Predictability of adult patient medical emergency condition from triage vital signs and comorbidities: a single-center, observational study.

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Maral Yazici, Ahmet Sefa Yeter, Sinan Genç, Ayça Koca, Ahmet Burak Oğuz, Müge Günalp Eneyli, Onur Polat
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引用次数: 0

Abstract

Background: Vital signs and comorbid diseases are the first information evaluated in patients admitted to the emergency department (ED). In most EDs, triage of patients takes place with vital signs and admission complaints only. Comorbidities are generally underestimated when determining the patient's status at the triage area. This study aims to assess the relationship between initial vital signs, comorbid diseases, and medical emergency conditions (MEC) in patients admitted to the ED.

Methods: This prospective study was designed as a single-center observational study, including patients admitted to a tertiary ED between 16.06.2022 and 09.09.2022. Patients younger than 18, readmitted to the ED within 24 h, or absence of vital signs due to cardiac arrest were excluded from the study. Vital signs and comorbid diseases of all patients were recorded. The mortality within 24 h, the need for intensive care unit admission, emergency surgery, and life-saving procedures were considered "medical emergency conditions". The role of vital signs and comorbid diseases in predicting emergencies was analyzed by binary logistic regression.

Results: A total of 10,022 patients were included in the study; 5056 (50.4%) were female, and 4966 (49.6%) were male. Six hundred four patients presented with an MEC. All vital signs -except diastolic hypertension and tachycardia- and comorbidities were found statistically significant. Hypoxia (Odd's Ratio [OR]: 1.73), diastolic hypotension (OR: 3.71), tachypnea (OR: 8.09), and tachycardia (OR: 1.61) were associated with MECs. Hemiplegia (OR: 5.7), leukemia (OR: 4.23), and moderate-severe liver disease (OR: 2.99) were the most associated comorbidities with MECs. In our study, an MEC was detected in 3.6% (186 patients) of the patients with no abnormal vital signs and without any comorbidities.

Conclusion: Among the vital signs, hypoxia, diastolic hypotension, tachypnea, and tachycardia should be considered indicators of an MEC. Hemiplegia, leukemia, and moderate-severe liver disease are the most relevant comorbidities that may accompany the MECs.

从分诊生命体征和合并症预测成人急诊病人病情:一项单中心观察研究。
背景:生命体征和合并疾病是急诊科(ED)收治病人的首要评估信息。大多数急诊科仅根据生命体征和入院主诉对患者进行分诊。在分诊区确定患者状况时,合并症通常会被低估。本研究旨在评估急诊室收治病人的初始生命体征、合并症和医疗紧急情况(MEC)之间的关系:这项前瞻性研究是一项单中心观察性研究,研究对象包括 2022 年 6 月 16 日至 2022 年 9 月 9 日期间入住三级急诊室的患者。小于 18 岁、24 小时内再次入院或因心脏骤停而无生命体征的患者不在研究范围内。研究记录了所有患者的生命体征和合并症。24 小时内死亡、需要入住重症监护室、急诊手术和抢救程序均被视为 "医疗紧急情况"。通过二元逻辑回归分析了生命体征和合并疾病在预测急诊中的作用:研究共纳入 10022 名患者,其中女性 5056 人(50.4%),男性 4966 人(49.6%)。有 64 名患者出现 MEC。除舒张期高血压和心动过速外,所有生命体征和合并症均有统计学意义。缺氧(奇数比[OR]:1.73)、舒张压过低(OR:3.71)、呼吸过速(OR:8.09)和心动过速(OR:1.61)与 MEC 相关。偏瘫(OR:5.7)、白血病(OR:4.23)和中重度肝病(OR:2.99)是与 MEC 最相关的合并症。在我们的研究中,3.6%(186 名患者)的生命体征未见异常且无任何合并症的患者中发现了 MEC:结论:在生命体征中,缺氧、舒张期低血压、呼吸过速和心动过速应被视为 MEC 的指标。偏瘫、白血病和中重度肝病是可能伴随 MEC 的最相关合并症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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