12 In the first cohort, the patients’ surrogate or designated caregiver was asked to complete the short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), with an IQCODE score greater than 3.3 considered to indicate a high risk of cognitive impairment. Research coordinators administered a baseline questionnaire to the patient and/or the surrogate asking about demographics and prehospital disability status using a modified Katz Index of Independence in Activities of Daily Living (ADL), 9, 10 instrumental ADL, 11 and markers of frailty. Baseline Demographics and Other Covariates Both studies were approved by the institutional review board at the Albert Einstein College of Medicine. In both cohorts, we obtained written informed consent from either the patient or their surrogate decision maker. Both cohorts excluded patients who were admitted for an elective surgical procedure, those whose death was imminent, and those who were being discharged from the hospital. The second study, called CAMINANDO, involved adults aged 18 years or older with acute respiratory failure admitted between July 2018 and December 2019 acute respiratory failure was defined by the need for critical care consultation and the acute need for invasive mechanical ventilation, high-flow nasal cannula therapy, or noninvasive mechanical ventilation. The first study, called FRAIL-STOOP, was previously described 8 briefly, it involved adult patients aged 50 years or older who were admitted to medical or surgical ICUs between January 2016 and July 2017. We conducted post hoc analyses using data from 2 observational cohort studies. AACN has been approved as a provider of continuing education in nursing by the California Board of Registered Nursing (CA BRN), CA Provider Number CEP1036, for 1.0 contact hour. The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation, ANCC Provider Number 0012. To complete the evaluation for CE contact hour(s) for this article #A223143, visit and click the “CE Articles” button. Identify baseline and hospitalization characteristics associated with cognitive impairment at hospital discharge. The evaluation demonstrates your knowledge of the following objectives:Īssess for cognitive impairment in survivors of critical care illness.Įxplore the utility of the Montreal Cognitive Assessment as a tool to screen for cognitive impairments in survivors of critical illness. Alternative non-pneumonia illness accounts for the acute clinical or radiographic findings that meet the study's inclusion criteria.This article has been designated for CE contact hour(s).Clinical team does not believe the patient should enter the study due to concerns about potential steroid-related complications.Pre-existing medical condition resulting in a life expectancy Gastro-intestinal bleeding treated with hospital admission and/or blood transfusion within the past 3 months.Any history of hospitalizations due to psychiatric illnesses within the past year.Substance abuse (alcohol, opioid, benzodiazepines, methamphetamines, cocaine) within the past year.Active cancer, defined as new diagnosis or treatment for cancer in the past 6 months.Severe immunosuppression, defined as any of the following: HIV with CD4 count Previous allergic or adverse reaction to a corticosteroid.Any history of diabetes mellitus, having a serum blood glucose > 250 mg/dL, or requiring an anti-diabetic medication (e.g., insulin).Acute pneumonia defined as fulfilling each of the following two criteria: (a) New ( 145 mEq/L (hypernatremia) or potassium 180 mmHg or a diastolic blood pressure > 100 mmHg at the start and end of screening.Hospital admission to ward or ICU (including observation status admissions). Why Should I Register and Submit Results?.
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