The American journal of emergency medicine
-
Multicenter Study Observational Study
Gestalt clinical severity score (GCSS) as a predictor of patient severity of illness or injury.
To determine if clinical judgement is accurate to predict the severity of injury or illness, and can be used at patient arrival when other formal scoring systems are not yet available. ⋯ Physicians can make accurate predictions of severity of injury and illness using a gestalt method and the scoring system we have developed as patient disposition correlates well with GCSS score. GCSS is most accurate with the 18-44 age group.
-
Multicenter Study Observational Study
Targeted temperature management on outcome of older adult patients after out-of-hospital cardiac arrest.
Targeted temperature management (TTM) can potentially improve the prognosis of patients with out-of-hospital cardiac arrest (OHCA). However, the effectiveness of TTM in older adults remains unknown. Therefore, this study aimed to assess the outcomes of older adult patients with OHCA who underwent TTM. ⋯ In this retrospective nationwide observational study in Japan, neurological outcomes worsened as age increased in patients with OHCA who underwent TTM.
-
Multicenter Study
Risk factors, management, and outcomes in isolated parafalcine or tentorial subdural hematomas.
Indications for hospitalization in patients with parafalcine or tentorial subdural hematomas (SDH) remain unclear. This study derived and validated a clinical decision rule to identify patients at low risk for complications such that hospitalization can be avoided. ⋯ Retrospective Cohort Study.
-
Multicenter Study
Development of a prehospital lactic acidosis score for early-mortality. A prospective, multicenter, ambulance-based, cohort study.
Lactic acidosis is a clinical status related to clinical worsening. Actually, higher levels of lactate is a well-established trigger of emergency situations. The aim of this work is to build-up a prehospital early warning score to predict 2-day mortality and intensive care unit (ICU) admission, constructed with other components of the lactic acidosis besides the lactate. ⋯ Our results showed that PLA predicts 2-day mortality better than other lactic acidosis components alone. Including PLA score in prehospital setting could improve emergency services decision-making.
-
Randomized Controlled Trial Multicenter Study
Efficacy of human C1 esterase inhibitor concentrate for treatment of ACE-inhibitor induced angioedema.
ACE inhibitor (ACEi) induced angioedema predominantly affects the upper aerodigestive tract. As ACEi induced angioedema is mediated by bradykinin, therapeutic response to antihistamines and glucocorticoids remains unsatisfactory. In bradykinin mediated hereditary angioedema, C1-esterase inhibitor (C1INH) is an effective and approved treatment since many years. Our aim was to evaluate the therapeutic effect of C1INH in ACEi induced angioedema. ⋯ In the context of baseline application of steroids and antihistamines C1INH was inferior in the treatment of ACEi induced angioedema when compared to placebo with respect to time to complete resolution of symptoms. Eudra-CT Number: 2012-001670-28.