Browsing by Author "Doig, Christopher"
Now showing 1 - 7 of 7
Results Per Page
Sort Options
- ItemOpen AccessA comparison between the APACHE II and Charlson Index Score for predicting hospital mortality in critically ill patients(BioMed Central, 2009-07-30) Quach, Susan; Hennessy, Deirdre A.; Faris, Peter; Fong, Andrew; Quan, Hude; Doig, Christopher
- ItemOpen AccessEpidemiology of severe acute renal failure and prognosis for renal recovery in critically ill patients(2005) Bagshaw, Sean Michael; Doig, Christopher; Laupland, Kevin B.
- ItemOpen AccessIntegration of metabolic and inflammatory mediator profiles as a potential prognostic approach for septic shock in the intensive care unit(Critical Care, BioMed Central, 2015-01-15) Mickiewicz, Beata; Tam, Patrick; Jenne, Craig N; Leger, Caroline; Wong, Josee; Winston, Brent W; Doig, Christopher; Kubes, Paul; Vogel, Hans JIntroduction Septic shock is a major life-threatening condition in critically ill patients and it is well known that early recognition of septic shock and expedient initiation of appropriate treatment improves patient outcome. Unfortunately, to date no single compound has shown sufficient sensitivity and specificity to be used as a routine biomarker for early diagnosis and prognosis of septic shock in the intensive care unit (ICU). Therefore, the identification of new diagnostic tools remains a priority for increasing the survival rate of ICU patients. In this study, we have evaluated whether a combined nuclear magnetic resonance spectroscopy-based metabolomics and a multiplex cytokine/chemokine profiling approach could be used for diagnosis and prognostic evaluation of septic shock patients in the ICU. Methods Serum and plasma samples were collected from septic shock patients and ICU controls (ICU patients with the systemic inflammatory response syndrome but not suspected of having an infection). 1H Nuclear magnetic resonance spectra were analyzed and quantified using the targeted profiling methodology. The analysis of the inflammatory mediators was performed using human cytokine and chemokine assay kits. Results By using multivariate statistical analysis we were able to distinguish patient groups and detect specific metabolic and cytokine/chemokine patterns associated with septic shock and its mortality. These metabolites and cytokines/chemokines represent candidate biomarkers of the human response to septic shock and have the potential to improve early diagnosis and prognosis of septic shock. Conclusions Our findings show that integration of quantitative metabolic and inflammatory mediator data can be utilized for the diagnosis and prognosis of septic shock in the ICU.
- ItemOpen AccessLong-term health related recovery and outcomes in survivors of intensive care(2013-04-04) Solverson, Kevin; Doig, ChristopherOur objective was to create a follow-up clinic for survivors of critical illness in order to examine objective physical functioning, mental health and sleep quality and relate these findings to health related quality of life (HRQL) and ICU risk factors. 56 patients were evaluated at 2 months post hospital discharge and 19 patients at 4 months. At 2 months post hospital discharge we found that: Patients had reduced muscle strength and physical functioning and neither were association with ICU risk factors; Reduced muscle strength was correlated with poor physical functioning; Patients’ HRQL was associated with decreased physical functioning; Anxiety was common and found to correlate with poor HRQL and physical functioning; Objective sleep quality was poor and predicted by increased severity of critical illness. Long-term physical and mental morbidity is common in critical illness survivors and impacts HRQL. ICU follow-up clinics should be considered in all survivors of critical illness.
- ItemOpen AccessPsychological Distress in Emergency Medical Services Practitioners: Identifying and Measuring the Issues(2017) Lefevre, Nicola Louise; Doig, Christopher; Mitchell, Ian; Page, Stacy; Guichon, Juliet; McLaughlin, KevinThis thesis investigates psychological distress in Emergency Medical Services practitioners through three pieces of inter-related research. The first examines the prevalence of compassion fatigue in all health care practitioners by systematic review of literature. The second conceptualizes three manifestations of distress (compassion fatigue, burnout, and post-traumatic stress disorder), places them in the context of EMS work by describing practitioners’ experience, and broadly strategizes ways to address them. The third measures the presence of compassion fatigue, burnout, and post-traumatic stress disorder in a sample of EMS practitioners through a survey based study. Overall, the research showed that EMS practitioners are experiencing psychological distress as compassion fatigue, burnout and PTSD, and that compassion fatigue has been identified across diverse practitioner groups in health care. Recommendations are consistently made that further research needs to be conducted to investigate root causes, and that education and support programs would be of benefit to practitioners.
- ItemOpen AccessThe applicability of meta-analyses to guide clinical practice in critical care(2005) Delaney, Anthony; Doig, Christopher
- ItemOpen AccessValidation of an ICD-10 coded case definition for the identification of patients diagnosed with sepsis and severe sepsis using administrative data(2015-02-10) Jolley, Rachel; Doig, ChristopherBackground: We assessed the validity of existing ICD case definitions used to identify sepsis in administrative data and validated and optimized an existing ICD-10-CA coding algorithm to identify patients diagnosed with sepsis. Methods: Standard systematic review methodology was applied to assess the validity of ICD case definitions for sepsis. The CIHI ICD-10-CA coding algorithm for sepsis was validated and optimized using a randomly selected cohort of ICU and non-ICU patients. Sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: Twelve studies were identified in the systematic review with a range of diagnostic accuracy reported indicating that sepsis is highly under-coded. We increased the accuracy of the CIHI ICD-10-CA coding algorithm for sepsis (Sn: 71.9%, NPV: 66.6%) and severe sepsis (Sn: 65.1%, NPV: 70.1%) while slightly decreasing Sp and PPV. Conclusions: Sepsis is highly under-coded in administrative data. The new definition has a much higher sensitivity and negative predictive value.