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Patients presenting on a weekend had a significantly higher risk of unadjusted in hospital mortality (OR 1.20, 95% CI 1.10 – 1.31, p < .001). Both the unadjusted 30 day mortality risk (OR 1.16, 95% CI 0.98 – 1.39, p= .090) and unadjusted 90 day mortality risk (OR 1.12, 95% CI 0.90 – 1.40, p= .30) were higher for those presenting at a weekend, but neither reached statistical significance. There was a significantly greater risk of combined unadjusted in hospital, 30 and 90 day mortality for those presenting at a weekend (OR 1.17, 95% CI 1.09 – 1.27, p < .001). Hospital length of stay was not statistically different between groups.

There is an association between weekend admission and higher mortality in patients presenting with ruptured abdominal aortic aneurysm.

There is an association between weekend admission and higher mortality in patients presenting with ruptured abdominal aortic aneurysm.

The aims of the present study were to examine the impact of type 2 endoleaks (T2EL) on overall survival and to determine the need for secondary intervention after endovascular aneurysm repair (EVAR).

A multicentre retrospective cohort study in the Netherlands was conducted among patients with an infrarenal abdominal aortic aneurysm (AAA) who underwent EVAR between 2007 and 2012. The primary endpoint was overall survival for patients with (T2EL+) or without (T2EL-) a T2EL. Secondary endpoints were sac growth, AAA rupture, and secondary intervention. Kaplan-Meier survival and multivariable Cox regression analysis were used.

A total of 2 018 patients were included. The median follow up was 62.1 (range 0.1 – 146.2) months. No difference in overall survival was found between T2EL+ (n= 388) and T2EL- patients (n= 1630) (p= .54). The overall survival estimates at five and 10 years were 73.3%/69.4% and 45.9%/44.1% for T2EL+/T2EL- patients, respectively. Eighty-five of 388 (21.9%) T2EL+ patients underwent a secos found between T2EL+ and T2EL- patients. Y27632 Also, patients who underwent a secondary intervention did not have better survival compared with those who did not undergo a secondary intervention. This study reinforces the need for conservative treatment of an isolated T2EL and the importance of a prospective study to determine possible advantages of the intervention.

This study aimed to investigate the impact of chronic kidney disease (CKD) and the delivery of nephrology care on outcomes of carotid endarterectomy (CEA).

This was a single centre, retrospective observational study. Between January 2007 and December 2014, 675 CEAs performed on 613 patients were stratified by pre-operative estimated glomerular filtration rate (eGFR) values (CKD [eGFR < 60 mL/min/1.73m

] and non-CKD [eGFR ≥ 60 mL/min/1.73m

] groups) for retrospective analysis. The study outcomes included the occurrence of major adverse cardiovascular events (MACEs), defined as fatal or non-fatal stroke, myocardial infarction, or all cause mortality, during the peri-operative period and within four years after CEA.

The CKD group consisted of 112 CEAs (16.6%), and the non-CKD group consisted of 563 CEAs (83.4%). The MACE incidence was higher among patients with CKD compared with non-CKD patients during the peri-operative period (4.5% vs. 1.8%; p= .086) and within four years after CEA (17.9% vs. 11.5%;all cause mortality rates among patients with CKD without nephrology care, patients with CKD under nephrology care had similar outcomes to non-CKD patients.

Despite the higher risk of peri-operative and four year MACE after CEA among patients with CKD, and the statistically significantly higher peri-operative and four year post-operative all cause mortality rates among patients with CKD without nephrology care, patients with CKD under nephrology care had similar outcomes to non-CKD patients.

Severe patient-ventilator asynchrony (PVA) might be associated with prolonged mechanical ventilation and mortality. It is unknown if systematic screening and application of conventional methods for PVA management can modify these outcomes. We therefore constructed a twice-daily bedside PVA screening and management protocoland investigated its effect on patient outcomes.

A retrospective cohort study of patients who were intubated in the emergency department and directly admitted to the medical intensive care unit (ICU). In phase 1 (6 months; August 2016 to January 2017), patients received usual care comprising lung protective ventilation and moderate analgesia/sedation. In phase 2 (6 months; February 2017 to July 2017), patients were additionally managed with a PVA protocol on ICU admission and twice daily (7am, 7pm).

A total of 280 patients (160 in phase 1, 120 in phase 2) were studied (age=64.5±21.4 years, 107women [38.2%], Acute Physiology and Chronic Health Evaluation II score=27.1±8.5, 271 [96.8%] on volume assist-control ventilation initially). Phase 2 patients had lower hospital mortality than phase 1 patients (20.0% versus 34.4%, respectively, P=0.011), even after adjustment for age and Acute Physiology and Chronic Health Evaluation II scores (odds ratio=0.46, 95% confidence interval=0.25-0.84).

Application of a bedside PVA protocol for mechanically ventilated patients on ICU admission and twice daily was associated with decreased hospital mortality. There was however no association with sedation-free days or mechanical ventilation-free days through day 28or length of hospital stay.

Application of a bedside PVA protocol for mechanically ventilated patients on ICU admission and twice daily was associated with decreased hospital mortality. There was however no association with sedation-free days or mechanical ventilation-free days through day 28 or length of hospital stay.

The aim of the study was to determine levels of depression, anxiety, and stress symptoms and factors associated with psychological burden amongst critical care healthcare workers in the early stages of the coronavirus disease 2019pandemic.

An anonymous Web-based survey distributed in April 2020. All healthcare workers employed in a critical care setting were eligible to participate. Invitations to the survey were distributed through Australian and New Zealand critical care societies and social media platforms. The primary outcome was the proportion of healthcare workers who reported moderate to extremely severe scores on the Depression, Anxiety, and Stress Scale-21 (DASS-21).

Of the 3770 complete responses, 3039 (80.6%) were from Australia. A total of 2871 respondents (76.2%) were women; the median age was 41 years. Nurses made up 2269 (60.2%) of respondents, with most (2029 [53.8%]) working in intensive care units. Overall, 813 (21.6%) respondents reported moderate to extremely severe depression, 1078 (28.