Abstract
Current medical scores have limited efficiency and safety profiles to enable assignment to the most appropriate treatment site in patients with lower respiratory tract infections (LRTIs). We describe our current triage practice and assess the potential of a combination of CURB65 with proadrenomedullin (ProADM) levels for triage decisions.Consecutive patients with LRTIs presenting to our emergency department were prospectively followed and retrospectively classified according to CURB65 and ProADM levels (CURB65-A). Low medical risk patients were further subgrouped according to biopsychosocial and functional risks. We compared the proportion of patients virtually allocated to triage sites with actual triage decisions and assessed the added impact of ProADM in a subgroup.Overall, 93% of 146 patients were hospitalised. Among the 138 patients with available CURB65-A, 17.4% had a low medical risk indicating possible treatment in an outpatient or non-acute medical setting; 34.1% had an intermediate medical risk (short-hospitalisation); and 48.6% had a high medical risk (hospitalisation). Fewer patients were in a low CURB65-A class (I) than a low CURB65 class (0,1) (17.4% vs. 46.3%, p <0.001). Mean length of hospitalisation was 9.8 days including 3.6 days after reaching medical stability. In 60.3% of patients, hospitalisation was prolonged after medical stability mainly for medical reasons.Current rates of hospitalisation are high in patients with LRTI and length of stay frequently extended beyond time of medical stabilization. The lower proportion of patients reclassified as low risk by adding ProADM to the CURB65 score might improve confidence in the triage algorithm.
Highlights
In this study we aimed to investigate the relationship between thyroid hormone abnormalities and major cardiovascular events and sudden cardiac death at 3 and 6 months after discharge in patients who were admitted to the Emergency Department with acute coronary syndrome
The aim of this study was to demonstrate the role of arginase and adenosine deaminase (ADA) in patients suffering from myocardial infarction (MI), and in a group of patients with chronic renal failure (CRF) with cardiovascular diseases (CVD)
ADA may be considered good diagnostic enzymes in patients suffering from MI, and ADA for patients with CRF with CVD
Summary
Results We studied 53 patients (42 males, mean age (SEM) 57.6 (2.8) years, illness severity scores APACHE II 21.3 (0.9); SAPS II 53.3 (2.3); SOFA 10.2 (0.2); and ICU stay 35.9 (4.8) days). Results We included 53 consecutive patients (42 males, mean age 57.6 ± 2.8 years, illness severity scores APACHE II 21.3 ± 0.9; SAPS II 53.3 ± 2.3; SOFA 10.2 ± 0.2; and mean ICU stay 35.9 ± 4.8 days) of which 25 (47.2%) had at least one US findings. The objective of this study was to determine the incidence and type of incidents related to intrahospital transport (IHT) of critically ill patients in our ICU and to identify contributing factors of these incidents. The aim of this study was to assess the effect of monotherapy with nebulized colistin on clinical and microbiological outcomes in critically ill patients with VAT due to polymyxin-only susceptible Gram-negative bacteria
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