Articles: outcome-assessment-health-care.
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Multicenter Study
Early Hyperoxia in Patients with Traumatic Brain Injury Admitted to Intensive Care in Australia and New Zealand: A Retrospective Multicenter Cohort Study.
Early hyperoxia may be an independent risk factor for mortality in critically ill traumatic brain injury (TBI) patients, although current data are inconclusive. Accordingly, we conducted a retrospective cohort study to determine the association between systemic oxygenation and in-hospital mortality, in critically ill mechanically ventilated TBI patients. ⋯ In this large multicenter cohort of TBI patients, hyperoxia in the first 24 h after ICU admission was not independently associated with greater in-hospital mortality. Hypoxia remains associated with greater in-hospital mortality risk and should be avoided where possible.
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Adequate identification of the severity of status epilepticus (SE) contributes to individualized treatment. The scales most widely used for this purpose are: Status Epilepticus Severity Score (STESS), Epidemiology-Based Mortality Score in Status Epilepticus (EMSE) and modified Rankin Scale STESS (mRSTESS). The aim of this study was to evaluate the performance of the STESS, EMSE and mRSTESS scales to predict high disability and hospital mortality at discharge (HD/HM). ⋯ All of the evaluated scales (STESS, mRSTESS, and EMSE) were shown to be useful in predicting HD/HM. EMSE was observed to be the most effective of the scales, with relative similarities among the variants.
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We performed a meta-analysis to evaluate the outcomes of acute ischemic stroke (AIS) in patients treated with mechanical thrombectomy (MT), according to diabetes mellitus and admission glucose level (AGL). ⋯ The present study confirms that a history of diabetes mellitus and high AGL are associated with unfavorable functional outcomes at 3 months after MT in AIS patients. However, the causal relationship between hyperglycemia and poor prognosis remains undetermined, and further investigations are required to ascertain whether AIS patients receiving MT could benefit from intensive glucose control.
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Comparative Study Observational Study
Management of chest pain in the French emergency healthcare system: the prospective observational EPIDOULTHO study.
The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). ⋯ Management of chest pain at the three levels of the French medical emergency system is mainly oriented towards ruling out ACS. The strategy of diagnostic management is based on minimizing missed diagnoses of ACS.