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Source: Internal and Emergency Medicine
Management: Hospitals
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Total 27 results found since Jan 2013.
Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke
AbstractTo investigate the association between the Emergency Medical Service dispatcher ’s initial stroke triage and prehospital stroke management, primary admission to hospitals offering revascularization treatment, prehospital time delay, and rate of acute revascularization. In an observational cohort study, patients with acute ischemic stroke (AIS) in Denmark (2017–2018) were in cluded if the emergency call to the Emergency Medical Dispatch Center (EMDC) was made within three hours after symptom onset. Among 3546 included AIS patients, the EMS dispatcher identified 74.6% (95% confidence interval (CI) 73.1–76.0) co...
Source: Internal and Emergency Medicine - June 27, 2023 Category: Emergency Medicine Source Type: research
Impact of the COVID-19 pandemic on visits to the hospital emergency service in two hospitals in Spain, from March 14, 2020 to June 21, 2020
This study will describe trends in the use of emergency departments before and after the Spanish State of Alarm, especially in pathologies not directly related to this infection. A cross-sectional study was conducted of all visits to the emergency departments in two third-level hospitals in two Spanish communities during the Spanish State of Alarm, compared with the same period of the previous year. The variables collected included the day of the week, the time of the visit, the duration of the visit, the final destination of the patients (home, admission to a conventional hospitalization ward, admission to the intensive c...
Source: Internal and Emergency Medicine - June 12, 2023 Category: Emergency Medicine Source Type: research
Association between cooling temperature and outcomes of patients with heat stroke
This study explored the relationship between body temperature and adverse outcomes in patients with heat stroke to identify the optimal target body temperature within the first 24 h. This retrospective, multicentre study enrolled 143 patients admitted to the emergency department and diagnosed with heat stroke. The primary outcome was the in-hospital mortality rate, while secondary outcomes included the presence and number of damaged organs and neurological sequelae at disch arge. A body temperature curve was built using a generalized additive mixed model, and the association between body temperatures and outcomes was est...
Source: Internal and Emergency Medicine - May 3, 2023 Category: Emergency Medicine Source Type: research
Sex differences in clinical outcomes amongst 1105 patients admitted with hip fractures
AbstractAmongst hip fracture admissions, mortality is higher in men than in women. However, sex differences in other care-quality measures have not been well-documented. We aimed to examine sex differences in mortality as well as a wide range of underlying health indicators and clinical outcomes in adults ≥ 60 year of age admitted with hip fractures from their own homes to a single NHS hospital between April-2009 and June-2019. Sex differences in delirium, length of stay (LOS) and mortality in hospital, readmission, and discharge destination, were examined by logistic regression. There were 7 87 women and 318 men o...
Source: Internal and Emergency Medicine - April 26, 2023 Category: Emergency Medicine Source Type: research
Mortality outcomes and predictors of failed thrombolysis following STEMI thrombolysis in a non-PCI capable tertiary hospital: a 5-year analysis
This study aimed to identify the incidence, mortality outcomes and predictors of FT in STEMI pharmacological reperfusion. This single-centre retrospective cohort study analyzed data on consecutive STEMI patients who received thrombolytic therapy from 2016 to 2020 in a public tertiary hospital. Total population sampling was used in this study. Logistic regression analyses were used to asse ss independent predictors of the mortality outcomes and FT. We analyzed 941 patients with a mean age of 53.0 ± 12.2 years who were predominantly male (n = 846, 89.9%). The in-hospital mortality was 10.3% (n = 97). FT occur...
Source: Internal and Emergency Medicine - January 17, 2023 Category: Emergency Medicine Source Type: research
ABCD2, ABCD2-I, and OTTAWA scores for stroke risk assessment: a direct retrospective comparison
The objective is to compare the accuracy of ABCD2, ABCD2-I, and OTTAWA scores in the prediction of a stroke at 7, 90 days, and 1 year in patients presenting with TIA. Single-centre, retrospective study including patients with TIA admitted to the Emergency Department of our third-level, University Hospital, between 2018 and 2019. Five hundred three patients were included. Thirty-nine (7.7%) had a stroke within 1 year from the TIA: 9 (1.7%) and 24 (4.7%) within 7 and 90 days, respectively. ABCD2, ABCD2-I, and OTTAWA scores were significantly higher in patients who developed a stroke. AUROCs ranged from 0.66 to 0.75, wi...
Source: Internal and Emergency Medicine - August 20, 2022 Category: Emergency Medicine Source Type: research
Echocardiographic predictors of mortality in intermediate-risk pulmonary embolism
AbstractData regarding further risk stratification of intermediate-risk pulmonary embolism (IR-PE) are scanty. Whether transthoracic echocardiography may be helpful in further risk assessment of death in such population has still to be proven. Two-hundred fifty-four consecutive patients (51.6% females, age 63.7 ± 17.3 years) with IR-PE admitted to a tertiary regional referral center were enrolled. Patients underwent a complete transthoracic echocardiography within 36 h from hospital admission, on top of clinical assessment, physical examination, computer tomography pulmonary angiography (CTPA), and serum measuremen...
Source: Internal and Emergency Medicine - January 21, 2022 Category: Emergency Medicine Source Type: research
Clinical characteristics and tumor markers in ischemic stroke patients with active cancer
AbstractCancer-associated ischemic stroke (CAS) refers to a hypercoagulation disorder related to malignant tumors, especially adenocarcinoma. Carbohydrate antigen (CA) 125 is a mucinous serum marker that might reflect hypercoagulation status, but the association between CA 125 and CAS is unclear across various types of cancer. The aim of this study was to investigate the associations among tumor markers, coagulation markers, and clinical factors in acute ischemic stroke (AIS) patients with active cancer. Consecutive AIS patients with active cancer (a diagnosis or ongoing active therapy for cancer within 6 months) were pr...
Source: Internal and Emergency Medicine - October 1, 2021 Category: Emergency Medicine Source Type: research
Request of hospital care dropped for TIA but remained stable for stroke during COVID-19 pandemic at a large Italian university hospital
AbstractReduced incidence of stroke during COVID-19 pandemic was sometimes reported. While decrease in stroke incidence and fear of patients to go to the hospitals were sometimes invoked to explain this decrease, reduction in urban pollution was also hypothesized as a possible cause. We investigated statistically the incidence of ischemic and hemorrhagic stroke, and of transient ischemic attacks, at a large Italian tertiary stroke center during the pandemic. We analyzed statistically the number of transient ischemic attacks (TIA), ischemic strokes (IS) and hemorrhagic strokes (HS) between March 8 and May 2, 2020, the pe...
Source: Internal and Emergency Medicine - October 15, 2020 Category: Emergency Medicine Source Type: research
Blood lactate predicts survival after percutaneous implantation of extracorporeal life support for refractory cardiac arrest or cardiogenic shock complicating acute coronary syndrome: insights from the CareGem registry
AbstractRefractory cardiogenic shock (RCS) or refractory cardiac arrest (RCA) complicating acute coronary syndrome (ACS) is associated with extremely high mortality rate. Veno-arterial extracorporeal life support (VA-ECLS) represents a valuable therapeutic option to stabilize patients ’ condition before or at the time of emergency revascularization. We analyzed 29 consecutive patients with RCS or RCA complicating ACS, and implanted with VA-ECLS in two centers who have adopted a similar, structured approach to ECLS implantation. Data were collected from January 2010 to December 2015 and ECLS had to be percutaneously impla...
Source: Internal and Emergency Medicine - August 8, 2020 Category: Emergency Medicine Source Type: research
Cognitive impairment in patients hospitalized for congestive heart failure: data from the RICA Registry
The objective of this study is to determine the prevalence of cognitive impairment (CogI) in patients hospitalized for congestive heart failure, and the influence of CogI on mortality and hospital readmission. This is a multicenter cohort study of patients hospitalized for congestive heart failure enrolled in the RICA registry. The patients were divided into 3 groups according to their Short Portable Mental Status Questionnaire score: 0 –3 errors (no CogI or mild CogI), 4–7 (moderate CogI) and 8–10 (severe CogI). A total of 3845 patients with a mean (SD) age of 79 (8.6) years were included; 2038 (53%) were women. A t...
Source: Internal and Emergency Medicine - June 14, 2020 Category: Emergency Medicine Source Type: research
SMASH-U classification: a tool for aetiology-oriented management of patients with acute haemorrhagic stroke
AbstractIntracerebral haemorrhage (ICH) is responsible for disproportionately high morbidity and mortality rates. The most used ICH classification system is based on the anatomical site. We used SMASH-U, an aetiological based classification system for ICH by predefined criteria: structural vascular lesions (S), medication (M), amyloid angiopathy (A), systemic disease (S), hypertension (H), or undetermined (U). We aimed to correlate SMASH-U classification of our patients to the intra-hospital mortality rates. We performed a single centre retrospective study at the Santa Maria Della Misericordia Hospital, Perugia (Italy) inc...
Source: Internal and Emergency Medicine - April 7, 2020 Category: Emergency Medicine Source Type: research
