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Ke Y, Yang R, Liu N. Comparing Open-Access Database and Traditional Intensive Care Studies Using Machine Learning: Bibliometric Analysis Study. J Med Internet Res 2024; 26:e48330. [PMID: 38630522 PMCID: PMC11063894 DOI: 10.2196/48330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/01/2023] [Accepted: 01/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Intensive care research has predominantly relied on conventional methods like randomized controlled trials. However, the increasing popularity of open-access, free databases in the past decade has opened new avenues for research, offering fresh insights. Leveraging machine learning (ML) techniques enables the analysis of trends in a vast number of studies. OBJECTIVE This study aims to conduct a comprehensive bibliometric analysis using ML to compare trends and research topics in traditional intensive care unit (ICU) studies and those done with open-access databases (OADs). METHODS We used ML for the analysis of publications in the Web of Science database in this study. Articles were categorized into "OAD" and "traditional intensive care" (TIC) studies. OAD studies were included in the Medical Information Mart for Intensive Care (MIMIC), eICU Collaborative Research Database (eICU-CRD), Amsterdam University Medical Centers Database (AmsterdamUMCdb), High Time Resolution ICU Dataset (HiRID), and Pediatric Intensive Care database. TIC studies included all other intensive care studies. Uniform manifold approximation and projection was used to visualize the corpus distribution. The BERTopic technique was used to generate 30 topic-unique identification numbers and to categorize topics into 22 topic families. RESULTS A total of 227,893 records were extracted. After exclusions, 145,426 articles were identified as TIC and 1301 articles as OAD studies. TIC studies experienced exponential growth over the last 2 decades, culminating in a peak of 16,378 articles in 2021, while OAD studies demonstrated a consistent upsurge since 2018. Sepsis, ventilation-related research, and pediatric intensive care were the most frequently discussed topics. TIC studies exhibited broader coverage than OAD studies, suggesting a more extensive research scope. CONCLUSIONS This study analyzed ICU research, providing valuable insights from a large number of publications. OAD studies complement TIC studies, focusing on predictive modeling, while TIC studies capture essential qualitative information. Integrating both approaches in a complementary manner is the future direction for ICU research. Additionally, natural language processing techniques offer a transformative alternative for literature review and bibliometric analysis.
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Affiliation(s)
- Yuhe Ke
- Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
| | - Rui Yang
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Nan Liu
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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Rai K, Douglas IS, Mehta AB. Association of Hospital Mortality With Initiation of Mechanical Ventilation on a Weekend: A Retrospective Cohort Study. J Intensive Care Med 2023; 38:1136-1142. [PMID: 37357730 DOI: 10.1177/08850666231185315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
RATIONALE Increased mortality in patients admitted to hospitals on weekends is a well-described phenomenon labeled the "weekend effect." Studies evaluating the weekend effect in intensive care units (ICUs) have arrived at conflicting results. Identifying a weekend effect for critically-ill patients may inform clinical care pathways and resource allocation. OBJECTIVES Determine the association of initiation of mechanical ventilation (MV) upon admission on a weekend versus weekday with hospital mortality. METHODS We conducted a retrospective cohort study of non-surgical adult patients using the California Patient Discharge Database from 2018 to 2019. We identified MV initiated on the day of admission and diagnoses using discharge billing codes. The primary exposure was admission and initiation of MV on a weekend versus weekday and the primary outcome was hospital mortality. Hierarchical logistic regression was used to determine the association between hospital mortality and MV initiation timing, adjusting for case-mix. RESULTS Among 90 288 admissions in 2018 and 2019 meeting inclusion criteria, 24 771 (27.5%) had MV initiated on weekends, while 65 517 (72.6%) had MV initiated on weekdays. Patient demographics and comorbidities were similar between groups. Chronic alcohol and substance use disorders, and acute intoxications and traumas were more prevalent among patients with MV initiated on weekends. No difference in hospital mortality was observed with initiation of MV on weekends versus weekdays (23.1% vs 22.8%, ARD = 0.3%, aOR = 1.02, 95% CI 0.98, 1.07). CONCLUSIONS Contrary to prior studies, no increased mortality was observed among newly admitted patients initiated on MV on weekends compared to weekdays. While weekend effects may exist in other settings, newly admitted patients likely have MV initiated in the emergency department or ICU, which tend to have more consistent staffing levels. Further research is needed to determine if care patterns in these units could be used as a model for units where weekend effects continue to impact outcomes.
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Affiliation(s)
- Karan Rai
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ivor S Douglas
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anuj B Mehta
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Xie Q, Shen Z, Pan M, Li Y, Luo Z, Wang C, Zhao L, Fang Y, Ding X, Teng J, Xu J. Weekend effect on the incidence and outcomes of cardiac surgery associated - acute kidney injury. BMC Cardiovasc Disord 2023; 23:524. [PMID: 37891475 PMCID: PMC10612359 DOI: 10.1186/s12872-023-03431-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/05/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The effects of surgical day (workdays or weekends) on occurrence and outcome of cardiac surgery associated -acute kidney injury (CSA-AKI) remains unclear. This study aimed to compare the incidence and short-term outcomes of CSA-AKI in patients undergoing surgery on workdays and weekends. MATERIALS AND METHODS Patients who underwent cardiac surgery from July 2020 to December 2020 were retrospectively enrolled in this study. These patients were divided into a weekend group and workday group. The primary endpoint was the incidence of CSA-AKI. The secondary endpoints included renal function recovery and in-hospital mortality. The logistic regression model was used to explore the risk factors for CSA-AKI. Stratification analysis was performed to estimate the association between CSA-AKI and weekend surgery stratified by emergency surgery. RESULTS A total of 1974 patients undergoing cardiac surgery were enrolled. The incidence of CSA-AKI in the weekend group was significantly higher than that in the workday group (42.8% vs. 34.7%, P = 0.038). Further analysis of patients with CSA-AKI showed that there was no difference in renal function recovery between the workday AKI group and weekend AKI group. There was no difference in in-hospital mortality between the weekend group and workday group (3.6% vs. 2.4%, P = 0.327); however, the in-hospital mortality of the weekend AKI group was significantly higher than that of the workday AKI group (8.5% vs. 2.9%, P = 0.014). Weekend surgery and emergency surgery were independent risk factors for CSA-AKI. The multiplicative model showed an interaction between weekend surgery and emergency surgery; weekend surgery was related to an increased risk of AKI among patients undergoing emergency surgery [adjusted OR (95% CI): 1.96 (1.012-8.128)]. CONCLUSIONS The incidence of CSA-AKI in patients undergoing cardiac surgery on weekends was significantly higher compared to that in patients undergoing cardiac surgery on workdays. Weekend surgery did not affect the in-hospital mortality of all patients but significantly increased the mortality of AKI patients. Weekend surgery and emergency surgery were independent risk factors for CSA-AKI. Weekend emergency surgery significantly increased the risk of CSA-AKI.
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Affiliation(s)
- Qiwen Xie
- Department of Nephrology, Zhongshan Hospital (Xiamen), Fudan University, Nephrology Clinical Quality Control Center of Xiamen, No.668 Jinhu Road, Xiamen, 361006, Fujian, China
| | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University; Kidney and Dialysis Institute of Shanghai; Kidney and Blood Purification Laboratory of Shanghai, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Mingzhen Pan
- Department of Nephrology, The Second People's Hospital of Kashgar, Xinjiang, 844000, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University; Kidney and Dialysis Institute of Shanghai; Kidney and Blood Purification Laboratory of Shanghai, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Zhe Luo
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Chunsheng Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Linxi Zhao
- Hopewell Eye Associates, 84 East Broad St, Hopewell, NJ, 08525, USA
| | - Yi Fang
- Department of Nephrology, Zhongshan Hospital (Xiamen), Fudan University, Nephrology Clinical Quality Control Center of Xiamen, No.668 Jinhu Road, Xiamen, 361006, Fujian, China
- Department of Nephrology, Zhongshan Hospital, Fudan University; Kidney and Dialysis Institute of Shanghai; Kidney and Blood Purification Laboratory of Shanghai, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital (Xiamen), Fudan University, Nephrology Clinical Quality Control Center of Xiamen, No.668 Jinhu Road, Xiamen, 361006, Fujian, China
- Department of Nephrology, Zhongshan Hospital, Fudan University; Kidney and Dialysis Institute of Shanghai; Kidney and Blood Purification Laboratory of Shanghai, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Jie Teng
- Department of Nephrology, Zhongshan Hospital (Xiamen), Fudan University, Nephrology Clinical Quality Control Center of Xiamen, No.668 Jinhu Road, Xiamen, 361006, Fujian, China.
- Department of Nephrology, Zhongshan Hospital, Fudan University; Kidney and Dialysis Institute of Shanghai; Kidney and Blood Purification Laboratory of Shanghai, No. 180 Fenglin Road, Shanghai, 200032, China.
| | - Jiarui Xu
- Department of Nephrology, Zhongshan Hospital, Fudan University; Kidney and Dialysis Institute of Shanghai; Kidney and Blood Purification Laboratory of Shanghai, No. 180 Fenglin Road, Shanghai, 200032, China.
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Dai J, Shen J, Zhang X, Peng W, Wen T, Li C. Safety of elective hepatectomy performed on weekend for patients with hepatocellular carcinoma. Chin Med J (Engl) 2022; 135:2596-2598. [PMID: 34534152 PMCID: PMC9945249 DOI: 10.1097/cm9.0000000000001722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Indexed: 02/05/2023] Open
Affiliation(s)
- Junlong Dai
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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Baig SH, Oxman DA, Yoo EJ. Weekend Admission Does Not Confer an Increased Risk of Mortality in Septic Shock. J Intensive Care Med 2021; 37:810-816. [PMID: 34459678 DOI: 10.1177/08850666211038549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To investigate the impact of weekend admission on mortality for patients with septic shock. Material and Methods: Retrospective cohort study of adults in the 2017 to 2018 National Inpatient Sample coded as R65.21 (severe sepsis with septic shock) within the first 3 diagnosis codes according to the 10th revision of the International Classification of Diseases. Measurements and Main Results: After exclusions, 100,584 records were analyzed (73,966 weekday and 26,618 weekend admissions). Severity-of-illness was estimated using the Charlson-Deyo comorbidity index. Using weighted logistic regression adjusted for factors identified on univariate analysis as potentially significant, we found no higher odds of death for weekday compared to weekend admissions (OR 1.00, 95% CI 0.99-1.02, P = .84). There was a temporal improvement in septic shock outcomes with 2018 admissions having lower odds of death (OR 0.97, 95% CI 0.96-0.98, P < .001). There was no evidence for interaction between weekend admission and individual years of admission (P = .17 and P = .05 for 2017 and 2018, respectively). However, weekend mortality did seem to vary by region in our interaction analysis with higher odds of death seen in the West (OR 1.08, 95% CI 1.05-1.11, P < .001). Conclusion: We found no evidence for higher mortality among patients admitted on weekends with septic shock.
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Affiliation(s)
- Saqib H Baig
- Division of Pulmonary, Allergy and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University and National Jewish Health, Sidney Kimmel Medical College, Philadelphia, PA, USA
| | - David A Oxman
- Division of Pulmonary, Allergy and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University and National Jewish Health, Sidney Kimmel Medical College, Philadelphia, PA, USA
| | - Erika J Yoo
- Division of Pulmonary, Allergy and Critical Care Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University and National Jewish Health, Sidney Kimmel Medical College, Philadelphia, PA, USA
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Association of Sepsis Diagnosis at Daytime and on Weekdays with Compliance with the 3-Hour Sepsis Treatment Bundles. A Multicenter Cohort Study. Ann Am Thorac Soc 2021; 17:980-987. [PMID: 32353248 DOI: 10.1513/annalsats.201910-781oc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Rationale: Compliance with sepsis bundles is associated with better outcomes, but information to support structural actions that might improve compliance is scarce. Few studies have evaluated bundle compliance in different time periods, with conflicting results.Objectives: To evaluate the association of sepsis identification during the daytime versus during the nighttime and on weekdays versus weekends with 3-hour sepsis treatment bundle compliance.Methods: This was an observational, multicenter study including patients with sepsis admitted between 2010 and 2017 to 10 hospitals in Brazil. Our exposures of interest were daytime (7:00 a.m.-6:59 p.m.) versus nighttime (7:00 p.m.-6:59 a.m.) and weekdays (Monday 7:00 a.m.-Friday 6:59 p.m.) versus weekends (Friday 7:00 p.m.-Monday 6:59 a.m.). Our primary outcome was full compliance with the 3-hour sepsis treatment bundles. We adjusted by potential confounding factors with multivariable logistic regression models.Results: Of 11,737 patients (8,733 sepsis and 3,004 septic shock), 3-hour bundle compliance was 79.1% and hospital mortality was 24.7%. The adjusted odds ratio (adjOR) for 3-hour full bundle compliance for patients diagnosed during the daytime versus during the nighttime was 1.35 (95% confidence interval [CI], 1.23-1.49; P < 0.001) and was more pronounced in the emergency department (adjOR, 1.55; 95% CI, 1.35-1.77; P < 0.001) than in nonemergency areas (adjOR, 1.19; 95% CI, 1.04-1.37; P = 0.014). Overall, there was no association between diagnosis on the weekends versus on weekdays and 3-hour full bundle compliance (adjOR, 1.08; 95% CI, 0.98-1.19; P = 0.115), although there was an association among those diagnosed in nonemergency areas (adjOR, 1.15; 95% CI, 1.00-1.32; P = 0.047). The lower compliance observed for sepsis diagnosed during the nighttime was more evident 2 years after implementation of the quality improvement initiative.Conclusions: Compliance with sepsis bundles was associated with the moment of sepsis diagnosis. The place of diagnosis and the time from campaign implementation were factors modifying this association. Our results support areas for better design of quality improvement initiatives to mitigate the influence of the period of sepsis diagnosis on treatment compliance.
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Volovici V, Dammers R, Meling TR. The "weekend effect" and outcomes after clipping of ruptured intracranial aneurysms-general healthcare metrics and trained vascular neurosurgeons. Acta Neurochir (Wien) 2021; 163:793-795. [PMID: 33389120 DOI: 10.1007/s00701-020-04690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Victor Volovici
- Department of Neurosurgery, Erasmus MC Stroke Center, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Ruben Dammers
- Department of Neurosurgery, Erasmus MC Stroke Center, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Torstein R Meling
- Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Wang L, Wu X. Caution should be taken when using electronic health record database. Crit Care 2019; 23:345. [PMID: 31690316 PMCID: PMC6829959 DOI: 10.1186/s13054-019-2612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/13/2019] [Indexed: 11/21/2022] Open
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Hatchimonji JS, Kaufman EJ, Sharoky CE, Ma LW, Holena DN. A 'weekend effect' in operative emergency general surgery. Am J Surg 2019; 220:237-239. [PMID: 31744597 DOI: 10.1016/j.amjsurg.2019.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/16/2019] [Accepted: 11/04/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Evidence of a "weekend effect" is limited in emergency general surgery (EGS). We hypothesized that there are increased rates of complications, death, and failure-to-rescue (FTR) in patients undergoing weekend EGS operations. METHODS National Inpatient Sample (NIS) data, January 2014-September 2015 were used. Operative EGS patients were identified by ICD-9 procedure code and timing to operation. Complications were defined by ICD-9 code. We performed survey-weighted multivariable regression analyses. RESULTS Of 438,110 EGS patients, 103,450 underwent weekend operation. There was no association between weekend operation and FTR (OR 1.17; 95%CI 0.95-1.45) or complications (OR 1.04; 95%CI 0.97-1.13). There was a weekend effect on mortality (OR 1.22; 95%CI 1.02-1.46) and an interactive effect between weekend operation and teaching status on complications (teaching OR 1.22; 95%CI 1.15-1.29; interaction OR 1.13; 95%CI 1.03-1.25). CONCLUSIONS There is evidence for a "weekend effect" on mortality, but not complications or FTR, in this cohort.
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Affiliation(s)
- Justin S Hatchimonji
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Elinore J Kaufman
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Catherine E Sharoky
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lucy W Ma
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel N Holena
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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