Emergencias
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Randomized Controlled Trial
Efficacy of emergency medical center use of a protocol during telephone calls to give medical advice related to fever or gastroenteritis: a cluster randomized controlled trial.
To determine the efficacy of emergency medical center physicians' use of a protocol to guide their management of telephone consultations for fever and gastroenteritis. ⋯ Use of the protocol was associated with fewer unscheduled in-person visits for care and fewer hospital admissions. The protocol is safe and less costly than the centers' usual approaches to giving telephone advice.
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Multicenter Study
Mortality risk model for patients with suspected COVID-19 based on information available from an emergency dispatch center.
To develop and validate a scale to stratify risk of 2-day mortality based on data collected during calls to an emergency dispatch center from patients with suspected coronavirus disease 2019 (COVID-19). ⋯ This risk scale derived from information available to an emergency dispatch center is applicable to patients with suspected COVID-19. It can stratify patients by risk of early death (within 2 days), possibly helping with decision making regarding whether to transport from home or what means of transport to use, and destination.
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Comparative Study
Risk models for predicting in-hospital mortality from COVID-19 pneumonia in the elderly.
To compare the prognostic value of 3 severity scales: the Pneumonia Severity Index (PSI), the CURB-65 pneumonia severity score, and the Severity Community-Acquired Pneumonia (SCAP) score. To build a new predictive model for in-hospital mortality in patients over the age of 75 years admitted with pneumonia due to the coronavirus disease 2019 (COVID-19). ⋯ This study shows that the predictive power of the PSI for mortality is moderate and perceptibly higher than the CURB-65 and SCAP scores. We propose a new predictive model for mortality that offers significantly better performance than any of the 3 scales compared. However, our model must undergo external validation.
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To describe current attitudes toward screening for undiagnosed human immunodeficiency virus (HIV) infection in Spanish hospital emergency departments (EDs). To describe staff willingness to implement screening protocols and the obstacles they foresee. ⋯ There is considerable room for improvement in hospital ED screening for undiagnosed HIV infection. Some measures aimed at better screening would be more acceptable to the surveyed EDs, but there are marked differences in attitudes between autonomous communities.