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    Tytuł:
    Sequential organ failure assessment and modified early warning score system versus quick SOFA score to predict the length of hospital stay in sepsis patients – accuracy scoring study.
    Autorzy:
    Krishna, Gopala
    Kumar, Siva
    Sankar, Ravi
    Raghu, Kondle
    Sathynarayana, Vemula
    Siripriya, Pasupuleti
    Powiązania:
    https://bibliotekanauki.pl/articles/1918242.pdf
    Data publikacji:
    2021-12-31
    Wydawca:
    Towarzystwo Pomocy Doraźnej
    Tematy:
    Sepsis
    prognostic accuracy
    SOFA score
    qSOFA score
    MEWS score
    Opis:
    INTRODUCTION: : Sepsis is a global healthcare challenge, and accurate scores are required to identify and stratify patients' risk. The current study aimed to compare the prognostic accuracy of quick SOFA (qSOFA) with comparison to SOFA and MEWS scores in order to identify the length of hospital stay and outcomes among patients with sepsis who presented to emergency department (EMD). MATERIAL AND METHODS: Between July and November 2018, 77 adult patients with sepsis were treated at EMD. The area under the receiver operating characteristic curve (AUROC) of quick SOFA (qSOFA), SOFA, and MEWS scores was used to compare prognostic accuracy for the outcome of hospital mortality and length of stay. RESULTS: The majority of patients (68%) were over the age of 50. Systemic Hypertension is the most common comorbid condition, accounting for 38.9% (n=30). Pneumonia is the most common diagnosis in 27.3 percent of cases (n=21). Patients required vasoactive support in 45.5 percent (n=35) of cases, and ventilator support in 50.6 percent (n=39) of cases. Mortality was observed in 34.1 percent (n=27) of the cases. Patients on vasopressor and ventilator support have a higher mortality rate [8(19%) vs. 21(50%)]. The mortality rate in patients with a qSOFA score of 3 is 71.4 percent. Patients with a SOFA score of >15 had higher mortality rate. The mortality rate in patients with MEWS score > 5 is 48.9%. A qSOFA score of 3 is associated with an increased risk of death, and the majority died in less than three days. Because of increased mortality, most patients with a SOFA score of 7 have a length of stay of 3 days. Most patients with a Mews score of 5 or higher have a length of stay of 3 days due to mortality. The AUC value for qSOFA is 0.721, the AUC value for SOFA is 0.714, and the AUC value for MEWS is 0.693, indicating that qSOFA is more sensitive in predicting the outcome than SOFA and MEWS. CONCLUSIONS: In all prediction scores, qSOFA outperformed than SOFA and MEWS in terms of hospital mortality and length of hospital stay. qSOFA is a simple, rapid bedside tool that does not require laboratory parameters and can be used to predict the prognosis of patients with sepsis in the EMD.
    Źródło:
    Critical Care Innovations; 2021, 4, 4; 9-18
    2545-2533
    Pojawia się w:
    Critical Care Innovations
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    To determine the prognostic accuracy of the HEART score as a predictor for major adverse cardiac events in patients presenting with chest pain to emergency department in a tertiary care hospital
    Autorzy:
    Krishna, Penagaluru Pranay
    Velavarthipati, Ravi Sankar
    Srikanth, Midde
    Krishna, B Skanda Gopala
    Sriramula, Nayan
    Goud, Dabbi Praveen Kumar
    Powiązania:
    https://bibliotekanauki.pl/articles/29432050.pdf
    Data publikacji:
    2023-03
    Wydawca:
    Towarzystwo Pomocy Doraźnej
    Tematy:
    Acute coronary syndrome
    emergency department
    chest pain
    score
    HEART
    Opis:
    INTRODUCTION: One of the main causes of sudden cardiac death in the emergency department is myocardial infarction. Although there are several scores that helped predict an identified acute coronary incident, there was no quantitative tool available to risk stratifying patients with chest pain to support more decisions. The study is aimed to determine the prognostic accuracy of the HEART score as a predictor for major adverse cardiac events in patients presenting with chest pain to the emergency medicine department (ED). MATERIAL AND METHODS: Study included 83 adult patients presenting with Acute Myocardial Infarction who had chest pain attending to the ED were studied their HEART score to predict major adverse cardiac events. RESULTS: 60.24% of males and 39.76% of females with mean age of 57.83 ± 12.85 years were presented to ED. 44.56% had hypertension, 46.99% of diabetes mellitus, 21.69% of smoking, 16.87% of alcoholism, 4.82% of obesity, and 3.61% of patients with family history of cardiac diseases. 28.92% had non-specific repolarization, and 33.73% of patients had significant ST-Depression. According to Heart score, 26.51% of patients had low risk, 39.76% of patients had moderate risk, and 33.73% of patients had high risk. More percentage of male patient’s (67.9%) were in the high risk group of heart score than females (32.1%). ST-Depression cases were more in the high risk group (85.7%), and statistical significant association seen between ECG and the heart score (P<0.0001). among risk factors, Hypertension and Diabetes mellitus patients was more in the high risk groups with 48.6%, and 53.8% (P=0.001). 100% of high risk cases had ≥3 x normal limit of troponin, and there was a statistically association seen between troponin and heart score (P<0.0001). Diagnosis of HEART score of the low risk group showed that the risk factor had significantly higher AUC value (AUC = 0.801) than the age group (AUC = 0.778), history (AUC = 0.747), Troponin (AUC = 0.738), and ECG (AUC = 0.722). Out of 22 cases of the low risk group, 6 of Unstable angina (UA), 16 of NSTEMI, 4 of Percutaneous coronary intervention (PCI), 2 CABG, and 1 cardiovascular (CV) death. For moderate risk group (n=33), 13 of UA, 17 of NSTEMI, 3 of STEMI, 20 of PCI, 14 of CABG, and 12 of CV deaths. For high risk group (n=28), 10 UA, 14 of NSTEMI, 3 of STEMI, 9 of PCI, 6 of CABG, and 4 number of CV death. CONCLUSIONS: It was concluded that the HEART score should be used as the primary clinical decision tool for the risk stratification and a good predictor of major adverse cardiac events in patients presenting with chest pain to the emergency department to promote their safe and efficient nature in a community hospital setting.
    Źródło:
    Critical Care Innovations; 2023, 6, 1; 1-16
    2545-2533
    Pojawia się w:
    Critical Care Innovations
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-2 z 2

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