Internal and emergency medicine
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Either hypoglycemia or hypoalbuminemia alone is an independent condition associated with increased risk of mortality in critical illness. This study evaluates whether the mortality risk increases in septic patients if these conditions are combined. Patients admitted to our hospital from 2008 to 2015 who satisfied the definition of sepsis were targeted (n = 336). ⋯ A higher mortality risk is observed in cases with Hypo-G + Hypo-A (OR 5.065) than those with Hypo-G (OR 3.503), Inter-G (OR 1.175), Hyper-G (OR 1.756) or Hypo-A (OR 3.243), calculated by a single logistic-regression analysis. Hypo-G + Hypo-A in patients with sepsis is related to higher ICU mortality. Physicians should be keenly aware of these conditions to provide immediate intensive treatment after admission of septic patients.
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Observational Study
Analysis of the early warning score to detect critical or high-risk patients in the prehospital setting.
The early warning score can help to prevent, recognize and act at the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different scales for use in the prehospital setting and to select the most relevant one by applicability and capacity to predict mortality in the first 48 h. A prospective longitudinal observational study was conducted in patients over 18 years of age who were treated by the advanced life support unit and transferred to the emergency department between April and July 2018. ⋯ The score with the lowest global classification error was 10 points with sensitivity of 81.5% (95% CI 62.7-92.1) and specificity of 88.5% (95% CI 84.5-91.6). The early warning score studied (except modified early warning score) shows no statistically significant differences between them; however, the National Early Warning Score 2 is the most used score internationally, validated at the prehospital scope and with a wide scientific literature that supports its use. The Prehospital Emergency Medical Services should include this scale among their operative elements to complement the structured and objective evaluation of the critical patient.