Articles: mortality.
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Emerg Med Australas · Jun 2024
Adaptive platform trials rather than randomised controlled trials for paediatric sepsis.
Adaptive platform trials (APTs) offer a promising alternative to traditional randomised controlled trials for evaluating treatments for paediatric sepsis. Randomised controlled trials, despite being the gold standard for establishing causality between interventions and outcomes, make many assumptions about disease prevalence, severity and intervention effects, which are often incorrect. As a result, the evidence for most treatments for paediatric sepsis are based on low-quality evidence. ⋯ As such, APTs offer a more efficient, flexible and more effective way to identify optimal treatments. The proposed Paediatric Adaptive Sepsis Platform Trial, leveraging the Paediatric Research in Emergency Departments International Collaborative network's infrastructure, will evaluate resuscitation fluids, vasoactive medications, corticosteroids and antimicrobials. This trial has the potential to substantially impact clinical practice and reduce global sepsis mortality in children.
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Multicenter Study
Impact of SARS-CoV-2 vaccine rollout on Hispanic and non-Hispanic admission and mortality trends: an interrupted time series analysis.
Challenges with SARS-CoV-2 vaccine prioritization, access, and hesitancy have influenced vaccination uptake. ⋯ SARS-CoV-2 vaccine rollout was associated with improved COVID-19 admission trends among non-Hispanic vs Hispanic patients. Vaccine rollout was not shown to influence mortality trends in either group, which were four times higher among Hispanic patients. Improved vaccine rollout may have reduced disparities in admission trends for Hispanic patients, but other factors influenced their mortality trends.
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Eur J Trauma Emerg Surg · Jun 2024
ReviewPrognostic accuracy of emergency surgery score: a systematic review.
This systematic review aimed to summarize the literature regarding the prognostic accuracy of the emergency surgery score (ESS). ⋯ Despite the acceptable prognostic accuracy of ESS in 30-day mortality, morbidities, and in-hospital ICU admission in different emergency surgeries, the high number of required variables and the high probability of missing data highlight the need for modifications to this scoring system.
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Multicenter Study
Long-Term Outcomes Following Freehand Minimally Invasive Aspiration for Deep Supratentorial Intracerebral Hemorrhage: A Multicenter Cohort Study.
The aim of this study was to compare the therapeutic effects of non-navigated freehand minimally invasive aspiration and conservative medical care in patients with deep supratentorial intracerebral hemorrhage (ICH). ⋯ For deep supratentorial ICH, non-navigated freehand minimally invasive aspiration was safe and reduced short-term mortality but did not effectively improve long-term functional outcomes.
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Critical care medicine · Jun 2024
Observational StudyEvolution of Clinical Characteristics and Outcomes of Critically Ill Patients 90 Years Old or Older Over a 12-Year Period: A Retrospective Cohort Study.
The global population is aging, and the proportion of very elderly patients 90 years old or older in the ICU is expected to increase. The changes in the comorbidities and outcomes of very elderly patients hospitalized in the ICU that have occurred over time are unknown. ⋯ The number of patients 90 years old or older who were treated in the ICU has increased in recent years. While the patients' clinical characteristics and short-term outcomes have not changed significantly, the long-term mortality of these patients has improved in recent years.