Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Hyperlactatemia affects the association of hyperglycemia with mortality in nondiabetic adults with sepsis.
Admission hyperglycemia has been reported as a mortality risk factor for septic nondiabetic patients; however, hyperglycemia's known association with hyperlactatemia was not addressed in these analyses. ⋯ In this cohort of septic adult nondiabetic patients, mortality risk did not increase with hyperglycemia unless associated with simultaneous hyperlactatemia. The previously reported association of hyperglycemia with mortality in nondiabetic sepsis may be due to the association of hyperglycemia with hyperlactatemia.
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Comparative Study
Effect of a physician assistant as triage liaison provider on patient throughput in an academic emergency department.
Overcapacity issues plague emergency departments (EDs). Studies suggest that triage liaison providers (TLPs) may shorten patient length of stay (LOS) and reduce the proportion of patients who leave without being seen (LWBS), but these results are not universal. Previous studies used physicians as TLPs. We evaluated whether a physician assistant (PA), acting as a TLP, would shorten LOS and decrease LWBS rates. ⋯ The addition of a PA as a TLP was associated with a 41-minute decrease in median total LOS and a lower proportion of patients who LWBS. The decrease in total LOS is likely attributable to the addition of the TLP, with patients having shorter duration in treatment rooms on pilot days compared to control days.
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Comparative Study
Does the current definition of contrast-induced acute kidney injury reflect a true clinical entity?
Contrast-induced acute kidney injury (CI-AKI) is defined as either a 25% increase in or an absolute elevation in serum creatinine (SCr) of 0.5 mg/dL, 48 to 72 hours after parenteral contrast exposure. The objective of this study was to compare the incidence and complications of AKI between patients exposed and those unexposed to intravenous (IV) contrast. ⋯ The definition of CI-AKI for ED patients with normal renal function may not represent a true clinical entity and the definition warrants revision.
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Comparative Study
Emergency medicine journal impact factor and change compared to other medical and surgical specialties.
A journal impact factor represents the mean number of citations per article published. Designed as one tool to measure the relative importance of a journal, impact factors are often incorporated into academic evaluation of investigators. The authors sought to determine how impact factors of emergency medicine (EM) journals compare to journals from other medical and surgical specialties and if any change has taken place over time. ⋯ Emergency medicine journals rank low in impact factor summary statistics and growth trends among 31 medical and surgical specialties.
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Comparative Study
A comparative study of the surgically relevant mechanical characteristics of the topical skin adhesives.
Topical skin adhesives (TSAs) offer a noninvasive alternative to sutures. The growing trend is to use them in addition to sutures and staples to add strength and provide a microbial barrier. The authors compared the mechanical characteristics of recently approved TSAs that are most likely to be of surgical relevance in the emergency department. ⋯ Of all the TSAs tested in this study, Dermabond Advanced was the strongest and most flexible, set in the shortest time, and was a fairly viscous adhesive, all of which are clinically desirable characteristics.