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  • 1
    Online Resource
    Online Resource
    Device-Associated Infection Rates in 20 Cities of India, Data Summary for 2004–2013: Findings of the International Nosocomial Infection Control Consortium
    Cambridge University Press (CUP) ; 2016
    In:  Infection Control & Hospital Epidemiology Vol. 37, No. 2 ( 2016-02), p. 172-181
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 37, No. 2 ( 2016-02), p. 172-181
    Abstract: To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013. METHODS Surveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology. RESULTS We collected data from 236,700 ICU patients for 970,713 bed-days Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–days In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–days Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs. CONCLUSIONS Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report. Infect. Control Hosp. Epidemiol. 2016;37(2):172–181
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1017/ice.2015.276
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2106319-9
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  • 2
    Online Resource
    Online Resource
    Prevalence and treatment of postobstructive pneumonia among older adults with advanced cancer
    Cambridge University Press (CUP) ; 2022
    In:  Antimicrobial Stewardship & Healthcare Epidemiology Vol. 2, No. 1 ( 2022)
    Details
    In: Antimicrobial Stewardship & Healthcare Epidemiology, Cambridge University Press (CUP), Vol. 2, No. 1 ( 2022)
    Abstract: Among 124 older adults with advanced cancer who were hospitalized with pneumonia, 7.3% met criteria for postobstructive pneumonia. There were no differences in antibiotic duration, antibiotic spectrum, 30-day and 90-day readmissions, or mortality between those with and without postobstructive pneumonia. Bacteria were identified in 5 patients with postobstructive pneumonia.
    Type of Medium: Online Resource
    ISSN: 2732-494X
    URL: Article
    DOI: 10.1017/ash.2022.293
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
    detail.hit.zdb_id: 3074908-6
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  • 3
    Online Resource
    Online Resource
    Evolution of Operative Interventions by Two University-Based Surgical Teams in Haiti during the First Month following the Earthquake
    Cambridge University Press (CUP) ; 2011
    In:  Prehospital and Disaster Medicine Vol. 26, No. 3 ( 2011-06), p. 206-211
    Details
    In: Prehospital and Disaster Medicine, Cambridge University Press (CUP), Vol. 26, No. 3 ( 2011-06), p. 206-211
    Abstract: Background: The earthquake that struck Haiti on 10 January 2010, killed 200,000 persons and injured thousands more. Working with Partners in Health, a non-governmental organization already present in Haiti, Dartmouth College, and the University of Pennsylvania sent multidisciplinary surgical teams to hospitals in the villages of Hinche and Cange. The purpose of this report is to describe the injuries seen and evolution of treatments rendered at these two outlying regional hospitals during the first month following the earthquake. Methods: A retrospective review of the database maintained by each team was performed. In addition to a list of equipment taken to Haiti, information collected included patient age, American Society of Anesthesiology (ASA) physical status, injuries sustained, procedures performed, wound management strategy, antibiotic therapy, and early outcomes. Results: A total of 113 surgical procedures were performed in 15 days by both teams. The average patient age was 25 years and average ASA score was 1.4. The majority of injuries involved large soft tissue wounds and closed fractures, although 21–40% of the patients at each hospital had either an open fracture or amputation wound. Initially, wound debridement was the most common procedure performed, but after two weeks, skin grafting, fracture fixation, and amputation revision were the more commonly needed operations. Conclusions: Academic surgical teams can ameliorate the morbidity and mortality following disasters caused by natural hazards by partnering with organizations that already have a presence in the affected region. A multidisciplinary team of surgeons and nurses can improve both mortality and morbidity following a disaster.
    Type of Medium: Online Resource
    ISSN: 1049-023X , 1945-1938
    URL: Article
    DOI: 10.1017/S1049023X11006236
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2011
    detail.hit.zdb_id: 2162069-6
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  • 4
    Online Resource
    Online Resource
    OP90 Do Patients With Open Fractures Need Urgent Surgery?
    Cambridge University Press (CUP) ; 2018
    In:  International Journal of Technology Assessment in Health Care Vol. 34, No. S1 ( 2018), p. 33-33
    Details
    In: International Journal of Technology Assessment in Health Care, Cambridge University Press (CUP), Vol. 34, No. S1 ( 2018), p. 33-33
    Abstract: Calling in staff and preparing the operating room for an urgent surgical procedure is a significant draw on hospital resources and disrupts care of other patients. It has been common practice to treat open fractures on an urgent basis. HTA methods can be applied to examine this prioritization of care, just like they can be applied to the acquisition of drugs and devices. Methods: Our center completed a rapid systematic review of guidelines, systematic reviews, and primary clinical evidence, on urgent surgical debridement and stabilization of open fractures of long bones (“urgent” being defined as within six hours of the injury) compared to surgical debridement and reduction performed at a later time point. Meta-analyses were performed for infection and non-union outcomes and the GRADE system was used to assess the strength of evidence for each conclusion. Results: We found no published clinical guidelines for the urgency of treating open fractures. A good systematic review on the topic was published in 2012. We found six cohort studies published since completion of the earlier review. The summary odds ratio for any infection in patients with later treatment was 0.97 (95% confidence interval (CI) 0.78–1.22, sixteen studies, 3,615 patients) and for deep or “major” infections was 1.00 (95% CI 0.74–1.34, nine studies, 2,013 patients). The summary odds ratio of non-union with later treatment was 0.95 (95% CI 0.65–1.41, six studies, 1,308 patients). There was no significant heterogeneity in any of the results (I-squared = 0 percent) and no apparent trends in the results as a function of study size or publication date. We graded the strength of each of the conclusions as very low because they were based on cohort studies where the treating physician could elect immediate treatment for patients with severe soft-tissue injuries or patients at risk of complications. This raises the risk of spectrum bias. Conclusions: Default urgent scheduling of patients with open fractures for surgical debridement and stabilization does not appear to reduce the risk of infection or fracture non-union. Based on this information, our surgery department managers no longer schedule patients with open fractures for immediate surgery unless there are specific circumstances necessitating it.
    Type of Medium: Online Resource
    ISSN: 0266-4623 , 1471-6348
    URL: Article
    DOI: 10.1017/S0266462318001241
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2020486-3
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