Browsing by Author "El Khoury, Marc"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Hypothermia is Associated With Poor Prognosis in Hospitalized Patients With Severe COVID-19 Symptoms
    (2021) Maait, Yousef; El Khoury, Marc; McKinley, Lee; El Khoury, Anthony; Graduate Medical Education, Office of Educational Affairs, IU School of Medicine
    Rationale Hypothermia forms a part of the diagnostic criteria for Systemic Inflammatory Response Syndrome (SIRS), National Early Warning Score (NEWS) and has repeatedly been shown to be associated with worse outcomes when compared to normothermic and hyperthermic patients with sepsis. We evaluate whether this is the case in COVID-19 patients. Objective To determine whether there is an association between hypothermia and worse prognosis in COVID-19 patients in the intensive care unit. Methods Retrospective study of a cohort of patients (n = 57) admitted to the intensive care unit of a community hospital with a positive test for COVID-19. Measurements Data relating to mortality, comorbidities and length of stay was recorded from electronic medical records for each patient. Hypothermia was defined as ≥2 recorded body temperatures of less than 96.5℉ (35.83℃) at the time of admission. Main results Of the 57 patients enrolled in the study, 21 developed hypothermia during their stay and 36 did not. Our results show that patients who have hypothermia at the time of admission spend a longer time intubated (p < 0.01) and go through longer ICU stays (p < 0.01). These patients are also 2.18 times more likely to suffer a fatal outcome compared to patients that did not develop hypothermia while in the intensive care unit (Chi-squared = 8.6209, p < 0.01, RR = 2.18). Conclusions Hypothermia in patients with severe COVID-19 at the time of admission to the ICU is associated with poorer outcomes for patients. This manifests as a longer period of intubation, longer ICU stay, and increased risk of mortality.
  • Thumbnail Image
    Item
    Tremor as a symptom of degenerative cervical myelopathy: a systematic review
    (Taylor & Francis, 2022) El Khoury, Marc; Mowforth, Oliver D.; El Khoury, Anthony; Partha-Sarathi, Celine; Hirayama, Yuri; Davies, Benjamin M.; Kotter, Mark R.; Medicine, School of Medicine
    Background: AO Spine RECODE-DCM (Research objectives and common data elements for degenerative cervical myelopathy) has highlighted that the subjective disability reported by people living with DCM is much broader than routinely considered today by most professionals. This includes a description of tremor. The objective of this review was to study the incidence and possible aetiology of tremor in degenerative cervical myelopathy (DCM). Methods: A systematic review registered in PROSPERO (CRD42020176905) was conducted in Embase and MEDLINE for papers studying tremor and DCM published on or before the 20th of July 2020. All manuscripts describing an association between tremor and DCM in humans were included. Articles relating to non-human animals, and those not available in English were excluded. An analysis was conducted in accordance with PRISMA and SWiM guidelines for systematic reviews. Results: Out of a total of 4402 screened abstracts, we identified 7 case reports and series describing tremor in 9 DCM patients. Papers were divided into three groups for the discussion. The first group includes DCM correctly identified on presentation, with tremor as a described symptom. The second group includes cases where DCM was misdiagnosed, often as Parkinson's disease. The third group includes a single case with a previous history of DCM, presenting with an otherwise unexplained tremor. This grouping allows for the clustering of cases supporting various arguments for the association between tremor and DCM. Conclusion: DCM can be associated with tremor. The current evidence is restricted to case series. Further study is warranted to establish tremor prevalence, and its significance to assessment and management.