Browsing by Author "Granja, Cristina"
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- Neurological outcome after cardiac arrest: cold and dark issuesPublication . Granja, Cristina; Junior, Antonio Paulo NassarPrognostication after cardiac arrest is important for patients, families and health providers. It also has ethical and social implications. With the introduction of therapeutic hypothermia after recovery from cardiac arrest in comatose patients,(1,2) prognostication has become more complex and concerns have been raised, particularly about the amount of time and the number of tools required for this treatment.
- Pyogenic liver abscess caused by accidental ingestion of a bottle capPublication . Rodrigues, Ana Isabel; Martins Fernandes, Rita; Uribe, Hugo Calderon; Granja, Cristina
- Reply to: Neurological outcome after cardiac arrest: cold and dark issues [editorial].Publication . Granja, Cristina; Nassar Junior, Antonio PauloWe are thankful for the interest in our editorial.(1) We agree that the study population in Kim et al.(2) is different from that of Leão et al.(3), insofar as the first consisted of patients who had pre-hospital cardiorespiratory arrest, and the second consisted of patients with out-of-hospital and in-hospital cardiorespiratory arrest. However, neither study showed benefits to achieving the target hypothermia more quickly. In addition, the study by Leão et al. suggested a worse prognosis in patients who reached hypothermia more quickly.(3) As mentioned in the editorial, although the study had several limitations, there is a pathophysiological rationale for this finding.(4,5)
- Surviving cardiac arrest: what happens after admission to the intensive care unit?Publication . Menezes Fernandes, Raquel; Nuñez, Daniel; Marques, Nuno; Dias, Cláudia Camila; Granja, CristinaPatients successfully resuscitated from cardiac arrest (CA) are admitted to the intensive care unit (ICU) for post-resuscitation care. These patients' prognosis remains dismal, with only a minority surviving to hospital discharge. Understanding the clinical factors involved in the management of these patients is essential to improve their prognosis.
- The role of memories on health-related quality of life after intensive care unit care: an unforgettable controversy?Publication . Orwelius, Lotti; Teixeira-Pinto, Armando; Lobo, Cristina; Costa-Pereira, Altamiro; Granja, CristinaBackground: Decreased health-related quality of life (HRQoL) is a significant problem after an intensive care stay and is affected by several known factors such as age, sex, and previous health-state. The objective of this study was to assess the association between memory and self-reported perceived HRQoL of patients discharged from the intensive care unit (ICU).Methods: A prospective, multicenter study involving nine general ICUs in Portugal. All adult patients with a length of stay >48 hours were invited to participate in a 6-month follow-up after ICU discharge by answering a set of structured questionnaires, including EuroQol 5-Dimensions and ICU memory tool.Results: A total of 313 (52% of the eligible) patients agreed to enter the study. The median age of patients was 60 years old, 58% were males, the median Simplified Acute Physiology Score II (SAPS II) was 38, and the median length of stay was 8 days for ICU and 21 days for total hospital stay. Eighty-nine percent (n=276) of the admissions were emergencies. Seventy-eight percent (n=234) of the patients had memories associated with the ICU stay. Patients with no memories had 2.1 higher chances (P=0.011) of being in the bottom half of the HRQoL score (<0.5 EuroQol 5-Dimensions index score). Even after adjusting for pre-admission characteristics, having memories was associated with higher perceived HRQoL (adjusted odds ratio =2.1, P=0.022).Conclusion: This study suggests that most of the ICU survivors have memories of their ICU stay. For the ICU survivors, having memories of the ICU stay is associated with a higher perceived HRQoL 6 months after ICU discharge.
- Waiting for ICU admission may increase the risk of death-A plea for better resource organizationPublication . Castro, Silvia; Pereira, Isabel Jesus; Dias, Claudia Camila; Granja, CristinaBackground Mortality is high in critically ill patients. In order to study the risk factors associated with mortality in these patients, we conducted an observational retrospective study in the general Intensive Care Unit (ICU) of Faro Hospital. Methods All patients discharged from the general ICU in the year 2015 were evaluated for inclusion. Mortality was characterized in the first 48 hours of ICU stay, at the time of discharge from ICU, and at discharge from hospital. Collected variables included demographic variables (age), and ICU variables: type of ICU admission (scheduled surgery, urgent surgery, medical and trauma), Simplified Acute Physiology Score (SAPS II), main diagnosis, hospital length of stay (HLS) before ICU (BICULS), in ICU (ICULS) and after ICU (AICULS). Results When comparing survivors with non-survivors, we found that age, disease severity expressed by SAPS II and BICULS were significantly higher in non-survivors. After multivariate regression analysis, BICULS was still significantly associated with mortality in the hospital. Conclusion Further studies are needed to characterize whether this longer BICULS is related to non-modifiable prior conditions or whether it is related to delayed ICU admission, which is a modifiable factor.