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https://www.readbyqxmd.com/read/29122648/early-deterioration-indicator-data-driven-approach-to-detecting-deterioration-in-general-ward
#1
Erina Ghosh, Larry Eshelman, Lin Yang, Eric Carlson, Bill Lord
INTRODUCTION: Early detection of deterioration could facilitate more timely interventions which are instrumental in reducing transfer to higher levels of care such as Intensive Care Unit (ICU) and mortality.(1,2) METHODS AND RESULTS: We developed the Early Deterioration Indicator (EDI) which uses log likelihood risk of vital signs to calculate continuous risk scores. EDI was developed using data from 11864 general ward admissions. To validate EDI, we calculated EDI scores on an additional 2418 general ward stays and compared it to the Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS)...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29115965/operationalization-of-diagnostic-criteria-of-dsm-5-somatic-symptom-disorders
#2
Nana Xiong, Yaoyin Zhang, Jing Wei, Rainer Leonhart, Kurt Fritzsche, Ricarda Mewes, Xia Hong, Jinya Cao, Tao Li, Jing Jiang, Xudong Zhao, Lan Zhang, Rainer Schaefert
BACKGROUND: The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. METHODS: This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus...
November 7, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29091954/comparison-of-the-mortality-in-emergency-department-sepsis-score-modified-early-warning-score-rapid-emergency-medicine-score-and-rapid-acute-physiology-score-for-predicting-the-outcomes-of-adult-splenic-abscess-patients-in-the-emergency-department
#3
Shang-Kai Hung, Chip-Jin Ng, Chang-Fu Kuo, Zhong Ning Leonard Goh, Lu-Hsiang Huang, Chih-Huang Li, Yi-Ling Chan, Yi-Ming Weng, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chen-June Seak
BACKGROUND: Splenic abscess is rare but has mortality rates as high as 14% even with recent improvements in management. Early and appropriate intervention may improve patient outcomes, yet at present there is no identified method that can predict mortality risk rapidly and accurately for emergency physicians, surgeons, and intensivists to decide on the ideal course of action. OBJECTIVE: This study aims to evaluate the performance of Mortality in Emergency Department Sepsis Score (MEDS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS) and Rapid Acute Physiology Score (RAPS) for predicting the mortality risk of adult splenic abscess patients...
2017: PloS One
https://www.readbyqxmd.com/read/29082001/derivation-and-validation-of-a-universal-vital-assessment-uva-score-a-tool-for-predicting-mortality-in-adult-hospitalised-patients-in-sub-saharan-africa
#4
Christopher C Moore, Riley Hazard, Kacie J Saulters, John Ainsworth, Susan A Adakun, Abdallah Amir, Ben Andrews, Mary Auma, Tim Baker, Patrick Banura, John A Crump, Martin P Grobusch, Michaëla A M Huson, Shevin T Jacob, Olamide D Jarrett, John Kellett, Shabir Lakhi, Albert Majwala, Martin Opio, Matthew P Rubach, Jamie Rylance, W Michael Scheld, John Schieffelin, Richard Ssekitoleko, India Wheeler, Laura E Barnes
BACKGROUND: Critical illness is a leading cause of morbidity and mortality in sub-Saharan Africa (SSA). Identifying patients with the highest risk of death could help with resource allocation and clinical decision making. Accordingly, we derived and validated a universal vital assessment (UVA) score for use in SSA. METHODS: We pooled data from hospital-based cohort studies conducted in six countries in SSA spanning the years 2009-2015. We derived and internally validated a UVA score using decision trees and linear regression and compared its performance with the modified early warning score (MEWS) and the quick sepsis-related organ failure assessment (qSOFA) score...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29056391/prehospital-triage-of-septic-patients-at-the-samu-regulation-comparison-of-qsofa-mrst-mews-and-presep-scores
#5
R Jouffroy, A Saade, S Ellouze, A Carpentier, M Michaloux, P Carli, B Vivien
PURPOSE: A couple of scoring systems have been developed for risk stratification of septic patients. Their performance in the management of out-of-hospital initial care delivery is not documented. This study try to evaluate the predictive ability of Quick Sequential Organ Failure Assessment (qSOFA), Robson Screening Tool (RST), Modified Early Warning Score (MEWS) and Prehospital Early Sepsis Detection (PRESEP) scores on out of-hospital triage of septic patients, to predict intensive care unit (ICU) admission...
October 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033602/early-in-hospital-clinical-deterioration-is-not-predicted-by-severity-of-illness-functional-status-or-comorbidity
#6
Janice Wang, Stella S Hahn, Myriam Kline, Rubin I Cohen
BACKGROUND: Prior studies concentrated on unplanned intensive care unit (ICU) transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT) activation within 48 hours of admission as an index of early clinical worsening. METHODS: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28993097/prognostic-value-of-early-warning-scores-in-the-emergency-department-ed-and-acute-medical-unit-amu-a-narrative-review
#7
REVIEW
R S Nannan Panday, T C Minderhoud, N Alam, P W B Nanayakkara
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28918932/building-and-verifying-a-severity-prediction-model-of-acute-pancreatitis-ap-based-on-bisap-mews-and-routine-test-indexes
#8
Jiang-Feng Ye, Yu-Xin Zhao, Jian Ju, Wei Wang
PURPOSE: To discuss the value of the Bedside Index for Severity in Acute Pancreatitis (BISAP), Modified Early Warning Score (MEWS), serum Ca2+, similarly hereinafter, and red cell distribution width (RDW) for predicting the severity grade of acute pancreatitis and to develop and verify a more accurate scoring system to predict the severity of AP. METHODS: In 302 patients with AP, we calculated BISAP and MEWS scores and conducted regression analyses on the relationships of BISAP scoring, RDW, MEWS, and serum Ca2+ with the severity of AP using single-factor logistics...
October 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28915258/rapid-emergency-medicine-score-a-novel-prognostic-tool-for-predicting-the-outcomes-of-adult-patients-with-hepatic-portal-venous-gas-in-the-emergency-department
#9
MULTICENTER STUDY
Chen-June Seak, David Hung-Tsang Yen, Chip-Jin Ng, Yon-Cheong Wong, Kuang-Hung Hsu, Joanna Chen-Yeen Seak, Hsien-Yi Chen, Chen-Ken Seak
OBJECTIVE: This study aims to evaluate the performance of Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Modified Early Warning Score (MEWS) in ascertaining the severity of illness and predicting the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians (EPs) in risk stratification. METHODS: Data for 66 adult HPVG patients who visited the EDs of 2 research hospitals between October 1999 and April 2016 were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28902681/early-warning-scores-to-predict-noncritical-events-overnight-in-hospitalized-medical-patients-a-prospective-case-cohort-study
#10
Jesse Bittman, Aman P Nijjar, Penny Tam, Nadia Khan
BACKGROUND: Physicians are often called to evaluate patients overnight with varying levels of clinical deterioration. Early warning scores predict critical clinical deterioration in patients; however, it is unknown whether they are able to reliably predict which patients will need to be seen overnight and whether these patients will require further resource use. METHODS: A prospective case cohort study of 522 patient nights in a single tertiary care hospital in Vancouver, British Columbia, Canada, was conducted to assess the ability of Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS) to predict patients who will need to be seen overnight by physicians and will require other healthcare resources...
September 12, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28893325/the-most-commonly-used-disease-severity-scores-are-inappropriate-for-risk-stratification-of-older-emergency-department-sepsis-patients-an-observational-multi-centre-study
#11
Bas de Groot, Frank Stolwijk, Mats Warmerdam, Jacinta A Lucke, Gurpreet K Singh, Mo Abbas, Simon P Mooijaart, Annemieke Ansems, Laura Esteve Cuevas, Douwe Rijpsma
BACKGROUND: Sepsis recognition in older emergency department (ED) patients is difficult due to atypical symptom presentation. We therefore investigated whether the prognostic and discriminative performance of the five most commonly used disease severity scores were appropriate for risk stratification of older ED sepsis patients (≥70 years) compared to a younger control group (<70 years). METHODS: This was an observational multi-centre study using an existing database in which ED patients who were hospitalized with a suspected infection were prospectively included...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28789825/the-effect-of-the-quality-of-vital-sign-recording-on-clinical-decision-making-in-a-regional-acute-care-trauma-ward
#12
Claire M Keene, Victor Y Kong, Damian L Clarke, Petra Brysiewicz
PURPOSE: Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score (MEWS) uses vital signs to categorise the severity of a patient's physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making...
July 5, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28743479/integrating-heart-rate-variability-vital-signs-electrocardiogram-and-troponin-to-triage-chest-pain-patients-in-the-ed
#13
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Current triage methods for chest pain patients typically utilize symptoms, electrocardiogram (ECG), and vital sign data, requiring interpretation by dedicated triage clinicians. In contrast, we aimed to create a quickly obtainable model integrating the objective parameters of heart rate variability (HRV), troponin, ECG, and vital signs to improve accuracy and efficiency of triage for chest pain patients in the emergency department (ED). METHODS: Adult patients presenting to the ED with chest pain from September 2010 to July 2015 were conveniently recruited...
July 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28679490/continuous-monitoring-of-vital-signs-using-wearable-devices-on-the-general-ward-pilot-study
#14
Mariska Weenk, Harry van Goor, Bas Frietman, Lucien Jlpg Engelen, Cornelis Jhm van Laarhoven, Jan Smit, Sebastian Jh Bredie, Tom H van de Belt
BACKGROUND: Measurement of vital signs in hospitalized patients is necessary to assess the clinical situation of the patient. Early warning scores (EWS), such as the modified early warning score (MEWS), are generally calculated 3 times a day, but these may not capture early deterioration. A delay in diagnosing deterioration is associated with increased mortality. Continuous monitoring with wearable devices might detect clinical deterioration at an earlier stage, which allows clinicians to take corrective actions...
July 5, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28589426/clinical-condition-and-comorbidity-as-determinants-for-blood-culture-positivity-in-patients-with-skin-and-soft-tissue-infections
#15
F V van Daalen, M C Kallen, C M A van den Bosch, M E J L Hulscher, S E Geerlings, J M Prins
The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including patients with cellulitis and wound infection who had been enrolled in three Dutch multicenter studies between 2011 and 2015. Patients' acute clinical condition was assessed using the Modified Early Warning Score (MEWS; severe: MEWS ≥2) and comorbidity with the Charlson Comorbidity Index (CCI; severe: CCI ≥2)...
June 7, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28515604/development-and-psychometric-evaluation-of-the-pre-hospital-medical-emergencies-early-warning-scale
#16
Abbasali Ebrahimian, Gholamreza Masoumi, Roohangiz Jamshidi-Orak, Hesam Seyedin
INTRODUCTION: The number of requests for emergency medical services (EMSs) has increased during the past decade. However, most of the transports are not essential. Therefore, it seems crucial to develop an instrument to help EMS staff accurately identify patients who need pre-hospital care and transportation. The aim of this study was to develop and evaluate the psychometric properties of the Pre-hospital Medical Emergencies Early Warning Scale (Pre-MEWS). MATERIALS AND METHODS: This mixed-method study was conducted in two phases...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28490566/a-retrospective-cohort-study-of-the-utility-of-the-modified-early-warning-score-for-interfacility-transfer-of-patients-with-traumatic-injury
#17
Kristin Salottolo, Matthew Carrick, Jacob Johnson, Mark Gamber, David Bar-Or
OBJECTIVE: The modified early warning score (MEWS) is a 'track and trigger' score using routine physiological vital signs. The objective is to determine if the pretransfer MEWS can be used for predicting outcomes in trauma patients requiring interfacility transfer to higher levels of care. DESIGN, SETTING AND PARTICIPANTS: Retrospective study of consecutively transferred trauma patients into a level-II trauma centre from 2013 to 2014. INTERVENTIONS: None...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28463183/personalized-risk-scoring-for-critical-care-prognosis-using-mixtures-of-gaussian-processes
#18
Ahmed M Alaa, Jinsung Yoon, Scott Hu, Mihaela van der Schaar
In this paper, we develop a personalized real-time risk scoring algorithm that provides timely and granular assessments for the clinical acuity of ward patients based on their (temporal) lab tests and vital signs; the proposed risk scoring system ensures timely intensive care unit (ICU) admissions for clinically deteriorating patients. METHODS: The risk scoring system is based on the idea of sequential hypothesis testing under an uncertain time horizon. The system learns a set of latent patient subtypes from the offline electronic health record data, and trains a mixture of Gaussian Process (GP) experts, where each expert models the physiological data streams associated with a specific patient subtype...
April 27, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28445859/a-risk-scoring-model-based-on-vital-signs-and-laboratory-data-predicting-transfer-to-the-intensive-care-unit-of-patients-admitted-to-gastroenterology-wards
#19
Won-Young Kim, Jinmi Lee, Ju-Ry Lee, Youn Kyung Jung, Hwa Jung Kim, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
PURPOSE: To compare the ability of a score based on vital signs and laboratory data with that of the modified early warning score (MEWS) to predict ICU transfer of patients with gastrointestinal disorders. MATERIALS AND METHODS: Consecutive events triggering medical emergency team activation in adult patients admitted to the gastroenterology wards of the Asan Medical Center were reviewed. Binary logistic regression was used to identify factors predicting transfer to the ICU...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28351349/development-and-validation-of-the-efficacy-safety-score-ess-a-novel-tool-for-postoperative-patient-management
#20
Erlend Skraastad, Johan Ræder, Vegard Dahl, Lars J Bjertnæs, Vladimir Kuklin
BACKGROUND: Several reports have shown that postoperative monitoring of general safety and quality issues, including pain treatment, after discharge from recovery is often non-systematic and inadequate. We suggest a new score with assessment of key recovery parameters, as a supportive tool for postoperative care and a call-out algorithm for need of extra help. The aim of this investigation was to validate the score. METHODS: After suggesting a prototype score from a pilot study in 182 postoperative patients, we performed a Delphi process by using international experts to create consensus on the final score contents and called the revised tool the Efficacy Safety Score (ESS)...
March 28, 2017: BMC Anesthesiology
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