ABSTRACT
Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045). Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.
ABSTRACT
Objectives: To describe central venous catheter (CVC) colonizations and catheter-related bloodstream infections (C-RBSIs) among patients admitted in the Intensive Care Unit (ICU) of a tertiary care teaching hospital. Materials and methods: This was a cross-sectional study conducted among critically ill patients admitted in ICU. The semi-quantitative method was used for catheter tip culture. The definitions of catheter infection and colonization were based on the Centre for Disease Control Blood Stream Infection Guidelines. Results: The study population comprised 75 ICU patients whose CVCs had been placed. The incidence of CVC-related colonizations and bloodstream infections was observed to be 42.7% (32/75) and 17.3% (13/75) respectively. Coagulase-negative staph was the most common organism found causing CVC colonization (50%) and C-RBSI (61.5%). Conclusion: Coagulase-negative staphylococci are the most frequent microorganisms which colonize the CVC. The findings of this study may help with implementation of educational and training programs on central line-associated bloodstream infections (CLABSIs) for health care personnel and enable better management of these devices with regard to the prevention, diagnosis, and treatment of CLABSIs.
ABSTRACT
Background: Burns represent a serious problem around the world especially in low and middle income countries. The aim of this study was to determine epidemiological characteristics, causes and mortality rate of burn deaths in tertiary care hospital of N India as well as to guide future education and prevention programs. Methods: A one year cross-sectional study of all burn patients admitted in Dr. RPGMC Tanda, Kangra, Himachal Pradesh, India was conducted between January 2014-December 2014. Results: Our study revealed that type II (absence of sutural bones) was commoner than type I (presence of type I) asterion. Total of 210 burn injury patients were admitted majority were males[54.5%] and females were [45.5%] males sustained burn injuries mostly at their work place with electric burns whereas females sustained burn injuries at home with cooking appliances. Conclusions: Burn injuries can be reduced by bringing about regulations to develop safer cooking appliances, promoting less inflammable fabrics to be worn out at home and educating the community especially women.