TY - JOUR
T1 - 1324: ABCDEF Bundle Elements and Mobility During Admission: Mortality Effects on the Critically Injured
AU - Shampo, Jackson
AU - Wenszell, Kenneth
AU - Luo-Owen, Xian
AU - Mukherjee, Natalie
AU - Cochran-Yu, Meghan
AU - Swentek, Lourdes
AU - Burruss, Sigrid
AU - Markovich, Susan
AU - Turay, David
AU - Dorotta, Ihab
AU - Mukherjee, Kaushik
PY - 2021/1/1
Y1 - 2021/1/1
N2 - INTRODUCTION: ABCDEF bundle compliance correlates with decreased mortality in the critically ill, but it is unclear which bundle elements are most critical. We studied this question using ABC-123, an EPIC-EMR real-time score assigning 1-3 points per bundle element with higher numbers being better, and improvement in patient mobility during admission (IMA). METHOD(S): We reviewed 6 months of prospectivelycollected data on critically injured adults at an ACS-verified level I trauma center, including demographics, injury severity, Richmond Agitation and Sedation (RASS) Score, Confusion Assessment Method-ICU (CAM-ICU), maximum daily ABC- 123 score (ABC-MAX), and mobility level (bedrest/dangle/ stand/out of bed to chair/ambulate). ABC-123 score includes CPOT assessment, performance of SAT/SBT, reducing IV infusions for sedation, CAM-ICU score, compliance with mobility protocol, and family updates. Patients with mobility level improvement during admission were considered IMA+. Hospital mortality was the endpoint for logistic regression with ISS, head AIS, penetrating trauma, gender, age, ABCMAX subscores, and IMA. RESULT(S): We reviewed 172 patients (69.8% male, 16.3% penetrating, mean age 50.3+/-20.9 years, ISS 18.5+/-9.5, head AIS 2.3+/-2.5). 66.9% had delirium and 11.0% died. IMA+ patients had lower mortality than IMA- (1/48 [2.1%] vs. 18/124 [14.5%], p=0.027 [Fisher's exact]). ISS (OR 1.06[95%CI 1.03-1.10,p
AB - INTRODUCTION: ABCDEF bundle compliance correlates with decreased mortality in the critically ill, but it is unclear which bundle elements are most critical. We studied this question using ABC-123, an EPIC-EMR real-time score assigning 1-3 points per bundle element with higher numbers being better, and improvement in patient mobility during admission (IMA). METHOD(S): We reviewed 6 months of prospectivelycollected data on critically injured adults at an ACS-verified level I trauma center, including demographics, injury severity, Richmond Agitation and Sedation (RASS) Score, Confusion Assessment Method-ICU (CAM-ICU), maximum daily ABC- 123 score (ABC-MAX), and mobility level (bedrest/dangle/ stand/out of bed to chair/ambulate). ABC-123 score includes CPOT assessment, performance of SAT/SBT, reducing IV infusions for sedation, CAM-ICU score, compliance with mobility protocol, and family updates. Patients with mobility level improvement during admission were considered IMA+. Hospital mortality was the endpoint for logistic regression with ISS, head AIS, penetrating trauma, gender, age, ABCMAX subscores, and IMA. RESULT(S): We reviewed 172 patients (69.8% male, 16.3% penetrating, mean age 50.3+/-20.9 years, ISS 18.5+/-9.5, head AIS 2.3+/-2.5). 66.9% had delirium and 11.0% died. IMA+ patients had lower mortality than IMA- (1/48 [2.1%] vs. 18/124 [14.5%], p=0.027 [Fisher's exact]). ISS (OR 1.06[95%CI 1.03-1.10,p
UR - https://journals.lww.com/10.1097/01.ccm.0000731184.01036.e9
UR - https://www.mendeley.com/catalogue/68ccc58e-56bf-346f-bcd3-e65b17d70a6f/
U2 - 10.1097/01.CCM.0000731184.01036.E9
DO - 10.1097/01.CCM.0000731184.01036.E9
M3 - Meeting abstract
VL - 49
SP - 669
EP - 669
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 1
ER -