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https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#1
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29659593/the-complexity-of-patients-hospitalized-in-internal-medicine-wards-evaluated-by-fadoi-complimed-score-s-a-hypothetical-approach
#2
Erminio Bonizzoni, Gualberto Gussoni, Giancarlo Agnelli, Raffaele Antonelli Incalzi, Moira Bonfanti, Franco Mastroianni, Marco Candela, Carlotta Franchi, Stefania Frasson, Antonio Greco, Micaela La Regina, Roberta Re, Giorgio Vescovo, Mauro Campanini
OBJECTIVES: The aim of this study is to develop a new predictive model to measure complexity of patients in medical wards. SETTING: 29 Internal Medicine departments in Italy. MATERIALS AND METHODS: The study cohort was made of 541 consecutive patients hospitalized for any cause, aged more than 40 years and with at least two chronic diseases. First, we applied a hierarchical cluster analysis and the principal component analysis (PCA) to a panel of questionnaires [comorbidity (Charlson, CIRS), clinical stability (MEWS), social frailty (Flugelman), cognitive dysfunction (SPSMQ), depression (5-item GDS), functional dependence (ADL, IADL, Barthel), risk of sore threats (Exton-Smith scale), nutrition (MNA), pain (NRPS), adherence to therapy (Morisky scale)], in order to select domains informative for the definition of complexity...
2018: PloS One
https://www.readbyqxmd.com/read/29653185/sex-differences-in-the-development-of-hepatic-steatosis-in-cafeteria-diet-induced-obesity-in-young-mice
#3
Fabiana Rodrigues Silva Gasparin, Fernando Olinto Carreño, Juliana Moraes Mewes, Eduardo Hideo Gilglioni, Clairce Luzia Salgueiro Pagadigorria, Maria Raquel Marçal Natali, Karina Sayuri Utsunomiya, Rodrigo Polimeni Constantin, Amanda Tomie Ouchida, Carlos Curti, Ingrid C Gaemers, Ronald Petrus Johannes Oude Elferink, Jorgete Constantin, Emy Luiza Ishii-Iwamoto
The present study was planned to improve our understanding about sex differences in the development of hepatic steatosis in cafeteria diet-induced obesity in young mice. Female (FCaf) and male (MCaf) mice fed a cafeteria diet had similar body weight gain and adiposity index, but FCaf had a more extensive steatosis than MCaf. FCaf livers exhibited a higher non-alcoholic fatty liver disease activity score, elevated lipid percentage area (+34%) in Sudan III staining and increased TG content (+25%) compared to MCaf...
April 10, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29651595/heart-rate-variability-for-rapid-risk-stratification-of-emergency-patients-with-malignant-disease
#4
K Boehm, M Duckheim, L Mizera, P Groga-Bada, N Malek, F Kreth, M Gawaz, C S Zuern, C Eick
INTRODUCTION: Neoplasms are the second most common diseases in western countries. Many patients with malignant diseases repeatedly present themselves in the emergency department (ED). Due to limited capacities, appropriate risk stratification strategies for cancer patients have to be developed. This study assesses if deceleration capacity (DC) of heart rate as a parameter of heart rate variability predicts mortality in emergency patients with malignant diseases. METHODS: Prospectively, 140 adults with different entities of malignant diseases who presented in the medical ED were included...
April 12, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29498148/the-value-of-the-modified-early-warning-score-for-unplanned-intensive-care-unit-admissions-of-patients-treated-in-hospital-general-wards
#5
Michail Zografakis-Sfakianakis, Eelco De Bree, Manolis Linardakis, Argyri Messaritaki, Helen Askitopoulou, Alexandra Papaioannou, Panagiotis Aggouridakis
AIM: To determine the value of the Modified Early Warning Score (MEWS) for general ward patients and its potential use as an alarm tool for ward nurses. METHODS: A combined prospective-retrospective observational study was conducted with 153 patients in a university hospital (2013-2014). All patients were admitted to the intensive care unit (ICU) from general wards. Parameters retrospectively studied were 5 MEWS values at 4 hourly intervals, up to 20 hours before ICU admission...
March 1, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29457945/factors-that-influence-nurses-assessment-of-patient-acuity-and-response-to-acute-deterioration
#6
Mark Dalton, John Harrison, Anitra Malin, Conan Leavey
BACKGROUND: nurses play a crucial role in the early recognition and management of the deteriorating patient. They are responsible for the care they provide to their patients, part of which is the monitoring of vital signs (blood pressure, pulse, respiratory rate and temperature), which are fundamental in the surveillance of deterioration. The aim of this study was to discover what factors influence how nurses assess patient acuity and their response to acute deterioration. METHODS: a generic qualitative approach was used...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29432461/a-smart-all-in-one-device-to-measure-vital-signs-in-admitted-patients
#7
Mariska Weenk, Harry van Goor, Maartje van Acht, Lucien Jlpg Engelen, Tom H van de Belt, Sebastian J H Bredie
BACKGROUND: Vital sign measurements in hospitalized patients by nurses are time consuming and prone to operational errors. The Checkme, a smart all-in-one device capable of measuring vital signs, could improve daily patient monitoring by reducing measurement time, inter-observer variability, and incorrect inputs in the Electronic Health Record (EHR). We evaluated the accuracy of self measurements by patient using the Checkme in comparison with gold standard and nurse measurements. METHODS AND FINDINGS: This prospective comparative study was conducted at the Internal Medicine ward of an academic hospital in the Netherlands...
2018: PloS One
https://www.readbyqxmd.com/read/29337035/early-warning-scores-do-not-accurately-predict-mortality-in-sepsis-a-meta-analysis-and-systematic-review-of-the-literature
#8
F Hamilton, D Arnold, A Baird, M Albur, P Whiting
OBJECTIVES: Early Warning Scores are used to evaluate patients in many hospital settings. It is not clear if these are accurate in predicting mortality in sepsis. We performed a systematic review and meta-analysis of multiple studies in sepsis. Our aim was to estimate the accuracy of EWS for mortality in this setting. METHODS: PubMED, CINAHL, Cochrane, Web of Science and EMBASE were searched to October 2016. Studies of adults with sepsis who had EWS calculated using any appropriate tool (e...
March 2018: Journal of Infection
https://www.readbyqxmd.com/read/29334564/validating-the-electronic-cardiac-arrest-risk-triage-ecart-score-for-risk-stratification-of-surgical-inpatients-in-the-postoperative-setting-retrospective-cohort-study
#9
Bartlomiej Bartkowiak, Ashley M Snyder, Andrew Benjamin, Andrew Schneider, Nicole M Twu, Matthew M Churpek, Kevin K Roggin, Dana P Edelson
OBJECTIVE: Assess the accuracy of 3 early warning scores for predicting severe adverse events in postoperative inpatients. SUMMARY OF BACKGROUND DATA: Postoperative clinical deterioration on inpatient hospital services is associated with increased morbidity, mortality, and cost. Early warning scores have been developed to detect inpatient clinical deterioration and trigger rapid response activation, but knowledge regarding the application of early warning scores to postoperative inpatients is limited...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29260893/accuracy-of-coronary-artery-calcium-scoring-with-tube-current-reduction-by-75-using-an-adaptive-iterative-reconstruction-algorithm
#10
Reny Luhur, Joanne D Schuijf, Jürgen Mews, Jörg Blobel, Bernd Hamm, Alexander Lembcke
OBJECTIVE: To assess the accuracy of an iterative reconstruction (IR) technique for coronary artery calcium scoring with reduced radiation dose. METHODS: 163 consecutive patients underwent twofold scanning by 320-row detector CT at 120 kVp. A low-dose scan at 25% tube current but with standard scan length (14 cm) was followed by a standard dose scan with routine tube current but reduced scan length (10 cm). Reduced dose images were constructed using filtered back-projection (FBP) and IR (adaptive iterative dose reduction in three dimensions)...
April 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29245221/deceleration-capacity-as-a-risk-predictor-in-patients-presenting-to-the-emergency-department-with-syncope-a-prospective-exploratory-pilot-study
#11
Martin Duckheim, Katharina Klee, Nina Götz, Paul Helle, Patrick Groga-Bada, Lars Mizera, Meinrad Gawaz, Christine S Zuern, Christian Eick
Syncope is a common cause for admission to the emergency department (ED). Due to limited clinical resources there is great interest in developing risk stratification tools that allow identifying patients with syncope who are at low risk and can be safely discharged. Deceleration capacity (DC) is a strong risk predictor in postinfarction and heart failure patients. The aim of this study was to evaluate whether DC provides prognostic information in patients presenting to ED with syncope.We prospectively enrolled 395 patients presenting to the ED due to syncope...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29169912/comparison-of-the-between-the-flags-calling-criteria-to-the-mews-news-and-the-electronic-cardiac-arrest-risk-triage-ecart-score-for-the-identification-of-deteriorating-ward-patients
#12
Malcolm Green, Harvey Lander, Ashley Snyder, Paul Hudson, Matthew Churpek, Dana Edelson
INTRODUCTION: Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration. OBJECTIVE(S): We sought to compare the Between the Flags (BTF) calling criteria to the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and electronic Cardiac Arrest Risk Triage (eCART) score...
February 2018: Resuscitation
https://www.readbyqxmd.com/read/29122648/early-deterioration-indicator-data-driven-approach-to-detecting-deterioration-in-general-ward
#13
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 11,864 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)...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29115965/operationalization-of-diagnostic-criteria-of-dsm-5-somatic-symptom-disorders
#14
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...
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
#15
COMPARATIVE STUDY
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
#16
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
#17
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
#18
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
#19
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...
November 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
#20
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
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