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Nader Markazi Moghaddam,Mohammad Fathi,Sanaz Zargar Balaye Jame,Mohammad Darvishi,Morteza Mortazavi 대한중환자의학회 2023 Acute and Critical Care Vol.38 No.1
Background We assessed predictors of mortality in the intensive care unit (ICU) and investigated if Glasgow coma scale (GCS) is associated with mortality in patients undergoing endotracheal intubation (EI). Methods From February 2020, we performed a 1-year study on 2,055 adult patients admitted to the ICU of two teaching hospitals. The outcome was mortality during ICU stay and the predictors were patients’ demographic, clinical, and laboratory features. Results EI was associated with a decreased risk for mortality compared with similar patients (adjusted odds ratio [AOR], 0.32; P=0.030). This shows that EI had been performed correctly with proper indications. Increasing age (AOR, 1.04; P<0.001) or blood pressure (AOR, 1.01; P<0.001), respiratory problems (AOR, 3.24; P<0.001), nosocomial infection (AOR, 1.64; P=0.014), diabetes (AOR, 5.69; P<0.001), history of myocardial infarction (AOR, 2.52; P<0.001), chronic obstructive pulmonary disease (AOR, 3.93; P<0.001), immunosuppression (AOR, 3.15; P<0.001), and the use of anesthetics/sedatives/hypnotics for reasons other than EI (AOR, 4.60; P<0.001) were directly; and GCS (AOR, 0.84; P<0.001) was inversely related to mortality. In patients with trauma surgeries (AOR, 0.62; P=0.014) or other surgical categories (AOR, 0.61; P=0.024) undergoing EI, GCS had an inverse relation with mortality (accuracy=82.6%, area under the receiver operator characteristic curve=0.81). Conclusions A variety of features affected the risk for mortality in patients admitted to the ICU. Considering GCS score for EI had the potential of affecting prognosis in subgroups of patients such as those with trauma surgeries or other surgical categories.
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Mostafa Alavi-Moghaddam,Shahram Yazdani,Fathie Mortazavi,Samira Chichi,Seyed-Mostafa Hosseini-Zijoud 전남대학교 의과학연구소 2016 전남의대학술지 Vol.52 No.2
This study aimed to compare evidence-based medicine (EBM) vs. conventional approachesto journal club sessions in teaching critical appraisal skills in reading papersby emergency medicine residents. This double cut off discontinuation regression quasi-experimental study was conducted among emergency medicine residents. EBM vs. the conventional approach were applied to teach critical appraisal skills for half of theresidents as an experimental group and another half as a control group respectively. Both groups participated in one hour monthly journal club sessions for six months. Before and after the study, all participants were examined by two tests: the Fresno Test(FT) [to evaluate their knowledge about EBM] and the Critical Appraisal Skills Test(CAST) [to evaluate their competency with critical appraisal skills]. The allocation ofthe participants into the experimental or control groups was according to their CASTscores before the study. 50 emergency medicine residents participated. After the study,the scores of both groups in the FT and CAST significantly improved (p<0.01), andthe promotion of scores of the FT and CAST in the experimental group were more thanthat of the conventional group (p<0.0001). The current study indicated that an evidence-based medicine approach in journal club sessions was comparatively more advantageouscompared to the conventional approach in teaching critical appraisal skillsfor reading papers among the residents of emergency medicine.
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