Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias最新文献

{"title":"Considerations regarding the use of the sex/gender variable in research: moving towards good practice. Progenders decalogue.","authors":"Gisela Sugranyes, M Carmen Sebastià, Blanca García-Delgar, Eduard Forcadel, Blanca Coll-Vinent","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 4","pages":"303-305"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9819489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seat-belt injuries: clinical presentation and need for surgery.","authors":"Nerea Quílez Trasobares, Yelco Chicote Carasa, Jesús Abelardo Barea Mendoza, Carlos García Fuentes, Mario Chico Fernández, Susana Borruel Nacenta","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 4","pages":"315-317"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9819491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decisions to admit vs. discharge patients with acute heart failure from the emergency department: consistency with a measure of severity of decompensation and the impact on prognosis.","authors":"Òscar Miró, Pere Llorens, Víctor Gil, María Pilar López Díez, Javier Jacob, Pablo Herrero, Lluís Llauger, Josep Tost, Alfons Aguirre, Carlos Bibiano, Marta Fuentes, María Luisa López Grima, Rodolfo Romero, Enrique Martín Mojarro, Aitor Alquézar Arbé, Héctor Alonso, Francisco Javier Martín-Sánchez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the consistency between decisions to discharge or admit patients with acute heart failure (AHF) treated in emergency departments (EDs) and the level of risk of adverse events, and to analyze the impact of decisions to discharge patients.</p><p><strong>Material and methods: </strong>Prospective study of baseline clinical data collected from patients diagnosed with AHF in 16 Spanish emergency departments. Patients were stratified by severity of decompensated AHF based on MEESSI assessment (Multiple Estimation of Risk Based on the Spanish Emergency Department Score). The distribution of severity was described for patients who were hospitalized (overall and for departments receiving the largest number of admissions) and for discharged patients. We analyzed the data for discharged patients for associations with the following quality-of-care indicators: all-cause mortality of less than 2% at 30 days, revisits to the ED for AHF in less than 10% of patients within 7 days of discharge, and revisits to the ED or admission for AHF in less than 20% within 30 days of discharge.</p><p><strong>Results: </strong>We included 2855 patients with a median (interquartile range) age of 84 (76-88) years. Fifty-four percent were women, 1042 (36.5%) were classified as low risk, 1239 (43.4%) as intermediate risk, 301 (10.5%) as high risk, and 273 (9.6%) as very high risk. Thirty-day mortality rates by level of low to very high risk were 1.9%, 9.3%, 15.3%, and 38.4%, respectively. One-year mortality rates by risk level were 15.4%, 35.6%, 52.0%, and 74.2%. Admission rates by risk level were 62.2%, 77.4%, 87.0%, and 88.3%. Overall, 47.1% o patients discharged from the ED were in the 3 higher-risk categories (intermediate to very high), and 30.7% were in the lowest risk category. The 5 hospital areas receiving the most admissions, in order of lowest-to-highest risk classification, were internal medicine, the short-stay unit, cardiology, intensive care, and geriatrics. Rates and 95% CIs for quality-of-care indicators in patients discharged from EDs were as follows: 30-day mortality, 4.3% (3.0%-6.1%); ED revisits within 7 days, 11.4% (9.2%-14.0%), and ED revisits or admissions within 30 days, 31.5% (28.0%-35.1%). In patients classified as low risk on ED discharge, these percentages were lower, as follows, respectively: 0.5% (0.1%-1.8%), 10.5% (7.6%-14.0%), and 29.5% (26.6%-32.6%).</p><p><strong>Conclusion: </strong>We detected disparity between severity of AHF decompensation and the decision to discharge or admit patients. Outcomes in patients discharged from EDs do not reach the recommended quality-of-care standards. Reducing inconsistencies between severity of decompensation and ED decisions could help to improve quality targets.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 4","pages":"261-269"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10498764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected call.","authors":"Johnnys Arzuza-Bustamante","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"224"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the frail patient in the emergency department: an urgent and necessary effort.","authors":"Sira Aguiló Mir","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"165-166"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9738999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training healthcare providers to respond to intimate partner violence against women.","authors":"Naira Kalra, Leesa Hooker, Sonia Reisenhofer, Gian Luca Di Tanna, Claudia García-Moreno","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"221-223"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10138915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term prognosis and emergency management for patients with an implantable cardioverter defibrillator: the EMERGE-ICD study.","authors":"Coral Suero, Alfonso Martín, Blanca Coll-Vinent, Esteban González-Torrecilla, José Ormaetxe, Miguel Álvarez, Carmen Del Arco, Manuel Cancio, Mercedes Varona, Susana Sánchez, Juan Sánchez, Ignacio Fernández-Lozano, Fernando Arribas, María Martín-Méndez, Rafael Peinado","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with implantable cardioverter defibrillators (ICDs) are at risk of serious complications that are often treated in hospital emergency departments (EDs). The EMERG-ICD study (Emergency Department Management and Long-term Prognosis for Patients with ICDs) analysed management and long-term prognosis of ED patients with an ICD after an acute clinical event.</p><p><strong>Material and methods: </strong>Observational multicenter cohort study including consecutive adult patients with ICDs who came to 27 hospital EDs in Spain for treatment and were followed for 10 years. We collected clinical variables on presentation, ED case management variables, and the date and cause of death in each case. The primary outcome variable was all-cause mortality.</p><p><strong>Results: </strong>Five-hundred three patients were studied; 471 had structural heart disease (SHD) and 32 had primary electrical heart disease (PEHD). Beta-blockers were prescribed in the ED for 55% of the patients for whom they were indicated. Twenty-four (4.8%), 75 (15.7%), and 368 (73.2%) patients died during follow-up at 1 month, 1 year, and 10 years, respectively. Of these, 363 (77.1%) had SHD and 5 (15.6%) had PEHD (hazard ratio, 8.05 (95% CI, 3.33- 19.46). Among patients with SHD, the cause of death was cardiovascular in 66%. Mortality correlated significantly with seeking care for cardiovascular symptoms, advanced age, male sex, diabetes, a New York Heart Association score of 2 or more, severe ventricular dysfunction, and long-term amiodarone therapy.</p><p><strong>Conclusion: </strong>Prognosis after an acute clinical event is poor in patients with SHD and ICDs, mainly due to cardiovascular causes, especially among patients with associated comorbidities and cardiovascular complaints. Mortality is lower in patients with PEHD.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"185-195"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct admission to home hospitalization from the emergency department: feasible, efficient, and necessary.","authors":"Carlos Bibiano Guillén","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"163-164"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9738998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist care in hospital emergency departments: a consensus paper from the Spanish hospital pharmacy and emergency medicine associations.","authors":"Jesús Ruiz Ramos, Beatriz Calderón Hernanz, Yolanda Castellanos Clemente, Manuel Bonete Sánchez, Emili Vallve Alcon, M ª Rosario Santolaya Perrin, M ª Ángeles García Martín, Ana de Lorenzo Pinto, José Manuel Real Campaña, Javier Ramos Rodríguez, Cristina Calzón Blanco, Milagros García Peláez, Héctor Alonso Ramos, Joan Altimiras Ruiz, Paloma Sempere Serrano, María Martín Cerezuela, Leonor Periañez Parraga, Ana María Juanes Borrego, Beatriz Somoza Fernández, Juan Manuel Rodríguez Camacho, Mireia Puig Campmany, Iria Miguens Blanco, Santiago Tomás Vecina, Catalina Nadal Galmes, Javier Povar Marco","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To draft a list of actions and quality indicators for pharmacist care in hospital emergency departments, based on consensus among a panel of experts regarding which actions to prioritize in this setting.</p><p><strong>Material and methods: </strong>A panel of experts from the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Emergency Medicine (SEMES) evaluated a preliminary list of potential actions and quality of care indicators. The experts used a questionnaire to assess the proposals on the basis of available evidence. In the first round, each expert individually assessed the importance of each proposed action based on 4 dimensions: evidence base, impact on clinical response and patient safety, ease of implementation, and priority. In the second round the experts attended a virtual meeting to reach consensus on a revised list of proposals; suggestions and comments that had been made anonymously in the first round were included. The group then prioritized each action as basic, intermediate, or advanced.</p><p><strong>Results: </strong>The experts evaluated a total of 26 potential actions and associated quality indicators. No items were eliminated in the analysis of scores and comments from the first round. After the second round, 25 actions survived. Nine were considered basic, 10 intermediate, and 6 advanced.</p><p><strong>Conclusion: </strong>The expert panel's list of pharmacist actions and care quality indicators provides a basis for developing a pharmacist care program in Spanish emergency departments on 3 levels of priority. The list can serve as a guide to pharmacists, managers, physicians, and nurses involved in the effort to improve drug therapy in this hospital setting.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"205-217"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the feasibility and usefulness of basic life support ambulances in prehospital care for stroke: Does type of ambulance matter in acute stroke?","authors":"José María Trejo-Gabriel-Galán, Jerónimo González-Bernal","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"161-162"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9738997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}