| 5 | Effect of introducing an online system on the follow-up of elbow arthroplasty显示文摘AIM To evaluate the effect of introducing a structured online follow-up system on the response rate.METHODS Since June 2015 we have set up an electronic followup system for prosthesis in orthopedic patients. This system allows prospective data gathering using both online and paper questionnaires. In the past all patients received questionnaires on paper. This study includes only patients who received elbow arthroplasty. Response rates before and after introduction of the online database were compared. After the implementation,completeness of the questionnaires was compared between paper and digital versions. For both comparisons Fisher's Exact tests were used.RESULTS A total of 233 patients were included in the study. With the introduction of this online follow-up system,the overall response rate increased from 49.8% to 91.6%(P < 0.01). The response rate of 92.0% in the paper group was comparable to 90.7% in the online group(P > 0.05).Paper questionnaires had a completeness of 54.4%,which was lower compared to the online questionnaires where we reached full completeness(P < 0.01). Furthermore,non-responders proved to be younger with a mean age of 52 years compared to a mean age 62 years of responders(P < 0.05).CONCLUSION The use of a structured online follow-up system increased the response rate. Moreover,online questionnaires are more complete than paper questionnaires. | Jetske Viveen Ante Prkic Bertram The Koen LM Koenraadt Denise Eygendaal | 2016 | World Journal of Orthopedics2016，7，12： | 0 |
| 6 | Septic shock 3.0 criteria application in severe COVID-19 patients:An unattended sepsis population with high mortality risk显示文摘BACKGROUND Coronavirus disease 2019(COVID-19)can be associated with life-threatening organ dysfunction due to septic shock,frequently requiring intensive care unit(ICU)admission,respi-ratory and vasopressor support.There-fore,clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ support.Although most patients with severe COVID-19 meet the Sepsis-3.0 criteria for septic shock,it has been increasingly recognized that hyperlactatemia is frequently absent,possibly leading to an underestimation of illness severity and mortality risk.AIM To identify the proportion of severe COVID-19 patients with vasopressor support requirements,with and without hyperlactatemia,and describe their clinical outcomes and mortality METHODS We performed a single-center prospective cohort study.All adult patients admitted to the ICU with COVID-19 were included in the analysis and were further divided into three groups:Sepsis group,without both criteria;Vasoplegic Shock group,with persistent hypotension and vasopressor support without hyperlactatemia;and Septic Shock 3.0 group,with both criteria.COVID-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)positive RT-PCR test.RESULTS 118 patients(mean age 63 years,87%males)were included in the analysis(n=51 Sepsis group,n=26 Vasoplegic Shock group,and n=41 Septic Shock 3.0 group).SOFA score at ICU admission and ICU length of stay were different between the groups(P<0.001).Mortality was significantly higher in the Vasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group(P<0.001)without a significant difference between the former two groups(P=0.713).The log rank tests of Kaplan-Meier survival curves were also different(P=0.007).Ventilator-free days and vasopressor-free days were different between the Sepsis vs Vasoplegic Shock and Septic Shock 3.0 groups(both P<0.001),and similar in the last two groups(P=0.128 and P=0.133,respectively).Logistic regression identified the maximum dose of vasopressor therapy used(AOR 1.046;95%CI:1.012-1.082,P=0.008)and serum lactate level(AOR 1.542;95%CI:1.055-2.255,P=0.02)as the major explanatory variables of mortality rates(R20.79).CONCLUSION In severe COVID-19 patients,the Sepsis 3.0 criteria of septic shock may exclude approximately one third of patients with a similarly high risk of a poor outcome and mortality rate,which should be equally addressed. | JoséPedro Cidade LM Coelho Vasco Costa Rui Morais Patrícia Moniz Luís Morais Pedro Fidalgo António Tralhão Carolina Paulino David Nora Bernardino Valério Vítor Mendes Camila Tapadinhas Pedro Povoa | 2022 | World Journal of Critical Care Medicine2022，11，4： | 0 |
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