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Accidental hypothermia: factors related to long-term hospitalization. A retrospective study from northern Finland.

https://arctichealth.org/en/permalink/ahliterature290758
Source
Intern Emerg Med. 2017 Dec; 12(8):1225-1233
Publication Type
Journal Article
Date
Dec-2017
Author
Jari Pirnes
Tero Ala-Kokko
Author Affiliation
Division of Intensive Care Medicine, and Medical Research Center Oulu, Department of Anaesthesiology, Oulu University Hospital and Research Group of Surgery, Anaesthesiology and Intensive Care, Medical Faculty, University of Oulu, Box 21, OUH, 90029, Oulu, Finland. jari.pirnes@fimnet.fi.
Source
Intern Emerg Med. 2017 Dec; 12(8):1225-1233
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Acidosis, Lactic - etiology - mortality
Adolescent
Adult
Aged
Chi-Square Distribution
Cohort Studies
Female
Finland
Hospitalization - statistics & numerical data
Humans
Hypothermia - mortality
Intensive Care Units - organization & administration - statistics & numerical data
Male
Middle Aged
Prognosis
Renal Insufficiency - complications - mortality
Retrospective Studies
Rhabdomyolysis - complications - mortality
Statistics, nonparametric
Abstract
Accidental hypothermia has a low incidence, but is associated with a high mortality rate. Knowledge about concomitant factors, complications, and length of hospital stay is limited. A retrospective cohort study on patients with accidental hypothermia admitted to Oulu University Hospital in Finland, over a 5-year period. Patients were categorized as short-stay patients (7 days or less) and long-stay patients (more than 7 days) according to their length of stay in hospital. From a total of 105 patients, 67 patients were included in the analyses. Alcohol abuse was the most common concomitant factor (54 %). Median length of hospital stay was 4 days, and 16 patients (24 %) stayed in hospital over 7 days (median 15 days). Thirty-day mortality was low (14/105, 13 %). Patients with long-term hospitalization had a lower initial temperature (28.4 versus 31.2 °C, p = 0.011), a lower level of consciousness (GCS score 8.4 versus 12.8, p = 0.003), more severe acidosis (pH 7.08 versus 7.28, p = 0.005, and lactate 7.2 versus 3.9, p = 0.043), and a lower level of platelets (183 versus 242, p = 0.041) on admission compared with short-stay patients. Thirty-six patients (54 %) had at least one complication, and this prolonged median hospital treatment for 2.5 days (p 
Notes
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PubMed ID
27677616 View in PubMed
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Accidental hypothermia: factors related to long-term hospitalization. A retrospective study from northern Finland.

https://arctichealth.org/en/permalink/ahliterature276471
Source
Intern Emerg Med. 2016 Sep 27;
Publication Type
Article
Date
Sep-27-2016
Author
Jari Pirnes
Tero Ala-Kokko
Source
Intern Emerg Med. 2016 Sep 27;
Date
Sep-27-2016
Language
English
Publication Type
Article
Abstract
Accidental hypothermia has a low incidence, but is associated with a high mortality rate. Knowledge about concomitant factors, complications, and length of hospital stay is limited. A retrospective cohort study on patients with accidental hypothermia admitted to Oulu University Hospital in Finland, over a 5-year period. Patients were categorized as short-stay patients (7 days or less) and long-stay patients (more than 7 days) according to their length of stay in hospital. From a total of 105 patients, 67 patients were included in the analyses. Alcohol abuse was the most common concomitant factor (54 %). Median length of hospital stay was 4 days, and 16 patients (24 %) stayed in hospital over 7 days (median 15 days). Thirty-day mortality was low (14/105, 13 %). Patients with long-term hospitalization had a lower initial temperature (28.4 versus 31.2 °C, p = 0.011), a lower level of consciousness (GCS score 8.4 versus 12.8, p = 0.003), more severe acidosis (pH 7.08 versus 7.28, p = 0.005, and lactate 7.2 versus 3.9, p = 0.043), and a lower level of platelets (183 versus 242, p = 0.041) on admission compared with short-stay patients. Thirty-six patients (54 %) had at least one complication, and this prolonged median hospital treatment for 2.5 days (p 
PubMed ID
27677616 View in PubMed
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Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature150309
Source
Intensive Care Med. 2009 Aug;35(8):1352-61
Publication Type
Article
Date
Aug-2009
Author
Rita Linko
Marjatta Okkonen
Ville Pettilä
Juha Perttilä
Ilkka Parviainen
Esko Ruokonen
Jyrki Tenhunen
Tero Ala-Kokko
Tero Varpula
Author Affiliation
Intensive Care Units, Department of Anaesthesia and Intensive Care Medicine, Division of Surgery, Helsinki University Hospital, Helsinki, Finland. rita.linko@hus.fi
Source
Intensive Care Med. 2009 Aug;35(8):1352-61
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Female
Finland - epidemiology
Humans
Intensive Care Units
Male
Middle Aged
Prospective Studies
Respiration, Artificial - utilization
Respiratory Distress Syndrome, Adult - etiology - mortality - physiopathology - therapy
Risk factors
Tidal Volume - physiology
Treatment Outcome
Abstract
To evaluate the incidence, treatment and mortality of acute respiratory failure (ARF) in Finnish intensive care units (ICUs).
Prospective multicentre cohort study.
All adult patients in 25 ICUs were screened for use of invasive or non-invasive ventilatory support during an 8-week period. Patients needing ventilatory support for more than 6 h were included and defined as ARF patients. Risk factors for ARF and details of prior chronic health status were assessed. Ventilatory and concomitant treatments were evaluated and recorded daily throughout the ICU stay. ICU and 90-day mortalities were assessed.
A total of 958 (39%) from the 2,473 admitted patients were treated with ventilatory support for more than 6 h. Incidence of ARF, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) was 149.5, 10.6 and 5.0/100,000 per year, respectively. Ventilatory support was started with non-invasive interfaces in 183 of 958 (19%) patients. Ventilatory modes allowing triggering of spontaneous breaths were preferred (81%). Median tidal volume/predicted body weight was 8.7 (7.6-9.9) ml/kg and plateau pressure 19 (16-23) cmH2O. The 90-day mortality of ARF was 31%.
While the incidence of ARF requiring ventilatory support is higher, the incidence of ALI and ARDS seems to be lower in Finland than previously reported in other countries. Tidal volumes are higher than recommended in the concept of lung protective strategy. However, restriction of peak airway pressure was used in the majority of ARF patients.
Notes
Comment In: Intensive Care Med. 2009 Aug;35(8):1328-3019526219
PubMed ID
19526218 View in PubMed
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Analysis of the temperature affects on leukocyte surface antigen expression.

https://arctichealth.org/en/permalink/ahliterature101771
Source
J Clin Lab Anal. 2011;25(2):118-25
Publication Type
Article
Date
2011
Author
Joel Jämsä
Virva Huotari
Eeva-Riitta Savolainen
Hannu Syrjälä
Tero Ala-Kokko
Author Affiliation
Department of Anaesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland. joel.jamsa@oulu.fi
Source
J Clin Lab Anal. 2011;25(2):118-25
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antigens, CD - immunology
Cold Temperature
Cryopreservation
Female
Flow Cytometry - methods
Humans
Male
Middle Aged
Sepsis - diagnosis - immunology
Time Factors
Young Adult
Abstract
Flow cytometric analysis of leukocyte surface antigens has been used to characterize infectious and septic processes in patients. We wanted to investigate how the sampling and processing temperature, the anticoagulant used, and the storage of the sample influence leukocyte immunophenotyping. Four blood samples, two using acid citrate dextrose and two using heparin as an anticoagulant, were taken from five intensive-care unit patients with severe sepsis and five healthy volunteers. The samples were collected, stored, and processed either at +4?C or at room temperature (RT). The samples were processed for flow cytometric analysis within 1 ?hr of collection or after 6 or 24? hr storage. The surface antigens of interest were neutrophilic CD11b and CD64, monocytic CD11b, CD14, CD40, CD64, CD80 and HLA-DR, and lymphocytic CD69 (separately in CD4+ and CD8+ T cells, B cells, and natural killer cells). The fluorescence intensities were higher at RT than at +4?C. During storage the intensities increased at RT, but at +4?C there were only minor changes. The effects were similar with both anticoagulants studied. According to our results, flow cytometric analysis of leukocyte surface antigen expressions should be performed using +4?C temperature throughout the process and within 6? hr.
PubMed ID
21438005 View in PubMed
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Are small hospitals with small intensive care units able to treat patients with severe sepsis?

https://arctichealth.org/en/permalink/ahliterature145528
Source
Intensive Care Med. 2010 Apr;36(4):673-9
Publication Type
Article
Date
Apr-2010
Author
Matti Reinikainen
Sari Karlsson
Tero Varpula
Ilkka Parviainen
Esko Ruokonen
Marjut Varpula
Tero Ala-Kokko
Ville Pettilä
Author Affiliation
Department of Intensive Care, North Karelia Central Hospital, Tikkamäentie 16, 80210, Joensuu, Finland. matti.reinikainen@pkssk.fi
Source
Intensive Care Med. 2010 Apr;36(4):673-9
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Chi-Square Distribution
Female
Finland - epidemiology
Health Facility Size
Hospital Mortality
Humans
Incidence
Intensive Care Units - organization & administration
Length of Stay - statistics & numerical data
Logistic Models
Male
Middle Aged
Retrospective Studies
Sepsis - mortality - therapy
Survival Analysis
Treatment Outcome
Abstract
To find out whether mortality from sepsis is influenced by the size of the hospital and of the intensive care unit (ICU).
In the Finnsepsis study, 470 patients with severe sepsis were identified. The present study is a retrospective subgroup analysis of the Finnsepsis study. Eighteen patients were excluded because of treatment in more than one ICU. We divided the 24 units into three groups based on hospital size and academic status.
There were no significant differences between the ICU groups in terms of severity of illness. Overall, the hospital mortality rate was 29.2%. In post-operative patients, the hospital mortality rate was 22.9% for patients treated in large ICUs (including university and large non-university hospital ICUs) but 42.3% for patients treated in small ICUs (p = 0.045). In medical patients, no differences in outcomes were found.
Treatment of surgical patients with severe sepsis in small ICUs was associated with increased mortality. Because of the relatively small sample size, further studies are needed to confirm or refute this association.
PubMed ID
20143222 View in PubMed
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Aspiration pneumonia following severe self-poisoning.

https://arctichealth.org/en/permalink/ahliterature71469
Source
Resuscitation. 2003 Jan;56(1):49-53
Publication Type
Article
Date
Jan-2003
Author
Janne Liisanantti
Päivi Kaukoranta
Matti Martikainen
Tero Ala-Kokko
Author Affiliation
Department of Anesthesiology, Oulu University Hospital, PO Box 21, 90029 OUH, Oulu, Finland.
Source
Resuscitation. 2003 Jan;56(1):49-53
Date
Jan-2003
Language
English
Publication Type
Article
Keywords
Adult
Charcoal
Female
Gastric Lavage
Humans
Intubation, Intratracheal
Length of Stay
Male
Odds Ratio
Pneumonia, Aspiration - etiology - prevention & control
Poisoning - complications
Retrospective Studies
Risk factors
Substance-Related Disorders - complications
Unconsciousness
Abstract
PURPOSE: To investigate the risk factors of aspiration pneumonia following severe self-poisoning. MATERIALS AND METHODS: Patients treated due to severe self-poisoning in the ICU of Oulu University Hospital, Oulu, Finland during 1.11.1989-31.10.2000 were analyzed retrospectively. RESULTS: 28.4% of 257 patients fulfilled the criteria of aspiration pneumonia. An unconscious patient who was not intubated until arrival at the emergency room (ER) had an odds ratio (OR) of 3.34 (CI 1.3-8.7) for aspiration pneumonia. If the patient was intubated at the first contact with health care providers, OR was 1.8 (CI 0.6-5.7). The use of gastric lavage or activated charcoal in the case of a non-intubated unconscious patient led to ORs of 2.7 (CI 0.8-9.3) and 3.7 (CI 1.01-12.5), respectively. The mean length of ICU stay was 0.9 (CI 0.8-0.9) days among patients without aspiration pneumonia and 1.9 (CI 1.3-2.6) days among those with aspiration pneumonia. The mean length of hospital stay was 2.8 (CI 2.5-3.1) days among the patients without aspiration pneumonia and 6.5 (CI 5.3-7.6) days among those with aspiration pneumonia. CONCLUSION: To avoid aspiration pneumonia intubation of an unconscious patient on scene before arrival at the ER is recommended. The use of gastric lavage and activated charcoal increase the risk of aspiration pneumonia if the patient is unconscious and not intubated. Aspiration pneumonia significantly prolongs the length of ICU and hospital stay.
PubMed ID
12505738 View in PubMed
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Do pre-hospital poisoning deaths differ from in-hospital deaths? A retrospective analysis.

https://arctichealth.org/en/permalink/ahliterature285849
Source
Scand J Trauma Resusc Emerg Med. 2017 May 08;25(1):48
Publication Type
Article
Date
May-08-2017
Author
Lauri Koskela
Lasse Raatiniemi
Håkon Kvåle Bakke
Tero Ala-Kokko
Janne Liisanantti
Source
Scand J Trauma Resusc Emerg Med. 2017 May 08;25(1):48
Date
May-08-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Finland - epidemiology
Hospital Mortality
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Poisoning - epidemiology - etiology - mortality
Registries
Retrospective Studies
Time Factors
Abstract
Most fatal poisonings occur outside the hospital and the victims found dead. The purpose of this study was to determine the general pattern and patient demographics of fatal poisonings in Northern Finland. In particular, we wanted to analyze differences between pre-hospital and in-hospital deaths.
All fatal poisonings that occurred in Northern Finland in 2007-2011 were retrieved from the Cause of Death Registry provided by Statistics Finland. We noted the patient demographics, causal agents, and other characteristics of the poisoning events.
A total of 689 fatal poisonings occurred during the study period, of which only 42 (6.1%) reached the hospital alive. Those who died pre-hospital were significantly younger (50 vs. 56 years, p = 0.04) and more likely to be male (77% vs. 57%, p = 0.003). Cardiopulmonary resuscitation was attempted less often in pre-hospital cases (9.9% vs. 47.6%, p
Notes
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PubMed ID
28482932 View in PubMed
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Factors related to delayed intensive care unit admission from emergency department-A retrospective cohort study.

https://arctichealth.org/en/permalink/ahliterature298873
Source
Acta Anaesthesiol Scand. 2019 Mar 18; :
Publication Type
Journal Article
Date
Mar-18-2019
Author
Mia Aitavaara-Anttila
Janne H Liisanantti
Lasse Raatiniemi
Pasi Ohtonen
Tero Ala-Kokko
Author Affiliation
Division of Intensive Care Medicine, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
Source
Acta Anaesthesiol Scand. 2019 Mar 18; :
Date
Mar-18-2019
Language
English
Publication Type
Journal Article
Abstract
The delays in transferring patients from emergency department (ED) to intensive care unit (ICU) are known to be linked with several adverse events, including prolonged ICU stay and increased hospital mortality. The factors associated with delayed ICU admission include shortage of ICU beds, organizational factors, ED overcrowding, and patient-related factors, including sepsis as admission diagnosis. The aim of this study was to examine ED-related factors associated with prolonged ED stay.
The study population consisted of adult patients admitted (n = 479) from ED to ICU between 31 May 2016 and 19 March 2017 in Oulu University Hospital. A patient's ED length of stay (LOS) exceeding 180 minutes was considered delayed.
Most of the patients (380, 79.3%) were admitted to the ICU within 3 hours of hospital admission. In a logistic regression analysis, odds ratios (ORs) for ED LOS > 180 minutes were as follows: for Glasgow Coma Scale score > 9, 2.73 (1.39-5.32); for thrombocytes 
PubMed ID
30883672 View in PubMed
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Fatal poisonings in Northern Finland: causes, incidence, and rural-urban differences.

https://arctichealth.org/en/permalink/ahliterature294578
Source
Scand J Trauma Resusc Emerg Med. 2017 Sep 08; 25(1):90
Publication Type
Journal Article
Multicenter Study
Date
Sep-08-2017
Author
Lauri Koskela
Lasse Raatiniemi
Håkon Kvåle Bakke
Tero Ala-Kokko
Janne Liisanantti
Author Affiliation
Oulu University Hospital, Department of Anesthesiology, Division of Intensive Care Medicine, P.O.BOX 21, 90029 OYS, Oulu, Finland. lauri.koskela@student.oulu.fi.
Source
Scand J Trauma Resusc Emerg Med. 2017 Sep 08; 25(1):90
Date
Sep-08-2017
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Adolescent
Adult
Aged
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Poisoning - epidemiology
Registries
Rural Population
Survival Rate - trends
Urban Population
Young Adult
Abstract
In this study we evaluate differences between rural and urban areas in the causes and incidence of fatal poisonings.
Data from all fatal poisonings that occurred in Northern Finland from 2007 to 2011 were retrieved from Cause of Death Registry death certificates provided by Statistics Finland. The demographics and causes of fatalities were compared between rural and urban areas. Incidences were calculated based on the population data.
There were a total of 684 fatal poisonings during the study period and 57.9% (n = 396) occurred in the urban population. Ethanol was the most common primary poisoning agent in cases of fatal poisoning, accounting for 47.5% of cases in urban areas and 68.1% in rural areas (P 
Notes
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PubMed ID
28886743 View in PubMed
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Five-Year Survival and Causes of Death in Children After Intensive Care-A National Registry Study.

https://arctichealth.org/en/permalink/ahliterature299383
Source
Pediatr Crit Care Med. 2018 03; 19(3):e145-e151
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2018
Author
Elina Kyösti
Janne H Liisanantti
Outi Peltoniemi
Pasi Ohtonen
Paula Rautiainen
Janne Kataja
Tero Ala-Kokko
Author Affiliation
Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
Source
Pediatr Crit Care Med. 2018 03; 19(3):e145-e151
Date
03-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Cause of Death
Child
Child Mortality
Child, Preschool
Female
Finland
Follow-Up Studies
Hospital Mortality
Hospitalization - statistics & numerical data
Hospitals, Pediatric - statistics & numerical data
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric - statistics & numerical data
Longitudinal Studies
Male
Patient Discharge - statistics & numerical data
Registries
Retrospective Studies
Survival Rate
Abstract
The aim of the study was to compare long-term mortality and causes of death in children post admission to an ICU with a control population of same age.
Longitudinal follow-up study.
Registry study of a national ICU register and hospital registries.
Children admitted to an ICU in the years 2009 and 2010.
None.
The mortality and causes of death following ICU discharge were analyzed retrospectively. The median follow-up period was 4.9 years (25-75th percentiles, 4.4-5.5 yr). The causes of death in survivors 30 days after ICU discharge were compared with a cohort of 1 million children of the general population of same age. In total, 2,792 children were admitted to an ICU during the study period. Of those, 53 (1.9%) died in the ICU and 2,739 were discharged. Thirteen children died within 30 days of discharge, and 68 died between 30 days and the end of follow-up (December 31, 2014). In the control population (n = 1,020,407 children), there were 1,037 deaths (0.10%) from 2009 to 2014. The standardized mortality rate for the children admitted to the ICU during the study period was 53.4 (95% CI, 44.7-63.2). The standardized mortality rate for those children alive 1 year after discharge was 16.7 (12.1-22.6). One-year cumulative mortality was 3.3%. The most common causes of death in subjects alive 30 days post ICU were cancer (35.3%), neurologic (17.6%), and metabolic diseases (11.7%), whereas trauma was the most common cause in the control group (45.3%).
There was an increased risk of death in a cohort of ICU-admitted children even 3 years after discharge. In those who survived 30 days after discharge, medical causes of death were dominant, whereas deaths due to trauma were most common in the control group.
Notes
CommentIn: Pediatr Crit Care Med. 2018 Mar;19(3):272-273 PMID 29499026
PubMed ID
29215400 View in PubMed
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26 records – page 1 of 3.