Intensive care unit exposures for long-term outcomes research: development and description of exposures for 150 patients with acute lung injury.
PURPOSE: Long-term follow-up studies in critical care have described survivors' outcomes, but provided less insight into the patient/disease characteristics and intensive care therapies ('exposures') associated with these outcomes. Such insights are essential for improving patients' long-term outcom...
| Publicado en: | Journal of Critical Care Vol. 22; no. 4; pp. 275 - 285 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Dec2007
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105857850&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105857850 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08839441 1YR jtl: Journal of Critical Care issn: 08839441 maglogo: N pubinfo: dt: Dec2007 vid: 22 iid: 4 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 105857850 105857850 2009757189 10.1016/j.jcrc.2007.02.001 NLM18086397 105857850 ppf: 275 ppct: 10 formats: tig: atl: Intensive care unit exposures for long-term outcomes research: development and description of exposures for 150 patients with acute lung injury. aug: au: Needham DM Wang W Desai SV Mendez-Tellez PA Dennison CR Sevransky J Shanholtz C Ciesla N Spillman K Pronovost PJ affil: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. dale.needham@jhmi.edu sug: subj: Epidemiological Research Intensive Care Units Outcome Assessment Methods Respiratory Distress Syndrome, Acute Therapy Study Design Adult Aged Data Collection Methods Female Health Status Male Maryland Middle Age Prospective Studies Quality of Life Respiratory Distress Syndrome, Acute Epidemiology Risk Factors Human Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: PURPOSE: Long-term follow-up studies in critical care have described survivors' outcomes, but provided less insight into the patient/disease characteristics and intensive care therapies ('exposures') associated with these outcomes. Such insights are essential for improving patients' long-term outcomes. This report describes the development of a strategy for comprehensively measuring relevant exposures for long-term outcomes research, and presents empiric results from its implementation. MATERIALS AND METHODS: A multistep, iterative process was used to develop the exposures strategy. First, a comprehensive list of potential exposures was generated and subsequently reduced based on feasibility, redundancy, and relevance criteria. Next, data abstraction methods were designed and tested. Finally, the strategy was implemented in 150 patients with acute lung injury with iterative refinement. RESULTS: The strategy resulted in the development of more than 60 unique exposures requiring less than 45 minutes per patient-day for data collection. Most exposures had minimal missing data and adequate reliability. These data revealed that evidence-based practices including lower tidal volume ventilation, spontaneous breathing trials, sedation interruption, adequate nutrition, and blood glucose of less than 6.1 mmol/L (110 mg/dL) occurred in only 23% to 50% of assessments. CONCLUSIONS: Using a multistep, iterative process, a comprehensive and feasible exposure measurement strategy for long-term outcomes research was successfully developed and implemented.Copyright © 2007 by Elsevier Inc. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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