medical devices is contributing to the development of persistent critical illness.
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spelling pubmed-92591662022-07-08 Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs Viglianti, Elizabeth M. Carlton, Erin F. McPeake, Joanne Wang, Xiao Qing Seelye, Sarah Iwashyna, Theodore J. Medicine (Baltimore) Research Article Patients who develop persistent critical illness remain in the ICU predominately because they develop new late-onset organ failure(s), which may render them at risk of acquiring a new medical device. The epidemiology and short-term outcomes of patients with persistent critical illness who acquire a new medical device are unknown. We retrospectively studied a cohort admitted to the Veterans Affairs (VA) ICUs from 2014 to 2019. Persistent critical illness was defined as an ICU length of stay of at least 14 days. Receipt of new devices was defined as acquisition of a new tracheostomy, feeding tube (including gastrostomy and jejunostomy tubes), implantable cardiac device, or ostomy. Logistic regression models were fit to identify patient factors associated with the acquisition of each new medical device. Among hospitalized survivors, 90-day posthospitalization discharge location and mortality were identified. From 2014 to 2019, there were 13,184 ICU hospitalizations in the VA which developed persistent critical illness. In total, 30.4% of patients (N = 3998/13,184) acquired at least 1 medical device during their persistent critical illness period. Patients with an initial higher severity of illness and prolonged hospital stay preICU admission had higher odds of acquiring each medical device. Among patients who survived their hospitalization, discharge location and mortality did not significantly differ among those who acquired a new medical device as compared to those who did not. Less than one-third of patients with persistent critical illness acquire a new medical device and no significant difference in short-term outcomes was identified. Future work is needed to understand if the acquisition of new medical devices is contributing to the development of persistent critical illness. Lippincott Williams & Wilkins 2022-07-08 /pmc/articles/PMC9259166/ /pubmed/35801748 http://dx.doi.org/10.1097/MD.0000000000029821 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle Research Article
Viglianti, Elizabeth M.
Carlton, Erin F.
McPeake, Joanne
Wang, Xiao Qing
Seelye, Sarah
Iwashyna, Theodore J.
Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs
title Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs
title_full Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs
title_fullStr Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs
title_full_unstemmed Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs
title_short Acquisition of new medical devices among the persistently critically ill: A retrospective cohort study in the Veterans Affairs
title_sort acquisition of new medical devices among the persistently critically ill: a retrospective cohort study in the veterans affairs
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259166/
https://www.ncbi.nlm.nih.gov/pubmed/35801748
http://dx.doi.org/10.1097/MD.0000000000029821
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