Potential drug-drug interactions among patients with spontaneous intracerebral hemorrhage treated at the Neurological Intensive Care Unit: a single-center experience

Abstract Our aim was to determine the prevalence of potential drug-drug interactions (pDDIs) and to identify relevant factors associated with the occurrence of the most dangerous or contraindicated pDDIs (pCDDIs) in hospitalized patients with spontaneous intracerebral hemorrhage (sICH). A retrospective cross-sectional study was performed enrolling all consecutive patients with sICH treated at the Neurological Intensive Care Unit, Clinical Center in Kragujevac, Serbia, during the three-year period (2012-2014). The inclusion criteria encompassed patients aged 18 years and over, those diagnosed with ICH, and those prescribed at least two drugs during hospitalization, while we did not include patients whose hospitalization lasted less than 7 days, those who were diagnosed with other neurological diseases and patients with incomplete medical files. For each day of hospitalization, the online checker Micromedex® software was used to identify pDDIs and classify them according to severity. A total of 110 participants were analysed. A high prevalence of pDDIs (98.2%) was observed. The median number of pDDIs regardless of severity, was 8.00 (IQR 4.75-13.00;1-30). The pairs of drugs involving cardiovascular medicines were the most commonly identified pDDIs. Twenty percent of the total number of participants was exposed to pCDDIs. The use of multiple drugs from different pharmacological-chemical subgroups and the prescribing of anticoagulant therapy significantly increase the chance of pCDDI (aOR with 95% CI 1.19 (1.05-1.35) and 7.40 (1.13-48.96), respectively). This study indicates a high prevalence of pDDIs and pCDDIs in patients with sICH. The use of anticoagulant therapy appears to be the only modifiable clinically relevant predictor of pCDDIs.

Status and influencing factors of sleep quality for family caregivers to neurological intensive care unit survivors / 中国实用护理杂志

Objective To investigate the level and influence factors of sleep quality in caregivers to neurological intensive care unit (NICU) survivors. Methods The Pittsburgh Sleep Quality Index (PQSI) and the sleep quality influence factor scale were administered on 167 family caregivers to NICU survivors. Results The score of PQSI was 8.81 ± 3.25,and 55.68%(98/167) of caregivers reported poor sleep quality. Logistic regression analysis showed that medical insurance(OR=2.025, P<0.01), hospital stay (OR==2.235, P<0.01), whether caregivers in service (OR=0.583, P<0.05), resisdence(OR=2.341, P<0.01), and tracheal tubes/ventricular drainage (OR=5.857, P<0.01) were influencing factors of sleep quality. Conclusions It proved that our intervention should focus on family caregivers to NICU survivors social and psychological characteristics may help to enhance their sleep quality and quality of life.

Validity of Chinese Version of John Hopkins Adapted Cognitive Exam for Patients in Neural Intensive Care Unit / 中国康复理论与实践

Objective To investigate the clinical validity of the Chinese version of John Hopkins Adapted Cognitive Exam (ACE) for in-patients in neurological intensive care unit (NICU). Methods From May, 2014 to June, 2015, 94 inpatients in NICU and 52 healthy persons were assessed with the Chinese version of ACE and Mini-Mental State Examination (MMSE). Results The total score of ACE correlated with the total score of MMSE (r=0.805, P2.458, P<0.05). The area under the receiver operating curve was not different between ACE and MMSE (Z=0.707, P=0.480). Conclusion The Chinese version of ACE can be the tool for assessment of cognition for pa-tients in NICU.

Research on relevant factors affecting results of extubation of trachea cannula in neurocritical care patients / 中华急诊医学杂志

Objective To Explored the relative factors which caused the extubation failure in neurological intensive care unit (NICU).Methods It was a retrospective study.40 cases of patients who met the criteria,were brought into statistical analysis.They were admitted in NICU in Nan Fang Hospital from December 2008 to February 2011.The name,sex,age,diagnosis,respiratory parameters,24 hours discrepancy quantity,sputum,and Glasgow Coma Scale,Full Outline of UnResponsiveness Scale were recorded.SPSS 13.0 was used as statistic software.P ＜ 0.05 was considered statistically significant.Results Both in extubation successful and failure groups,GCS and Four were significantly different (all P ＜ 0.05).Howerer,there were no statistically significant in the other factors.There were significantly differences between GCS and Four in predicting extubation results (P =0.012).Logistic multiple regression showed that Four and GCS grade were predictive factor of extubation failure (P =0.041).Conclusions The result suggests that it is statistically significant to use GCS and Four as factors to predict extubation results.It can be widely used to help medical personnels monitoring the changes of patients'clinical conditions,judging prognosis,and making treatment plan in NICU.Wether other factors would effect the extubation results,more prospective,randomized controlled studies were needed.

Analysis of the death risk factors in patients with acute stroke in the neurological intensive care unit / 临床神经病学杂志

Objective To investigate the risk factors of death in patients with acute stroke in the neurological intensive care unit(NICU). Methods The clinical data of 137 patients with acute stroke in the NICU were induced. The risk factors were analysed by univariate and multi-variate Logistic regression analysis.Results There were 13 risk factors including age, coma, hyperpyrexia, pulmonary disease, atrial fibrilation/cardiac dilatation, stroke history, mechanical ventilation, brain midline shift, initial serum glucose, APACHEⅡscores, feeding tube, urethral catheter and concurrent pulmonary infection which had statistical significance between the death group and survive group,by univariate analysis(P