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JOURNAL ARTICLE
Yi-Min Wang, I-Min Chiu, Yu-Ping Chuang, Chi-Yung Cheng, Chun-Fu Lin, Fu-Jen Cheng, Chien-Fu Lin, Chao-Jui Li
INTRODUCTION: The objective of this multi-center retrospective cohort study was to devise a predictive tool known as RAPID-ED. This model identifies non-traumatic adult patients at significant risk for cardiac arrest within 48 hours post-admission from the emergency department. METHODS: Data from 224,413 patients admitted through the emergency department (2016-2020) was analyzed, incorporating vital signs, lab tests, and administered therapies. A multivariable regression model was devised to anticipate early cardiac arrest...
March 2024: Resuscitation plus
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JOURNAL ARTICLE
Aravinda Kumar Balan, Ramesh Kannan, Vanitha Muralikumar, Vamseedhar Annam, Sakthi Balan Murugesan, M M Sekhar, Renu Medasani
BACKGROUND: While several drugs are in the pipeline for treatment of various grades of COVID-19 disease, none of them have shown promise until now. Medicinal plants are crucial in developing and developed countries for their primary and basic health needs owing to better tolerability, superior compatibility with human body and having lesser side effects. OBJECTIVE: To test adjuvant effect of AEV01, a patented herbal extract of kutki (Picrorhiza kurroa), in mild COVID19 in elderly patients at risk of complications and aging immunity...
February 5, 2024: Journal of Ayurveda and Integrative Medicine
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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
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JOURNAL ARTICLE
Rex Pui Kin Lam, Kevin Kei Ching Hung, Chun Tat Lui, Wai Shing Kwok, Wendy Wing Tak Lam, Eric Ho Yin Lau, Siddharth Sridhar, Peter Yau Tak Ng, Chi Hung Cheng, Tat Chi Tsang, Matthew Sik Hon Tsui, Colin Alexander Graham, Timothy Hudson Rainer
INTRODUCTION: Early sepsis treatment in the emergency department (ED) is crucial to improve patient survival. Despite international promulgation, the uptake of the Surviving Sepsis Campaign (SSC) Hour-1 Bundle (lactate measurement, blood culture, broad-spectrum antibiotics, 30 mL/kg crystalloid for hypotension/lactate ≥4 mmol/L and vasopressors for hypotension during/after fluid resuscitation within 1 hour of sepsis recognition) is low across healthcare settings...
February 1, 2024: BMJ Open
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JOURNAL ARTICLE
Gianni Turcato, Arian Zaboli, Serena Sibilio, Marta Parodi, Michael Mian, Francesco Brigo
BACKGROUND: Accurately estimating the prognosis of septic patients on arrival in the emergency department (ED) is clinically challenging. The lactate-to-albumin ratio (LAR) has recently been proposed to improve the predictive performance of septic patients admitted to the ICU. OBJECTIVES: This study aims to assess whether the LAR could be used as an early prognostic marker of 30-day mortality in patients with sepsis in the ED. METHODS: A prospective observational study was conducted in the ED of the Hospital of Merano...
March 2024: Current Medical Research and Opinion
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JOURNAL ARTICLE
Sherif Gonem, Joseph Lemberger, Abdulla Baguneid, Steve Briggs, Tricia M McKeever, Dominick Shaw
INTRODUCTION: The National Early Warning Score-2 (NEWS-2) is used to detect deteriorating patients in hospital settings. We aimed to understand how NEWS-2 functions in the real-life setting of an acute respiratory unit. METHODS: Clinical observations data were extracted for adult patients (age ≥18 years), admitted under the care of respiratory medicine services from July to December 2019, who had at least one recorded task relating to clinical deterioration...
January 31, 2024: BMJ Open Respiratory Research
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JOURNAL ARTICLE
Karl Charlton, Jon Rees, Emma Burrow
BACKGROUND: Individuals with low socio-economic status (SES) have disproportionate rates of cardio- vascular disease (CVD) but poorer engagement with preventative health. This study aimed to compare characteristics of individuals with and without hyperlipidaemia and describe their health behaviours. METHODS: A mixed-methods study between January and December 2022. Patients aged ≥40 years using the ambulance service with blood pressure of ≥140/90 had their total cholesterol measured using a point of care device...
January 30, 2024: Journal of Public Health
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JOURNAL ARTICLE
Graciela Cárdenas, María Chávez-Canales, Ana María Espinosa, Antonio Jordán-Ríos, Daniel Anica Malagon, Manlio Fabio Márquez Murillo, Laura Victoria Torres Araujo, Ricardo Leopoldo Barajas Campos, Rosa María Wong-Chew, Luis Esteban Ramirez González, Karent Ibet Cresencio, Enrique García Velázquez, Mariana Rodriguez de la Cerda, Yoana Leyva, Joselin Hernández-Ruiz, María Luisa Hernández-Medel, Mireya León-Hernández, Karen Medina Quero, Anahí Sánchez Monciváis, Eduardo Beltrán Sarmiento, Rafael Ignacio Aguilar Reynoso, Daniela Murillo Reyes, Luis Rodrigo Del Río Ambriz, Juan Salvador García Hernández, Jocelyn Cruz, Sergio Iván Valdés Ferrer, Leonor Huerta, Nora Alma Fierro, Marisela Hernández, Mayra Pérez-Tapia, Gabriela Meneses, Gabriela Rosas, Juan Alberto Hernández-Aceves, Jaquelynne Cervantes-Torres, Ricardo A Valdez, Anai Fuentes Rodríguez, Erick Espíndola-Arriaga, Mauricio Ortiz, Evelyn Alvarez Salazar, Carlos Castellanos Barba, Hugo Besedovsky, Marta C Romano, Helgi Jung, Raúl J Bobes, Gloria Soldevila, Juan C López-Alvarenga, Gladis Fragoso, Juan Pedro Laclette, Edda Sciutto
BACKGROUND: SARS-CoV2 induces flu-like symptoms that can rapidly progress to severe acute lung injury and even death. The virus also invades the central nervous system (CNS), causing neuroinflammation and death from central failure. Intravenous (IV) or oral dexamethasone (DXM) reduced 28 d mortality in patients who required supplemental oxygen compared to those who received conventional care alone. Through these routes, DMX fails to reach therapeutic levels in the CNS. In contrast, the intranasal (IN) route produces therapeutic levels of DXM in the CNS, even at low doses, with similar systemic bioavailability...
January 29, 2024: Archives of Medical Research
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JOURNAL ARTICLE
Viviana Cristillo, Andrea Pilotto, Stefano Cotti Piccinelli, Ilenia Libri, Martina Locatelli, Marcello Giunta, Valentina Mazzoleni, Debora Pezzini, Davide Arici, Stefano Gipponi, Francesca Schiano di Cola, Elisabetta Cottini, Massimo Gamba, Mauro Magoni, Alessandro Padovani
BACKGROUND: The role of vaccination on Covid-19 severity in neurological patients is still unknown. We aim at describing clinical characteristics and outcomes of breakthrough and unvaccinated Covid-19 patients hospitalized for neurological disorders. METHODS: Two hundred thirty-two Covid-19 patients were admitted to a neuro-Covid Unit form March 1st 2021 to February 28th 2022. Out of the total sample, 74 (32%) were full vaccinated. The prevalence, clinical characteristics, disease severity, expressed by Brescia-COVID Respiratory Severity Scale (BCRSS) and National Early Warning Score 2 (NEWS2), and final outcomes of neurological syndromes were compared between vaccinated and unvaccinated cases...
February 15, 2024: Journal of the Neurological Sciences
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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
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JOURNAL ARTICLE
Kadir Küçükceran, Mustafa Kürşat Ayrancı, Sedat Koçak, Abdullah Sadık Girişgin, Zerrin Defne Dündar, Sami Ataman, Enes Bayındır, Oğuz Karaçadır, İbrahim Tatar, Mustafa Doğru
BACKGROUND: Due to the high rate of geriatric patient visits, scoring systems are needed to predict increasing mortality rates. OBJECTIVE: In this study, we aimed to investigate the in-hospital mortality prediction power of the National Early Warning Score 2 (NEWS2) and the Laboratory Data Decision Tree Early Warning Score (LDT-EWS), which consists of frequently performed laboratory parameters. METHODS: We retrospectively analyzed 651 geriatric patients who visited the emergency department (ED), were not discharged on the same day from ED, and were hospitalized...
October 14, 2023: Journal of Emergency Medicine
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JOURNAL ARTICLE
Filip Haegdorens, Julie Lefebvre, Carolien Wils, Erik Franck, Peter Van Bogaert
OBJECTIVES: This prospective cohort study aimed to assess the predictive value of the Nurse Intuition Patient Deterioration Scale (NIPDS) combined with the National Early Warning Score (NEWS) for identifying serious adverse events in patients admitted to diverse hospital wards. RESEARCH METHODOLOGY/DESIGN: Data was collected between December 2020 and February 2021 in a 350-bed acute hospital near Brussels, Belgium. The study followed a prospective cohort design, employing NIPDS alongside NEWS for risk assessment...
January 19, 2024: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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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
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JOURNAL ARTICLE
Abhishek Kumar, Ashok Kumar Pannu, Mohan Kumar, Archana Angrup, Pinaki Dutta, Navneet Sharma
Background: An early prediction of infection is challenging in diabetic ketoacidosis (DKA). Methods: This prospective cohort study aimed to assess effectiveness of various sepsis screening tools in predicting infections and prognosis in DKA. Results: Among 141 cases, infection (44.0%) was the commonest precipitating factor. A Sequential Organ Failure Assessment score ≥4 showed high specificity (82.28%) and high positive likelihood ratio (2.64) but limited sensitivity (46.77%). Conversely, Systemic Inflammatory Response Syndrome ≥2 exhibited good sensitivity (95...
November 2023: Biomarkers in Medicine
#35
JOURNAL ARTICLE
Yuan Bian, Qi Han, Yue Zheng, Yu Yao, Xinhui Fan, Ruijuan Lv, Jiaojiao Pang, Feng Xu, Yuguo Chen
BACKGROUND: Some COVID-19 patients deteriorate to severe cases with relatively higher case-fatality rates, which increases the medical burden. This necessitates identification of patients at risk of severe disease. Early assessment plays a crucial role in identifying patients at risk of severe disease. This study is to assess the effectiveness of SUPER score as a predictor of severe COVID-19 cases. METHODS: We consecutively enrolled COVID-19 patients admitted to a comprehensive medical center in Wuhan, China, and recorded clinical characteristics and laboratory indexes...
December 2023: Infect Med (Beijing)
#36
JOURNAL ARTICLE
Konlawij Trongtrakul, Pattraporn Tajarernmuang, Atikun Limsukon, Theerakorn Theerakittikul, Nutchanok Niyatiwatchanchai, Karjbundid Surasit, Pimpimok Glunriangsang, Chalerm Liwsrisakun, Chaiwat Bumroongkit, Chaicharn Pothirat, Juthamas Inchai, Warawut Chaiwong, Panida Chanayat, Athavudh Deesomchok
(1) Background: Early identification of severe coronavirus disease 2019 (COVID-19) pneumonia at the initial phase of hospitalization is very crucial. To address this, we validated and updated the National Early Warning Score 2 (NEWS2) for this purpose. (2) Methods: We conducted a study on adult patients with COVID-19 infection in Chiang Mai, Thailand, between May 2021 and October 2021. (3) Results: From a total of 725 COVID-19 adult patients, 350 (48.3%) patients suffered severe COVID-19 pneumonia. In determining severe COVID-19 pneumonia, NEWS2 and NEWS2 + Age + BMI (NEWS2 Plus) showed the C-statistic values of 0...
January 4, 2024: Journal of Clinical Medicine
#37
JOURNAL ARTICLE
Thomas Knight, Catherine Atkin, Vicky Kamwa, Tim Cooksley, Chris Subbe, Mark Holland, Elizabeth Sapey, Daniel Lasserson
BACKGROUND: Frailty is associated with a range of adverse clinical outcomes in the acute hospital setting. We sought to determine whether frailty and related factors affected clinical processes such as time to assessment during emergency hospital admission within the National Health Service (NHS) in the UK. METHODS: The Society for Acute Medicine Benchmarking Audit (SAMBA) is an annual cross-sectional day of care survey. SAMBA 2022 was conducted on Thursday 23rd June 2022...
December 2023: EClinicalMedicine
#38
JOURNAL ARTICLE
Matthew Inada-Kim, Francis P Chmiel, Michael Boniface, Daniel Burns, Helen Pocock, John Black, Charles Deakin
OBJECTIVES: To evaluate oxygen saturation and vital signs measured in the community by emergency medical services (EMS) as clinical markers of COVID-19-positive patient deterioration. DESIGN: A retrospective data analysis. SETTING: Patients were conveyed by EMS to two hospitals in Hampshire, UK, between 1 March 2020 and 31 July 2020. PARTICIPANTS: A total of 1080 patients aged ≥18 years with a COVID-19 diagnosis were conveyed by EMS to the hospital...
January 2, 2024: BMJ Open
#39
JOURNAL ARTICLE
Ronan O'Driscoll, Nawar Diar Bakerly
BACKGROUND: The British Thoracic Society (BTS) has organised intermittent audits of hospital oxygen use in UK hospitals since 2008. Manual audits are time-consuming and subject to human errors. Oxygen prescribing and bedside observations including National Early Warning Scores (NEWS2 scores) are undertaken within an integrated electronic medical record (EMR) at this hospital. METHODS: The hospital's Business Information team were commissioned in late 2019 to devise a bespoke automated audit of oxygen prescribing and use...
December 28, 2023: BMJ Open Respiratory Research
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JOURNAL ARTICLE
Iqra Zia, Syeda Kisa Fatima Zaidi
Introduction Sepsis is a preventable cause of mortality and presents challenges in triage and management. The Surviving Sepsis Campaign care bundles improve patient outcomes; however, non-compliance with guidelines, understaffing, and scarcity of training opportunities undermine care quality in resource-limited countries. We aimed to implement the sepsis hour-1 care bundle in the emergency department of a tertiary-care hospital in Pakistan and develop hospital antimicrobial guidelines. Methods The baseline assessment included a survey of knowledge and confidence in sepsis management and a retrospective audit of inpatient medical records...
November 2023: Curēus
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