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JOURNAL ARTICLE
Norawit Kijpaisalratana, Jutamas Saoraya, Padcha Nhuboonkaew, Komsanti Vongkulbhisan, Khrongwong Musikatavorn
Machine learning (ML) has been applied in sepsis recognition across different healthcare settings with outstanding diagnostic accuracy. However, the advantage of ML-assisted sepsis alert in expediting clinical decisions leading to enhanced quality for emergency department (ED) patients remains unclear. A cluster-randomized trial was conducted in a tertiary-care hospital. Adult patient data were subjected to an ML model for sepsis alert. Patient visits were assigned into one of two groups. In the intervention cluster, staff received alerts on a display screen if patients met the ML threshold for sepsis diagnosis, while patients in the control cluster followed the regular alert process...
February 21, 2024: Internal and Emergency Medicine
#22
REVIEW
Wei Ling Chua, Khairul Dzakirin Bin Rusli, Leanne M Aitken
AIM: The early warning scores (EWS), quick Sequential Organ Failure Assessment (qSOFA) and systemic inflammatory response syndrome (SIRS) criteria have been proposed as sepsis screening tools. This review aims to summarise and compare the performance of EWS with the qSOFA and SIRS criteria for predicting sepsis diagnosis and in-hospital mortality in patients with sepsis. DESIGN: A systematic review with meta-analysis. REVIEW METHODS: Seven databases were searched from January 1, 2016 until March 10, 2022...
February 20, 2024: Journal of Clinical Nursing
#23
JOURNAL ARTICLE
Silke Piedmont, Ludwig Goldhahn, Enno Swart, Bernt-Peter Robra, Carolin Fleischmann-Struzek, Rajan Somasundaram, Wolfgang Bauer
PURPOSE: Sepsis suspicion by Emergency Medical Services (EMS) is associated with improved patient outcomes. This study assessed sepsis incidence and recognition by EMS and analyzed which of the screening tools recommended by the Surviving Sepsis Campaign best facilitates sepsis prediction. METHODS: Retrospective cohort study of claims data from health insurances (n = 221,429 EMS cases), and paramedics' and emergency physicians' EMS documentation (n = 110,419); analyzed outcomes were: sepsis incidence and case fatality compared to stroke and myocardial infarction, the extent of documentation for screening-relevant variables and sepsis suspicion, tools' intersections for screening positive in identical EMS cases and their predictive ability for an inpatient sepsis diagnosis...
February 19, 2024: Infection
#24
JOURNAL ARTICLE
Delphine Douillet, Jérémie Riou, François Morin, Rafaël Mahieu, Anthony Chauvin, Stéphane Gennai, Lionel Ferrant, Raphaëlle Lopez, Mustapha Sebbane, Gaëtan Plantefeve, Christian Brice, Coralie Cayeux, Dominique Savary, Thomas Moumneh, Andrea Penaloza, Pierre Marie Roy
BACKGROUND: The HOME-CoV (Hospitalisation or Outpatient ManagEment of patients with SARS-CoV-2 infection) score is a validated list of uniquely clinical criteria indicating which patients with probable or proven COVID-19 can be treated at home. The aim of this study was to optimise the score to improve its ability to discriminate between patients who do and do not need admission. METHODS: A revised HOME-CoV score was derived using data from a previous prospective multicentre study which evaluated the original Home-CoV score...
February 16, 2024: Emergency Medicine Journal: EMJ
#25
RANDOMIZED CONTROLLED TRIAL
Maria Evangelia Adami, Antigone Kotsaki, Nikolaos Antonakos, Efthymia Giannitsioti, Stamatios Chalvatzis, Maria Saridaki, Christina Avgoustou, Karolina Akinosoglou, Konstantina Dakou, Georgia Damoraki, Konstantina Katrini, Panagiotis Koufargyris, Vasileios Lekakis, Antonia Panagaki, Asimina Safarika, Jesper Eugen-Olsen, Evangelos J Giamarellos-Bourboulis
BACKGROUND: Sepsis guidelines suggest immediate start of resuscitation for patients with quick Sequential Organ Failure Assessment (qSOFA) 2 or 3. However, the interpretation of qSOFA 1 remains controversial. We investigated whether measurements of soluble urokinase plasminogen activator receptor (suPAR) may improve risk detection when qSOFA is 1. METHODS: The study had two parts. At the first part, the combination of suPAR with qSOFA was analyzed in a prospective cohort for early risk detection...
February 6, 2024: Critical Care: the Official Journal of the Critical Care Forum
#26
JOURNAL ARTICLE
Carlota Clemente, Manuel Enrique Fuentes Ferrer, Dolores Ortega Heredia, Agustín Julián Jiménez, Francisco Javier Martín-Sánchez, Juan González Del Castillo
OBJECTIVES: To determine whether combining biomarkers of inflammatory response and clinical scales can improve risk stratification of patients with suspected infection in a hospital emergency department (ED). MATERIAL AND METHODS: Prospective observational study of ED patients treated for infections. We collected the following information on arrival: demographic and baseline clinical data, comorbidities, the focus of infection, and values for the following inflammatory biomarkers: leukocyte counts, and C-reactive protein, procalcitonin, and midregional proadrenomedullin (MR-proADM) concentrations...
January 2024: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
#27
JOURNAL ARTICLE
Koji Takao, Katsushi Takebayashi, Sachiko Kaida, Reiko Otake, Takashi Matsunaga, Toru Miyake, Masatsugu Kojima, Soichiro Tani, Hiromitsu Maehira, Haruki Mori, Yumi Zen, Yusuke Nishina, Yuichi Takenaka, Hajime Ishikawa, Masaji Tani
The patient was a 60s male. He underwent esophagectomy and gastric tube reconstruction for Barrett's esophageal cancer( pT3N1M0, pStage Ⅲ). Postoperatively, anastomotic leakage and mediastinitis resulted in septic shock. On the 8th day after first surgery, he transferred to our hospital. At the time of admission, qSOFA was 3 points. We judged to be difficult to treat with conservative treatment. Emergency right thoracotomy drainage underwent with resection of the esophagogastric anastomosis and cervical esophagostomy construction...
December 2023: Gan to Kagaku Ryoho. Cancer & Chemotherapy
#28
JOURNAL ARTICLE
Eric Jorge García-Lamberechts, Manuel Fuentes Ferrer, Cesáreo Fernández-Alonso, Guillermo Burillo-Putze, Sira Aguiló, Aitor Alquezar-Arbé, Francisco Javier Montero-Pérez, Javier Jacob, Pascual Piñera Salmerón, Manuel Salido Mota, Maria José Marchena, Alba Martínez Alonso, Ana Chacón García, Cristina Güemes de la Iglesia, Osvaldo Jorge Troiano Ungerer, Patricia Eiroa-Hernández, Patricia Parra-Esquivel, Paula Lázaro Aragüés, Patricia Gantes Nieto, Sandra Cuerpo Cardeñosa, Cristina Chacón García, Leticia Serrano Lázaro, María Caballero Martínez, Lara Guillen, Rocío Muñoz Martos, Juan González Del Castillo, Òscar Miró
OBJECTIVE: To analyze the prognostic accuracy of the scores NEWS, qSOFA, GYM used in hospital emergency department (ED) in the assessment of elderly patients who consult for an infectious disease. METHODS: Data from the EDEN (Emergency Department and Elderly Need) cohort were used. This retrospective cohort included all patients aged ≥65 years seen in 52 Spanish EDs during two weeks (from 1-4-2019 to 7-4-2019 and 30/3/2020 to 5/4/2020) with an infectious disease diagnosis in the emergency department...
January 30, 2024: Enfermedades infecciosas y microbiologia clinica
#29
JOURNAL ARTICLE
Dong-Young Lee, Seung Ryu, So-Young Jeon, Jung-Soo Park, Yeon-Ho You, Won-Joon Jeong, Yong-Chul Cho, Hong-Joon Ahn, Chang-Shin Kang, Se-Kwang Oh
OBJECT: Effective triage of febrile patients in the emergency department is crucial during times of overcrowding to prioritize care and allocate resources, especially during pandemics. However, available triage tools often require laboratory data and lack accuracy. We aimed to develop a simple and accurate triage tool for febrile patients by modifying the qSOFA score. METHODS: We retrospectively analyzed data from 7,303 febrile patients and created modified versions of qSOFA using factors identified through multivariable analysis...
January 29, 2024: Clinical and Experimental Emergency Medicine
#30
JOURNAL ARTICLE
Li Wang, Xin Cai, Shi Peng, Dongling Tang, Pingan Zhang
BACKGROUND: Sepsis is a common disease in the intensive care unit (ICU). In recent years, the incidence rate and mortality rate remain high. Early diagnosis of sepsis is crucial for treatment and can effectively reduce mortality. So far, the ability of serum peptidylarginine deaminase 2 (PAD2) in the diagnosis and prognosis of sepsis patients is still unclear. We conducted this study to reveal the clinical value of PAD2 as a biomarker for sepsis patients. METHODS: A prospective study method was used to select 207 patients in the ICU of Renmin Hospital of Wuhan University from May 2022 to May 2023...
January 26, 2024: Clinica Chimica Acta; International Journal of Clinical Chemistry
#31
JOURNAL ARTICLE
Anandhi Deva, Ronit Juthani, Ezhil Kugan, N Balamurugan, Manu Ayyan
BACKGROUND: Serum and radiological parameters used to predict prognosis in COVID patients are not feasible in the Emergency Department. Due to its damaging effect on multiple organs and lungs, scores used to assess multiorgan damage and pneumonia such as Pandemic Medical Early Warning Score (PMEWS), National Early Warning Score 2 (NEWS2), WHO score, quick Sequential Organ Failure Assessment (qSOFA), and DS-CRB 65 can be used to triage patients in the Emergency Department. They can be used to predict patients with the highest risk of seven-day mortality and need for intensive respiratory or vasopressor support (IRVS)...
January 23, 2024: American Journal of Emergency Medicine
#32
JOURNAL ARTICLE
Mercy Kumwenda, Roxanne Assies, Ilse Snik, Gloria Chatima, Josephine Langton, Yamikani Chimalizeni, Sam T Romaine, Job B M van Woensel, Philip Pallmann, Enitan D Carrol, Job C J Calis
In low-resource settings, a reliable bedside score for timely identification of children at risk of dying, could help focus resources and improve survival. The rapid bedside Liverpool quick Sequential Organ Failure Assessment (LqSOFA) uses clinical parameters only and performed well in United Kingdom cohorts. A similarly quick clinical assessment-only score has however not yet been developed for paediatric populations in sub-Saharan Africa. In a development cohort of critically ill children in Malawi, we calculated the LqSOFA scores using age-adjusted heart rate and respiratory rate, capillary refill time and Blantyre Coma Scale, and evaluated its prognostic performance for mortality...
2024: PLOS Glob Public Health
#33
JOURNAL ARTICLE
Joachim Doua, Jesús Rodríguez-Baño, Rachel Froget, Padma Puranam, Oscar Go, Jeroen Geurtsen, Sanne van Rooij, Tuba Vilken, Inage Minoru, Izumi Yasumori, Bart Spiessens, Evelina Tacconelli, Lena M Biehl, Joshua T Thaden, Michal Sarnecki, Herman Goossens, Jan Poolman, Marc Bonten, Miquel Ekkelenkamp
BACKGROUND: Clinical data characterizing invasive Escherichia coli disease (IED) are limited. We assessed the clinical presentation of IED and antimicrobial resistance (AMR) patterns of causative E. coli isolates in older adults. METHODS: EXPECT-2 (NCT04117113) was a prospective, observational, multinational, hospital-based study conducted in patients with IED aged ≥ 60 years. IED was determined by the microbiological confirmation of E...
January 25, 2024: Infection
#34
JOURNAL ARTICLE
Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study.
Hakan Erdem, Jaffar A Al-Tawfiq, Maha Abid, Wissal Ben Yahia, George Akafity, Manar Ezzelarab Ramadan, Fatma Amer, Amani El-Kholy, Atousa Hakamifard, Bilal Ahmad Rahimi, Farouq Dayyab, Hulya Caskurlu, Reham Khedr, Muhammad Tahir, Lysien Zambrano, Mumtaz Ali Khan, Aun Raza, Nagwa Mostafa El-Sayed, Magdalena Baymakova, Aysun Yalci, Yasemin Cag, Umran Elbahr, Aamer Ikram
BACKGROUND: Fever of unknown origin (FUO) in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO. METHODS: A multi-center study for infectious causes of FUO in lower middle-income countries (LMIC) and low-income countries (LIC) was conducted between January 1, 2018 and January 1, 2023. In total, 15 participating centers from seven different countries provided the data, which were collected through the Infectious Diseases-International Research Initiative platform...
January 2024: J Intensive Med
#35
JOURNAL ARTICLE
Andrew Li, Lowell Ling, Hanyu Qin, Yaseen M Arabi, Sheila Nainan Myatra, Moritoki Egi, Je Hyeong Kim, Mohd Basri Mat Nor, Do Ngoc Son, Wen-Feng Fang, Bambang Wahyuprajitno, Madiha Hashmi, Mohammad Omar Faruq, Boonsong Patjanasoontorn, Maher Jaffer Al Bahrani, Babu Raja Shrestha, Ujma Shrestha, Khalid Mahmood Khan Nafees, Kyi Kyi Sann, Jose Emmanuel M Palo, Naranpurev Mendsaikhan, Aidos Konkayev, Khamsay Detleuxay, Yiong Huak Chan, Bin Du, Jigeeshu Vasishtha Divatia, Younsuck Koh, Jason Phua
BACKGROUND: There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions...
January 23, 2024: Critical Care: the Official Journal of the Critical Care Forum
#36
JOURNAL ARTICLE
Bianca Leal de Almeida, Tania Mara Varejao Strabelli, Marcio Sommer Bittencourt, Vítor Falcão de Oliveira, Danielle Menosi Gualandro, Alfredo Jose Mansur, Flavio Tarasouchi, Lucas Pocebon, Milena Paixão, Flora Goldemberg, Reinaldo Salomão, Rinaldo Focaccia Siciliano
BACKGROUND: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores to predict mortality in patients with infective endocarditis. METHODS: Between January 2010 and June 2019, 867 patients with suspected left-sided endocarditis were evaluated; 517 were included with left-sided infective endocarditis defined as "possible" or "definite" endocarditis, according to the Modified Duke Criteria...
January 16, 2024: Tropical Medicine and Infectious Disease
#37
JOURNAL ARTICLE
Suma D Borra, Dnyanesh N Morkar
INTRODUCTION: Sepsis is a complicated host response to infection involving organ failure which ultimately causes death of the host. Procalcitonin (PCT) is an effective marker used to diagnose sepsis but until now, there has been no ideal marker for sepsis. Phospholipase A2 (PLA2) also increases infections; however, only a few studies have assessed its capacity as a biomarker to diagnose sepsis. Thus, we aimed to examine PLA2 and compare its diagnostic capacity and accuracy with PCT as a biomarker of sepsis...
December 2023: Curēus
#38
JOURNAL ARTICLE
Cheng-Yang Wen, Sung-Yuan Hu, Ming-Shun Hsieh, Shih-Che Huang, Chia-Hui Shen, Yi-Chun Tsai
BACKGROUND: Aeromonas species, Gram-negative, non-sporulating, facultative, and anaerobic bacilli, widely distributed in aquatic environments, derive various infections, including bacteremia. Most of these infections were opportunistic and found in patients with predisposing conditions. Among the infections, bacteremia remains with notable mortality, reported from 15% to 45%. However, predicting systems for assessing the mortality risk of this disease have yet to be investigated. We aimed to validate the performance of specific predictive scoring systems to assess the clinical outcomes of Aeromonas bacteremia and applied the revised systems to predict mortality risk...
January 5, 2024: Diagnostics
#39
JOURNAL ARTICLE
Abdullah M Algarni, Musa S Alfaifi, Ali A Al Bshabshe, Othman M Omair, Mohammed A Alsultan, Hasan M Alzahrani, Hadi E Alali, Abdullah A Alsabaani, Ali M Alqarni, Salah A Alghanem, Bandar S Al Mufareh, Ayesha M Almemari, Abdulrahman A Sindi, Ibrahim U Ozturan, Abdullah A Alhadhira, Asaad S Shujaa, Abdullah H Alotaibi, Moosa M Awladthani, Ahmed A Alsaad, Abdullah A Almarshed, AlHanouv M AlQahtani, Tim R Harris, Bader A Alyahya, Saad A Assiri, Feras H Abuzeyad, Sara N Kazim, Abdulrahman A Al-Fares, Faisal Y Almazroua, Naif T Marzook, Abdullah A Basri, Abdallah M Elsafti, Abdulaziz S Alalshaikh, Cansu A Özturan, Yousef I Alawad, Awad AlOmari, Malek A Alkhateeb, Moonis M Farooq, Latifa Ali AlMutairi, Muneera M Alasfour, Mohammad I Al Haber, Umma-Kulthum A Umar, Nidal H Bokhary, Saeed F Alqahtani, Abdulrhman Almutairi, Hisham F Alyahya, Wejdan S Alzahrani, Fawziah Alsalmi, Abdulmajeed M Omair, Faysal M Alasmari, Sultan Y Alfifi, Mohammed S Al-Nujimi, Farid Foroutan
BACKGROUND: Early identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ dysfunction. Screening tools using these parameters can help identify the condition, such as SIRS, quick SOFA (qSOFA), National Early Warning Score (NEWS), or Modified Early Warning Score (MEWS)...
2024: PloS One
#40
JOURNAL ARTICLE
Carolin Fleischmann-Struzek, Norman Rose, Bianka Ditscheid, Lea Draeger, Patrik Dröge, Antje Freytag, Ludwig Goldhahn, Lena Kannengießer, Aurelia Kimmig, Claudia Matthäus-Krämer, Thomas Ruhnke, Konrad Reinhart, Peter Schlattmann, Konrad Schmidt, Josephine Storch, Ruben Ulbrich, Susanne Ullmann, Lisa Wedekind, Enno Swart
BACKGROUND: Sepsis is associated with about 20% of deaths worldwide. It often presents with non-specific initial symptoms, making its emergency treatment an interdisciplinary and cross-sectoral challenge. Three in four sepsis survivors suffers from new cognitive, psychological, or physical sequelae for which specific treatment concepts are scarce. The AVENIR project aims to improve the understanding of patient pathways, and subjective care experiences and needs along the entire healthcare pathway before, with and after sepsis...
January 8, 2024: BMC Health Services Research
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