Evidence map›Paper›PMID 35411491›Full record

ArticleIntensive care medicine2022

Diarrhea during critical illness: a multicenter cohort study.

Joanna C Dionne, Lawrence Mbuagbaw, John W Devlin, Matthew S Duprey, Rodrigo Cartin-Ceba, Jennifer Tsang, Kristen Sullivan, John Muscedere, Mohammed Alshahrani, Wojciech Szczeklik and 16 more

Open access · greenAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 32 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 14 institutions in 4 countries.

Joanna C DionneDepartment of Medicine, McMaster University, Hamilton, ON, Canada. dionnejc@mcmaster.ca.ORCID 0000-0002-9401-6868
Lawrence MbuagbawDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
John W DevlinSchool of Pharmacy, Northeastern University, Boston, MA, USA.
Matthew S DupreySchool of Public Health, Brown University, Providence, RI, USA.
Rodrigo Cartin-CebaDepartment of Critical Care, Mayo Clinic, Phoenix, AZ, USA.
Jennifer TsangDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Kristen SullivanDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
John MuscedereDepartment of Critical Care Medicine, Queen's University, Kingston, ON, Canada.
Mohammed AlshahraniEmergency and Critical Care Department, King Fahad Hospital of the University Imam Abdul Rahman ben Faisal university Dammam, Dammam, Saudi Arabia.
Wojciech SzczeklikJagiellonian University Medical College, Kraków, Poland.
Paul LyseckiJoseph Brant Hospital, Burlington, ON, Canada.
Alyson TakaokaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Brenda ReeveBrantford General Hospital, Brantford, ON, Canada.
Tracy CampbellJoseph Brant Hospital, Burlington, ON, Canada.
Karolina BorowskaJagiellonian University Medical College, Kraków, Poland.
Wojciech SerednickiJagiellonian University Medical College, Kraków, Poland.
Robert CironeSt. Joseph's Health Centre, Toronto, ON, Canada.
Waleed AlhazzaniDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Paul MoayyediDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
David ArmstrongDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Roman JaeschkeDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Cindy HamielecDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Tim KarachiDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Deborah J CookDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
DICE Investigators
Impact · CAJagiellonian University · PLMcMaster University · CAJoseph Brant Hospital · CANiagara Health System · CANortheastern University · USQueen's University · CASt Joseph's Health Centre · CABrown University · USKing Fahd Hospital of the University · SAPopulation Health Research Institute · CAJuravinski Cancer Centre · CAJuravinski Hospital · CAMayo Clinic Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo study the incidence, predictors, and outcomes of diarrhea during the stay in the intensive care unit (ICU).

methodsProspective cohort of consecutive adults in the ICU for > 24 h during a 10-week period across 12 intensive care units (ICUs) internationally. The explored outcomes were: (1) incidence of diarrhea, (2) Clostridioides difficile-associated diarrhea (CDAD); (3) ICU and hospital length of stay (LOS) and mortality in patients with diarrhea. We fit generalized linear models to evaluate the predictors, management, morbidity and mortality associated with diarrhea.

resultsAmong 1109 patients aged 61.4 (17.5) [mean (standard deviation)] years, 981(88.5%) were medical and 645 (58.2%) were mechanically ventilated. The incidence was 73.8% (818 patients, 73.8%, 95% confidence interval [CI] 71.1-76.6) using the definition of the World Health Organisation (WHO). Incidence varied across definitions (Bristol 53.5%, 95% CI 50.4-56.7; Bliss 37.7%, 95% CI 34.9-40.4). Of 99 patients with diarrhea undergoing CDAD testing, 23 tested positive (2.2% incidence, 95% CI 1.5-3.4). Independent predictors included enteral nutrition (RR 1.23, 95% CI 1.16-1.31, p < 0.001), antibiotic days (RR 1.02, 95% CI 1.02-1.03, p < 0.001), and suppositories (RR 1.14 95% CI 1.06-1.22, p < 0.001). Opiates decreased diarrhea risk (RR 0.76, 95% CI 0.68-0.86, p < 0.001). Diarrhea prompted management modifications (altered enteral nutrition or medications: RR 10.25, 95% CI 5.14-20.45, p < 0.001) or other consequences (fecal management device or CDAD testing: RR 6.16, 95% CI 3.4-11.17, p < 0.001). Diarrhea was associated with a longer time to discharge for ICU or hospital stay, but was not associated with hospital mortality.

conclusionDiarrhea is common, has several predictors, and prompts changes in patient care, is associated with longer time to discharge but not mortality.

Indexed as

Critical IllnessIntensive Care UnitsAdultDiarrheaEnteral NutritionHumansLength of StayProspective StudiesCritical illnessDiarrheaEnteral nutritionIncidencePredictors

Identifiers

PMID35411491
OpenAlexW4223418322

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.