Emergency Medicine International最新文献

{"title":"Assessment of Cardiopulmonary Resuscitation Knowledge Among Physicians in the Pediatrics Department of an Urban Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study.","authors":"Muluwork Tefera Dinberu, Dagmawi Hailu Yemane","doi":"10.1155/2024/8815197","DOIUrl":"10.1155/2024/8815197","url":null,"abstract":"<p><p><b>Background:</b> Early recognition of cardiac arrest and prompt start of cardiopulmonary resuscitation (CPR) boost survival rates and reduce postarrest consequences. Little information is available about the fundamental CPR knowledge of healthcare workers who work with children in Ethiopia. <b>Methods:</b> All physicians, regardless of seniority, participated in this cross-sectional survey from June to August 2022. They received a structured survey that was modified from the American Heart Association (AHA) Basic Life Support (BLS) test which was made up of 10 questions about participants' job experience and 25 multiple-choice CPR knowledge questions. Data analysis was done using a multinomial logistic regression test with a <i>p</i> value of 0.05. <b>Result:</b> One hundred sixty-eight doctors with various levels of seniority participated in this study. The participants included a male-to-female ratio of 1.3:1, a median age of 28 years, 92 (57.9%) male participants, and 124 (78%) participants with less than 5 years of clinical experience. Ninety-seven participants, or 61%, had scored less than 75% whereas 13 (8.2%), participants, had good knowledge that is scoring above 75%. Participants who had training in CPR within the previous year showed significantly higher levels of knowledge than those who hadn't. Even though 90% of the participants claimed to have CPR knowledge, the majority of participants were found not to have below 75%. <b>Conclusion:</b> The study concludes that while many doctors believe they have adequate CPR knowledge, actual knowledge levels are insufficient. Staff should undergo regular certification and assessments to ensure they retain their resuscitation knowledge. This ongoing evaluation is crucial for maintaining high standards of care and preparedness in emergencies.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"YouTube as a Source of Information in Trauma Management for ATLS (10th Edition) Guidelines: Evaluation of Trauma Management Videos on YouTube.","authors":"Merve Yazla, Seyma Handan Akyon, Esin Aslı Aybayar, Seyda Gedikaslan, Lukasz Szarpak, Omer Faruk Turan, Jacek Smereka, Mustafa Ekici, Abdullah Osman Kocak, Burak Katipoglu","doi":"10.1155/2024/7077469","DOIUrl":"10.1155/2024/7077469","url":null,"abstract":"<p><p><b>Background:</b> Trauma is one of the leading causes of mortality worldwide, and online platforms have become essential sources of information for trauma management. YouTube can play a significant role in helping people access medical information. <b>Methods:</b> YouTube was searched using the keywords management of trauma and assessment of trauma to identify relevant videos. Two authors independently evaluated the videos according to the ATLS (10th edition) guidelines, the modified DISCERN (m-DISCERN) scale, and the Global Quality Scale (GQS) criteria. The videos that met the study criteria were evaluated based on the provider, video length, and view count. <b>Results:</b> Out of 939 videos, 667 were excluded resulting in 272 videos included in the study. According to the ATLS (10th edition) guidelines, the median score for videos was 8 (IQR 7-8). Videos uploaded by official institutions and healthcare professionals received higher scores than from uncertain sources (<i>p</i> = 0.003). According to the GQS, 86% of the videos were low or moderate quality; uncertain sources uploaded 78% of low-quality videos. <b>Conclusion:</b> YouTube is an information source about trauma management that contains videos of varying quality and has a broad audience. Official institutions and healthcare professionals should be aware of this evolving technology and publish up-to-date, accurate content to increase awareness about trauma management and help patients distinguish helpful information from misleading content.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between the Advanced Cardiac Life Support and Adult Advanced Life Support Protocols: A Simulation-Based Pilot Study.","authors":"Fawaz Altuwaijri, Abdulaziz Alrabiah, Abdullah Alqarni, Alia Kamal Habash, Mohammad Alghofili, Omar Alotaibi, Mansour Altuwaijri","doi":"10.1155/2024/6696879","DOIUrl":"10.1155/2024/6696879","url":null,"abstract":"<p><p><b>Introduction:</b> Cardiac arrest is a public health concern associated with unfavorable disease outcomes. Cardiopulmonary resuscitation (CPR) of optimal quality is widely acknowledged as an indispensable technique in restoring spontaneous circulation. In order to perform advanced cardiac life support (ACLS), chest compression must be paused twice: once to assess the rhythm and again to administer the shock. Australian advanced life support (ALS) recommends that the defibrillator needs to be precharged in order to administer the shock during a solitary interval in chest compressions. While performing chest compressions, precharging defibrillators can decrease hands-off time without posing a risk of injury. <b>Aim:</b> To compare chest compression fraction (CCF)-which is the cumulative time spent providing chest compressions divided by the total time taken for the entire resuscitation-by calculating the hands-off time duration in cardiac arrest between the Australian Resuscitation Council (ARC) and American Heart Association (AHA) protocols for CPR. <b>Methods:</b> A simulation-based pilot study was designed using a Laerdal Resusci Anne mannequin and a LIFEPACK 20 defibrillator. The study included six participants recruited from King Khalid University Hospital in Riyadh, Saudi Arabia, where three participants were certified ACLS providers and there were certified ALS providers. Participants were divided into two groups, ALS and ACLS, each following one protocol. For each scenario, a random job was assigned to each participant, regardless of their role as assistant, team leader, or performer of CPR. Each case's shockable and nonshockable rhythms were hidden from the team leader and the chest compressor. Ten trials of CPR were performed, each for four cycles with a total time of 8 min. The simulation was video recorded for hands-off time counting. Comparison between CCF (seconds) per cycle between the two protocols was performed using an independent sample <i>t</i>-test. A <i>p</i> value of 0.05 was used to measure statistical significance. <b>Results:</b> Comparing CCF in shockable rhythms between ARC and AHA protocols, it was observed that the CCF of ALS-ARC was significantly higher than ACLS-AHA in all cycles; the first cycle: <i>t</i> = 3.782, <i>p</i>=0.004; the second cycle: <i>t</i> = 3.380, <i>p</i>=0.007; the third cycle: <i>t</i> = 3.803, <i>p</i>=0.003; and the fourth cycle: <i>t</i> = 4.341, <i>p</i>=0.001. <b>Conclusion:</b> Precharging a defibrillator before a rhythm check during chest compression, in anticipation of a potentially shockable rhythm, reduces the time required for defibrillation and limits interruptions in chest compression during CPR. This practice effectively enhances the CCF. Enhancing the continuity of chest compressions can potentially improve survival rates in ARC.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiomics Analysis Identifies Prognostic Signatures for Sepsis-Associated Hepatocellular Carcinoma in Emergency Medicine.","authors":"Xin Chu, Qi Wu, Linglin Kong, Qiang Peng, Junhua Shen","doi":"10.1155/2024/1999820","DOIUrl":"https://doi.org/10.1155/2024/1999820","url":null,"abstract":"<p><strong>Objectives: </strong>Sepsis, caused by the body's response to infection, poses a life-threatening condition and represents a significant global health challenge. Characterized by dysregulated immune response to infection, sepsis may lead to organ dysfunction and failure, ultimately resulting in high mortality rates. The liver plays a crucial role in sepsis, yet the role of differentially expressed genes in septic patients remains unclear in hepatocellular carcinoma (HCC). In this study, we aim to investigate the significance of differentially expressed genes related to sepsis in the occurrence and prognosis of tumors in HCC.</p><p><strong>Methods: </strong>We conducted analyses by obtaining gene transcriptome data and clinical data of HCC cases from The Cancer Genome Atlas (TCGA). Furthermore, we obtained transcriptomic sequencing results of septic patients from the Gene Expression Omnibus (GEO) database, identified intersecting differentially expressed genes between the two, and performed survival analysis on the samples using LASSO and Cox regression analysis. Combining analyses of tumor mutation burden (TMB) and immune function, we further elucidated the mechanisms of sepsis-related genes in the prognosis and treatment of HCC.</p><p><strong>Results: </strong>We established a prognostic model consisting of four sepsis-related genes: KRT20, PAEP, CCR3, and ANLN. Both the training and validation sets showed excellent outcomes in the prognosis of tumor patients, with significantly longer survival times observed in the low-risk group based on this model compared to the high-risk group. Furthermore, analyses, such as differential analysis of tumor mutation burden, immune function analysis, GO/KEGG pathway enrichment analysis, and drug sensitivity analysis, also demonstrated the potential mechanisms of action of sepsis-related genes.</p><p><strong>Conclusions: </strong>Models constructed based on sepsis-related genes have shown excellent predictive ability in prognosis and differential analysis of drug sensitivity among tumor patients. These predictive models can enhance patient prognosis and inform the creation of early treatment protocols for sepsis, consequently aiding in the prevention of sepsis-induced HCC development through the modulation of the overall immune status. This may play a crucial role in patient management and immunotherapy, providing valuable reference for subsequent research.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPR-Induced Consciousness during Ventricular Fibrillation: Case Report and Literature Review.","authors":"Xiaoqing Zhou, Boru Sun","doi":"10.1155/2024/2834376","DOIUrl":"10.1155/2024/2834376","url":null,"abstract":"<p><strong>Introduction: </strong>Over the years, numerous studies have suggested the occurrence of a peculiar phenomenon known as \"CPRIC\" during the revival process. The revelation of this phenomenon has ignited widespread discussion and investigation, yet many enigmas remain unsolved. This study describes the case of a 52-year-old man diagnosed with acute anterior myocardial infarction, who experienced ventricular fibrillation while awaiting further treatment. Despite ultimately not regaining spontaneous circulation, he remained conscious for a period during chest compressions and showed signs of resistance.</p><p><strong>Methods: </strong>PubMed and Web of Science were searched until July 11, 2024. We included original studies and case reports relevant to CPRIC. For case reports, we extracted information on the author (year), country, patients, location, compression, signs of CPRIC, treatment of CPRIC, and patient outcomes. For other studies, we included the author (year), country, participants, and results. The extracted data were synthesized using a narrative approach.</p><p><strong>Results: </strong>Of 3038 articles, 32 were included, i.e., 18 case reports (24 cases), 9 cross-sectional surveys, and 5 cohort studies. In CPRIC cases, patients exhibited various manifestations including opening their eyes, speaking, and moving. Other included studies explored healthcare workers' awareness and experiences of CPRIC, the incidence and manifestations of CPRIC, the impact of CPRIC on patient outcomes, memories and perceptions of cardiac arrest indicating consciousness, the effects of CPRIC on rescuers, and the management of CPRIC.</p><p><strong>Conclusions: </strong>There is an urgent need to establish a globally recognized definition of CPRIC. It is crucial to develop clear algorithms that focus not only on identifying this phenomenon but also on determining the best approaches to manage it. Furthermore, CPRIC can cause multiple interruptions during CPR, making it essential to differentiate whether these interruptions are due to CPRIC or indicative of a return of spontaneous circulation.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Bedside Lung Ultrasound in Detecting Traumatic Pneumothorax by Novice Physicians in the Emergency Department of a Tertiary Care Hospital of Nepal.","authors":"Monisma Malla, Anmol Purna Shrestha, Shailesh Prasad Shrestha, Roshana Shrestha","doi":"10.1155/2024/9956637","DOIUrl":"https://doi.org/10.1155/2024/9956637","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic pneumothorax is a life-threatening condition requiring vigilant clinical assessment and urgent management. Lung ultrasound (LUS) is considered to be a safer, rapid, and accurate modality for the early diagnosis of traumatic pneumothorax. The principle objective of this study was to evaluate the diagnostic accuracy of bedside LUS performed by trained novice physicians in the diagnosis of traumatic pneumothorax as compared to supine chest X-rays (CXRs) and/or computed tomography (CT) scans and/or air leak during needle/tube thoracostomy as composite standard.</p><p><strong>Methods: </strong>It is a prospective, cross-sectional, single-blinded study using a nonprobability quota sampling technique. A total of 96 patients presenting to the emergency department (ED) with polytrauma and chest injuries within a period of twelve months were included. The diagnostic accuracy of bedside LUS performed by trained novice physicians was calculated in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared with the composite standard.</p><p><strong>Results: </strong>The sensitivity of LUS in diagnosing traumatic pneumothorax as compared to the composite standard was 100% (95% confidence interval (CI): 59.05%-100.00%), whereas its specificity was 97.75% (95% CI: 92.12%-99.73%). Similarly, the PPV and NPV of LUS were 77.7% (95% CI: 39.99%-97.19%) and 100% (95% CI: 95.85%-100.00%), respectively.</p><p><strong>Conclusion: </strong>The results of the study showed that the application of LUS in detecting traumatic pneumothorax had similar diagnostic accuracy as supine CXR. Bedside LUS is widely available, portable, and inexpensive. It also has the capability of real-time imaging and can be repeated as necessary with less risk of radiation exposure. Therefore, physicians working in tertiary and rural health institutions must be trained adequately in order to uplift the clinical utility of LUS for the timely and cost-effective detection of traumatic pneumothorax.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostatic Interventions and All-Cause Mortality in Hemodynamically Unstable Pelvic Fractures: A Systematic Review and Meta-Analysis.","authors":"XuWen Zheng, MaoBing Chen, Yi Zhuang, Jin Xu, Liang Zhao, YongJun Qian, WenMing Shen, Ying Chu","doi":"10.1155/2024/6397444","DOIUrl":"10.1155/2024/6397444","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a systematic review and meta-analysis of the all-cause mortality associated with the most commonly used hemostatic treatments in patients with hemodynamically unstable pelvic fractures.</p><p><strong>Methods: </strong>Up to April 30, 2023, we searched PubMed, Embase, Web of Science, and Cochrane, including the references to qualified papers. A meta-analysis was performed on studies that reported odds ratios (ORs) or the number of events needed to calculate them. The PROSPERO registration number was CRD42023421137.</p><p><strong>Results: </strong>Of the 3452 titles identified in our original search, 29 met our criteria. Extraperitoneal packing (EPP) (OR = 0.626 and 95% CI = 0.413-0.949), external fixation (EF) (OR = 0.649 and 95% CI = 0.518-0.814), and arterial embolism (AE) (OR = 0.459 and 95% CI = 0.291-0.724) were associated with decreased mortality. Resuscitative endovascular balloon occlusion of the aorta (REBOA) (OR = 2.824 and 95% CI = 1.594-5.005) was associated with increased mortality. A random effect model meta-analysis of eight articles showed no difference in mortality between patients with AE and patients with EPP for the initial treatments for controlling blood loss (OR = 0.910 and 95% CI = 0.623-1.328).</p><p><strong>Conclusion: </strong>This meta-analysis collectively suggested EF, AE, or EPP as life-saving procedures for patients with hemodynamically unstable pelvic fractures.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of CD4+ T Lymphocyte Counts to Predict Survival of ICU Patients with Sepsis Using Sepsis-3 Criteria: A Prospective Cohort Study.","authors":"Guoge Huang,Xusheng Li,Chunmei Zhang,Haizhong Li,Mengling Jian,Chunyang Huang,Yingqin Zhang,Luhua Xian,Hongke Zeng,Yuanyuan Xia,Wenqiang Jiang","doi":"10.1155/2024/4293700","DOIUrl":"https://doi.org/10.1155/2024/4293700","url":null,"abstract":"BackgroundSepsis remains a major health condition with a high mortality rate that may be related to immunosuppression. T lymphocyte subsets may reflect the immune function of sepsis patients. The purpose of this study was to investigate the predictive value of CD4+ T lymphocyte counts of ICU patients for their short-term prognosis.MethodsWe conducted a prospective, observational cohort study in a general ICU and enrolled patients with sepsis using the Sepsis-3 criteria. Peripheral blood samples were collected within 24 hours of enrollment or measurement of blood cell analysis and biomarkers of CD4+ T lymphocytes and CD8+ T lymphocytes. Severity was classified by the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment (SOFA) scores. The primary outcome was 28-day mortality.ResultsA total of 100 patients with sepsis were enrolled and analyzed. CD4+ T lymphocyte counts gradually decreased based on 28-day mortality (p < 0.001). Similarly, multivariate logistic regression analysis showed that only CD4+ T lymphocyte counts were an independent predictor of 28-day mortality in sepsis patients. The area under the receiver operating characteristic curve of the combination of CD4+ T lymphocyte counts and the SOFA score was 0.78.ConclusionOur study demonstrated that CD4+ T lymphocyte counts are associated with 28-day mortality. A combination of CD4+ T lymphocyte counts with the SOFA score increased the predictive accuracy for 28-day mortality.","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Injury Severity Score (ISS) and New Injury Severity Score (NISS) in the Evaluation of Thoracic Trauma Patients: A Retrospective Cohort Study.","authors":"He Jin, Yuanyuan Zhang, Qi Zhang, Lijuan Ouyang, Xueyao Li, Yiyan Zhang, Baosheng Yang, Junfeng Sun, Chaohui Wei, Guimei Yang, Li Guan, Shilan Luo, Junyu Zhu, Huaping Liang","doi":"10.1155/2024/4861308","DOIUrl":"10.1155/2024/4861308","url":null,"abstract":"<p><strong>Objective: </strong>To explore the value of the injury severity score (ISS) and the new injury severity score (NISS) for evaluating injuries and predicting complications (pneumonia and respiratory failure) and poor prognoses (in-hospital tracheal intubation, extended length of hospital stay, ICU admission, prolonged ICU stay, and death) in patients with thoracic trauma.</p><p><strong>Methods: </strong>The data of consecutive patients with thoracic trauma who were admitted to the department of cardiothoracic surgery of a tertiary hospital between January 2018 and December 2021 were retrospectively collected. ISS and NISS were calculated for each patient. The study outcomes were complications and poor prognoses. The differences in ISS and NISS between patients with complications and poor prognoses and patients without the abovementioned conditions were compared using the Mann‒Whitney <i>U</i> test. Discrimination and calibration of ISS and NISS in predicting outcomes were compared using the area under the receiver operating characteristic (ROC) curve (AUC) and Hosmer‒Lemeshow (H-L) statistic.</p><p><strong>Results: </strong>A total of 310 patients were included. ISS and NISS of patients with complications and poor prognoses were greater than those of patients without complications and poor prognoses, respectively. The discrimination of ISS in predicting pneumonia, respiratory failure, in-hospital tracheal intubation, extended length of hospital stay, ICU admission, prolonged ICU stay, and death (AUCs: 0.609, 0.721, 0.848, 0.784, 0.763, 0.716, and 0.804, respectively) was not statistically significantly different from that of NISS in predicting the corresponding outcomes (AUCs: 0.628, 0.712, 0.795, 0.767, 0.750, 0.750, and 0.818, respectively). ISS showed better calibration than NISS for predicting pneumonia, respiratory failure, in-hospital tracheal intubation, extended length of hospital stay, and ICU admission but worse calibration for predicting prolonged ICU stay and death.</p><p><strong>Conclusion: </strong>ISS and NISS are both suitable for injury evaluation. There was no statistically significant difference in discrimination between ISS and NISS, but they had different calibrations when predicting different outcomes.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hepatic Portal Venous Gas on the Prognosis of Traumatic Out-of-Hospital Cardiac Arrest: A Reason to Consider Terminating Cardiopulmonary Resuscitation.","authors":"Seok Ran Yeom, Mun Ki Min, Dae Sup Lee, Min Jee Lee, Mo Se Chun, Sung Wook Park, Wook Tae Yang","doi":"10.1155/2024/7756946","DOIUrl":"10.1155/2024/7756946","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the prognosis of traumatic out-of-hospital cardiac arrest (OHCA) by assessing the presence of hepatic portal vein gas (HPVG) observed in ultrasound (US) or point-of-care ultrasonography (POCUS) performed during CPR. Furthermore, we aimed to understand the role of HPVG in decision-making regarding CPR discontinuation or withholding in traumatic OHCA.</p><p><strong>Methods: </strong>The retrospective study was conducted at the level 1 trauma center of urban academic medical centers in South Korea. We included adult trauma OHCA patients who underwent CPR between January 1, 2020, and June 30, 2022. Data on traumatic OHCA patients who presented to the level I trauma center during this period were extracted from the hospital's electronic medical record system. The arrest data were separately managed through the hospital's electronic medical record system for quality control, specifically the arrest registry. US images or clips of the hepatic portal vasculature (HPV) during CPR were used to assess the presence of HPVG. These images were independently reviewed by two emergency medicine physicians with several years of US examination experience who were blinded to all clinical details and outcomes. We evaluated the prognosis of traumatic OHCA by assessing the presence of HPVG using the US. In addition, we analyzed the general characteristics and assessed the impact on the ROSC in traumatic OHCA.</p><p><strong>Results: </strong>Among the 383 cardiac arrest patients, 318 traumatic OHCA patients were included. The mean age was 54.9 ± 19.4 years, and most patients were male. The initial rhythm was mainly asystole, and falls were the most frequent cause of injury. The overall ROSC rate was 18.8%, with a survival rate of 7.2% at hospital discharge. Among the 50 patients who underwent a US examination of HPV, 40 showed HPVG. The HPVG group had a significantly lower ROSC rate and survival rate at ED discharge and hospital discharge compared to the group without HPVG.</p><p><strong>Conclusion: </strong>Traumatic OHCA with HPVG presents a significantly worse prognosis. This suggests that early consideration of termination or withholding of CPR may be appropriate in such cases.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}