Pub Date : 2025-02-27DOI: 10.1016/s0140-6736(25)00039-x
Daniel J Baker, Bruce L Levine, Carl H June
Section snippets
Contributors
DJB led the conceptualisation and writing of the original draft. All authors provided comments and edits of subsequent drafts. All authors approved the final manuscript and had final responsibility for the decision to submit for publication.
Declaration of interests
BLL is an inventor on patents or has patent applications licensed to Novartis Institutes of Biomedical Research and Kite Pharma and receives licence revenue from such licences; is a scientific founder of Tmunity Therapeutics and Capstan Therapeutics; and is a member of the scientific advisory boards of Avectas, Capstan Therapeutics, Cellula Therapeutics, Immuneel Therapeutics, Immusoft, In8bio, Kite Gilead, Ori Biotech, Oxford Biomedica, ThermoFisher Pharma Services, and UTC Therapeutics. CHJ
Acknowledgments
This work was supported by the Centurion Foundation Innovation Fund (1P01CA214278, R01CA226983) and the Parker Institute for Cancer Immunotherapy. The funders had no role in the writing of the manuscript or the decision to submit for publication.
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Pub Date : 2025-02-27DOI: 10.1016/s0140-6736(25)00399-x
Talha Burki
No Abstract
无摘要
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Pub Date : 2025-02-27DOI: 10.1016/s0140-6736(24)02843-5
Nazir I Lone, John A Masterson, Swagata Tripathy
No Abstract
{"title":"Understanding the scale of critical illness in Africa and the need for universal access to emergency and critical care","authors":"Nazir I Lone, John A Masterson, Swagata Tripathy","doi":"10.1016/s0140-6736(24)02843-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02843-5","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"85 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/s0140-6736(25)00245-4
Marcos A Espinal, Mariela Licha Salomon, Mirta Roses Periago
No Abstract
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{"title":"PAHO is Latin America's Centre for Disease Control and Prevention – Authors' reply","authors":"Patricia J García, Jorge Saavedra, Ximena Garzon, Adolfo Rubinstein, Javier Guzman","doi":"10.1016/s0140-6736(25)00246-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00246-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/s0140-6736(24)02846-0
Background
Critical illness represents a major global health-care burden and critical care is an essential component of hospital care. There are few data describing the prevalence, treatment, and outcomes of critically ill patients in African hospitals.
Methods
This was an international, prospective, point prevalence study in acute hospitals across Africa. Investigators examined all inpatients aged 18 years or older, regardless of location, to assess the coprimary outcomes of critical illness and 7-day mortality. Patients were classified as critically ill if at least one vital sign was severely deranged. Data were collected for the available resources at each hospital and care provided to patients.
Findings
We included 19 872 patients from 180 hospitals in 22 African countries or territories between September, 2023 and December, 2023. The median age was 40 (IQR 29–59) years, and 11 078/19 862 (55·8%) patients were women. There were 967/19 780 (4·9%) deaths. On census day, 2461/19 743 (12·5%) patients were critically ill, with 1688/2459 (68·6%) cared for in general wards. Among the critically ill, 507/2450 (20·7%) patients died in hospital. Mortality for non-critically ill patients was 458/17 205 (2·7%). Critical illness on census day was independently associated with subsequent in-hospital mortality (adjusted odds ratio 7·72 [6·65–8·95]). Of the critically ill patients with respiratory failure, 557/1151 (48·4%) were receiving oxygen; of the patients with circulatory failure, 521/965 (54·0%) were receiving intravenous fluids or vasopressors; and of patients with low conscious level, 387/784 (49·4%) were receiving an airway intervention or placed in the recovery position.
Interpretation
One in eight patients in hospitals in Africa are critically ill, of whom one in five dies within 7 days. Most critically ill patients are cared for in general wards, and most do not receive the essential emergency and critical care treatments they require. Our findings suggest a high burden of critical illness in Africa and that improving the care of critically ill patients would have the potential to save many lives.
Funding
National Institute for Health and Care Research (NIHR) Global Health Group in Perioperative and Critical Care (NIHR133850).
{"title":"The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa","authors":"","doi":"10.1016/s0140-6736(24)02846-0","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02846-0","url":null,"abstract":"<h3>Background</h3>Critical illness represents a major global health-care burden and critical care is an essential component of hospital care. There are few data describing the prevalence, treatment, and outcomes of critically ill patients in African hospitals.<h3>Methods</h3>This was an international, prospective, point prevalence study in acute hospitals across Africa. Investigators examined all inpatients aged 18 years or older, regardless of location, to assess the coprimary outcomes of critical illness and 7-day mortality. Patients were classified as critically ill if at least one vital sign was severely deranged. Data were collected for the available resources at each hospital and care provided to patients.<h3>Findings</h3>We included 19 872 patients from 180 hospitals in 22 African countries or territories between September, 2023 and December, 2023. The median age was 40 (IQR 29–59) years, and 11 078/19 862 (55·8%) patients were women. There were 967/19 780 (4·9%) deaths. On census day, 2461/19 743 (12·5%) patients were critically ill, with 1688/2459 (68·6%) cared for in general wards. Among the critically ill, 507/2450 (20·7%) patients died in hospital. Mortality for non-critically ill patients was 458/17 205 (2·7%). Critical illness on census day was independently associated with subsequent in-hospital mortality (adjusted odds ratio 7·72 [6·65–8·95]). Of the critically ill patients with respiratory failure, 557/1151 (48·4%) were receiving oxygen; of the patients with circulatory failure, 521/965 (54·0%) were receiving intravenous fluids or vasopressors; and of patients with low conscious level, 387/784 (49·4%) were receiving an airway intervention or placed in the recovery position.<h3>Interpretation</h3>One in eight patients in hospitals in Africa are critically ill, of whom one in five dies within 7 days. Most critically ill patients are cared for in general wards, and most do not receive the essential emergency and critical care treatments they require. Our findings suggest a high burden of critical illness in Africa and that improving the care of critically ill patients would have the potential to save many lives.<h3>Funding</h3>National Institute for Health and Care Research (NIHR) Global Health Group in Perioperative and Critical Care (NIHR133850).","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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