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7 results on '"Wesselink, R. M."'

1. Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients with COVID-19: A Nationwide Observational Cohort Study∗

Author

den Uil, Corstiaan A., Termorshuizen, Fabian, Rietdijk, Wim J. R., Sablerolles, Roos S. G., van der Kuy, Hugo P. M., Haas, Lenneke E. M., van der Voort, Peter H. J., de Lange, Dylan W., Pickkers, Peter, de Keizer, Nicolette F., Arbous, M. S., Barnas, M. G. W., Boer, D. P., Bosman, R. J., Brunnekreef, G. B., de Bruin, M. Th., de Graaff, M. J., de Jong, R. M., de Meijer, A. R., de Ruijter, W., de Waal, R., Dijkhuizen, A., Dongelmans, D. A., Dormans, T. P. J., Draisma, A., Drogt, I., Eikemans, B. J. W., Elbers, P. W. G., Epker, J. L., Erkamp, M. L., Festen-Spanjer, B., Frenzel, T., Georgieva, L., Gritters, N. C., Hené, I. Z., Hoeksema, M., Holtkamp, J. W. M., Hoogendoorn, M. E., Jacobs, C. J. G. M., Janssen, I. T. A., Kieft, H., Koetsier, M. P., Koning, T. J. J., Kreeftenberg, H., Kusadasi, N., Lens, J. A., Lutisan, J. G., Mehagnoul-Schipper, D. J., Moolenaar, D., Nooteboom, F., Postma, N., Pruijsten, R. V., Ramnarain, D., Reidinga, A. C., Rengers, E., Rijkeboer, A. A., Rijpstra, T., Rozendaal, F. W., Schnabel, R. M., Silderhuis, V. M., Spijkstra, J. J., Spronk, P. E., te Velde, L. F., Urlings-Strop, L. C., van den Berg, A. E., van den Berg, R., van der Horst, I. C. C., van Driel, E. M., van Gulik, L., van Iersel, F. M., van Lieshout, M., van Oers, J. A. H., van Slobbe-Bijlsma, E. R., van Tellingen, M., Vandeputte, J., Verbiest, D. P., Versluis, D. J., Verweij, E., Vrolijk-de Mos, M., Wesselink, R. M. J., Medical Informatics, APH - Methodology, APH - Digital Health, APH - Quality of Care, Intensive Care Medicine, AII - Infectious diseases, Radiology and Nuclear Medicine, ACS - Microcirculation, and ANS - Neurovascular Disorders

Subjects
obesity, COVID-19, critical illness, age groups, prognosis
Abstract

OBJECTIVES: A high body mass index (BMI) is associated with an unfavorable disease course in COVID-19, but not among those who require admission to the ICU. This has not been examined across different age groups. We examined whether age modifies the association between BMI and mortality among critically ill COVID-19 patients. DESIGN: An observational cohort study. SETTING: A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry. PATIENTS: We included 15,701 critically ill patients with COVID-19 (10,768 males [68.6%] with median [interquartile range] age 64 yr [55-71 yr]), of whom 1,402 (8.9%) patients were less than 45 years. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In the total sample and after adjustment for age, gender, Acute Physiology and Chronic Health Evaluation IV, mechanical ventilation, and use of vasoactive drugs, we found that a BMI greater than or equal to 30 kg/m2does not affect hospital mortality (adjusted odds ratio [ORadj] = 0.98; 95% CI, 0.90-1.06; p = 0.62). For patients less than 45 years old, but not for those greater than or equal to 45 years old, a BMI greater than or equal to 30 kg/m2was associated with a lower hospital mortality (ORadj= 0.59; 95% CI, 0.36-0.96; p = 0.03). CONCLUSIONS: A higher BMI may be favorably associated with a lower mortality among those less than 45 years old. This is in line with the so-called "obesity paradox" that was established for other groups of critically ill patients in broad age ranges. Further research is needed to understand this favorable association in young critically ill patients with COVID-19.

Published
2023

2. Comparison of patient characteristics and long-term mortality between transferred and non-transferred COVID-19 patients in Dutch intensive care units: A national cohort study

Author

Wortel, Safira A., Bakhshi-Raiez, Ferishta, Termorshuizen, Fabian, de Lange, Dylan W., Dongelmans, Dave A., de Keizer, Nicolette F., Arbous, M. S., Barnas, M. G. W., Bindels, A. J. G. H., Boer, D. P., Bosman, R. J., Brunnekreef, G. B., de Bruin, M. Th., de Graaff, M., de Jong, R. M., de Meijer, A. R., de Ruijter, W., de Waal, R., Dijkhuizen, A., Dormans, T. P. J., Draisma, A., Drogt, I., Eikemans, B. J. W., Elbers, P. W. G., Epker, J. L., Erkamp, M. L., Festen-Spanjer, B., Frenzel, T., Gommers, D., Gritters, N. C., Hené, I. Z., Hoeksema, M., Holtkamp, J. W. M., Hoogendoorn, M. E., Houwink, A. P. I., Jacobs, C. J. M. G., Janssen, I. T. A., Kieft, H., Koetsier, M. P., Koning, T. J. J., Kusadasi, N., Lens, J. A., Lutisan, J. G., Mehagnoul-Schipper, D. J., Moolenaar, D., Nooteboom, F., Pruijsten, R. V., Ramnarain, D., Reidinga, A. C., Rengers, E., Rijkeboer, A. A., Rozendaal, F. W., Schnabel, R. M., Silderhuis, V. M., Spijkstra, J. J., Spronk, P., te Velde, L. F., Urlings-Strop, L. C., van Bussel, B. C. T., van den Berg, A. E., van den Berg, R., van der Voort, P. H. J., van Driel, E. M., van Gulik, L., van Iersel, F. M., van Lieshout, M., van Slobbe-Bijlsma, E. R., van Tellingen, M., Vandeputte, J., Verbiest, D. P., Versluis, D. J., Verweij, E., Mos, M. Vrolijk-de, Wesselink, R. M. J., Graduate School, Medical Informatics, APH - Methodology, APH - Quality of Care, Intensive Care Medicine, APH - Digital Health, Radiology and Nuclear Medicine, ACS - Microcirculation, and ANS - Neurovascular Disorders

Subjects
COVID-19, intrahospital transfer, severity of illness, intensive care unit, mortality
Abstract

Background: COVID-19 patients were often transferred to other intensive care units (ICUs) to prevent that ICUs would reach their maximum capacity. However, transferring ICU patients is not free of risk. We aim to compare the characteristics and outcomes of transferred versus non-transferred COVID-19 ICU patients in the Netherlands. Methods: We included adult COVID-19 patients admitted to Dutch ICUs between March 1, 2020 and July 1, 2021. We compared the patient characteristics and outcomes of non-transferred and transferred patients and used a Directed Acyclic Graph to identify potential confounders in the relationship between transfer and mortality. We used these confounders in a Cox regression model with left truncation at the day of transfer to analyze the effect of transfers on mortality during the 180 days after ICU admission. Results: We included 10,209 patients: 7395 non-transferred and 2814 (27.6%) transferred patients. In both groups, the median age was 64 years. Transferred patients were mostly ventilated at ICU admission (83.7% vs. 56.2%) and included a larger proportion of low-risk patients (70.3% vs. 66.5% with mortality risk

Published
2022

3. Benchmarking the use of blood products in cardiac surgery to stimulate awareness of transfusion behaviour

Author

Brouwers, C., Hooftman, B., Vonk, S., Vonk, A., Stooker, W., te Gussinklo, W. H., Wesselink, R. M., Wagner, C., de Bruijne, M. C., Cardiothoracic Surgery, and ACS - Amsterdam Cardiovascular Sciences

Subjects
surgical procedures, operative, Cardiology and Cardiovascular Medicine
Abstract

Introduction Cardiac operations account for a large proportion of the blood transfusions given each year, leading to high costs and an increased risk to patient safety. Therefore, it is important to explore initiatives to reduce transfusion rates. This study aims to provide a benchmark for transfusion practice by inter-hospital comparison of transfusion rates, blood product use and costs related to patients undergoing coronary artery bypass grafting (CABG), valve surgery or combined CABG and valve surgery. Methods Between 2010 and 2013, patients from four Dutch hospitals undergoing CABG, valve surgery or combined CABG and valve surgery (n = 11,150) were included by means of a retrospective longitudinal study design. Results In CABG surgery the transfusion rate ranged between 43 and 54%, in valve surgery between 54 and 67%, and in combined CABG and valve surgery between 80 and 88%. With the exception of one hospital, the trend in trans-fusion rate showed a significant decrease over time for all procedures. Hospitals differed significantly in the units of blood products given to each patient, and in the use of specific transfused combinations of blood products, such as red blood cells (RBCs) and a combination of RBCs, fresh frozen plasma (FFP) and platelets. Conclusion This study indicates that benchmarking blood product usage stimulates awareness of transfusion behaviour, which may lead to better patient safety and lower costs. Further studies are warranted to improve awareness of transfusion behaviour and increase the standardisation of transfusion practice in cardiac surgery

Published
2017

4. Neue Studie zur selektiven Darmdekontamination zeigt nur marginalen Benefit

Author

Panknin, Hardy Thorsten, De Smet, A. M., Kluytmans, J. A., Cooper, B. S., Mascini, E. M., Benus, R. F., Van Der Werf, T. S., Van Der Hoeven, J. G., Pickkers, P., Bogaers-Hofman, D., Van Der Meer, N. J., Bernards, A. T., Kuijper, E. J., Joore, J. C., Leverstein-van Hall, Ma, Bindels, A. J., Jansz, A. R., Wesselink, R. M., De Jongh, B. M., Dennesen, P. J., Van Asselt, G. J., Velde, L. E.Te, Frenay, I. H., Kaasjager, K., Bosch, F. H., Van Iterson, M., Thijsen, S. F., Kluge, G. H., Pauw, W., De Vries, J. W., Kaan, J. A., Arends, J. P., Aarts, L. P., Sturm, P. D., Harinck, H. I., Voss, A., Uijtendaal, E. V., Blok, H. E., Groen, E. S.Thieme, Pauw, M. E., Kalkman, C. J., and Bonten, M. J.

Published
2009

5. Trends in time: Results from the NICE registry

Author

Voort, P. H. J., Bakhshi-Raiez, F., Dylan De Lange, Bosman, R. J., Jonge, E., Joore, H., Waal, H., Wesselink, R. M. J., Berkel, G., Maanen, R., Keizer, N. F., Medical Informatics, Intensive Care Medicine, and Amsterdam Public Health

Subjects
NICE, VLAD curve, Intensive care, Quality of care, Mortality
Abstract

Introduction: The NICE registry contains data from individual intensive care admissions concerning severity of illness and outcome. This study was undertaken to analyze the trends in time related to crude mortality and severity of illness corrected mortality. Methods: Data on all patients admitted from January 1 1999 to January 1 2008 were used. Patients who did not fulfil the inclusion criteria for the SAPS II prediction model were excluded. To analyze trends in time for individual ICUs, this study uses data from ICUs that participated in the NICE registry for a minimum of 5 years between January 1, 2001 and January 1, 2008. Repeated cross-sectional data analysis was performed for Standardized Mortality Ratio (SMR), and longitudinal data analysis using Variable Live Adjusted Displays (VLAD both on individual and national level were used. Results: Overall, 243 182 patients were included in the NICE registry. Of these, 144 696 met the SAPS II inclusion criteria and were included in this study. In the non-cardiac surgery population, the SAPS II model was customized on 9227 admissions from 13 ICUs between 1999 and 2000 to obtain a baseline Dutch SMR of 1.0 for comparison of subsequent years. In individual ICUs, the SAPS II model was customized on 15 863 admissions from 20 ICUs that participated in NICE for a minimum of five years between 2001 and 2002 to obtain a baseline SMR of 1.0 for comparison of subsequent years. From 2001 to 2007 in the non-cardiac surgery population, a significant decrease in SMR was shown from 1.0 tot 0.83 (p=0.023). This decrease was most significant in patients after elective surgery (p=0.01). Seven (25%) individual ICUs showed a significant decrease in their SMR. The VLAD curve for individual ICUs showed a highly variable course. Conclusion Over time, the NICE registry showed a significant improvement in SMR for all patient groups nationwide, and for 7 individual ICUs. Longitudinal analysis for individual ICUs by VLAD curve shows a variable course between ICUs and within an individual ICU over time. This information can be used for quality improvement initiatives both locally and nationwide.

Published
2009

6. One year of COVID-19 in the Netherlands - a Dutch narrative

Author

Verbiest, D. P., Te Velde, L. F., Driel, E. M., Rijpstra, T., Elbers, P. H. J., Houwink, A. P. I., Georgieva, L., Verweij, E., Jong, R. M., Iersel, F. M., Koning, T. J. J., Rengers, E., Kusadasi, N., Erkamp, M. L., Den Berg, R., Jacobs, C. J. M. G., Epker, J. L., Rijkeboer, A. A., Bruin, M. T., Spronk, P., Draisma, A., Versluis, D. J., Den Berg, A. E., Vrolijk-De Mos, M., Lens, J. A., Pruijsten, R. V., Kieft, H., Rozendaal, J., Nooteboom, F., Boer, D. P., Janssen, I. T. A., Gulik, L., Koetsier, M. P., Silderhuis, V. M., Schnabel, R. M., Drogt, I., Ruijter, W., Bosman, R. J., Frenzel, T., Urlings-Strop, L. C., Dijkhuizen, A., Hene, I. Z., Meijer, A. R., Holtkamp, J. W. M., Postma, N., Bindels, A. J. G. H., Wesselink, R. M. J., Brinkman, S., Slobbe-Bijlsma, E. R., Voort, P. H. J., Eikemans, B. J. W., Mehagnoul-Schipper, D. J., Gommers, D., Lutisan, J. G., Hoeksema, M., Barnas, M. G. W., Festen-Spanjer, B., Lieshout, M., Gritters, N. C., Tellingen, M., Brunnekreef, G. B., Vandeputte, J., Dormans, T. P. J., Hoogendoorn, M. E., Graaff, M., Moolenaar, D., Reidinga, A. C., Spijkstra, J. J., Waal, R., Dongelmans, D. A., Dylan De Lange, Keizer, N. F., Surgery, Intensive care medicine, Elderly care medicine, Internal medicine, Cardio-thoracic surgery, Medical oncology, Psychiatry, APH - Mental Health, Pediatrics, Pediatric surgery, Cardiology, APH - Methodology, and ACS - Diabetes & metabolism

7. New study on selective intestinal decontamination shows only marginal benefit | Neue Studie zur selektiven Darmdekontamination zeigt nur marginalen Benefit

Author

Panknin, H. -T, Smet, A. M., Kluytmans, J. A., Ben Cooper, Mascini, E. M., Benus, R. F., Werf, T. S., Hoeven, J. G., Pickkers, P., Bogaers-Hofman, D., Meer, N. J., Bernards, A. T., Kuijper, E. J., Joore, J. C., Leverstein-Van Hall, Ma, Bindels, A. J., Jansz, A. R., Wesselink, R. M., Jongh, B. M., Dennesen, P. J., Asselt, G. J., Velde, L. E. T., Frenay, I. H., Kaasjager, K., Bosch, F. H., Iterson, M., Thijsen, S. F., Kluge, G. H., Pauw, W., Vries, J. W., Kaan, J. A., Arends, J. P., Aarts, L. P., Sturm, P. D., Harinck, H. I., Voss, A., Uijtendaal, E. V., Blok, H. E., Groen, E. S. T., Pauw, M. E., Kalkman, C. J., and Bonten, M. J.

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