Emergency最新文献

{"title":"The Accuracy of Ultrasonography in Detection of Ulnar Collateral Ligament of Thumb Injuries; a Cross-Sectional Study","authors":"B. Shekarchi, Mohammadreza Mokhdanzadeh Dashti, M. Shahrezaei, E. Karimi","doi":"10.22037/EMERGENCY.V6I1.20463","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.20463","url":null,"abstract":"Introduction: Timely diagnosis and treatment of traumatic injury to ulnar collateral ligament (UCL) of thumb is of special importance for preserving the full function of the hand. Therefore, the present study has been designed with the aim of evaluating the accuracy of ultrasonography in detection of these injuries. Methods: The present diagnostic accuracy study was performed on trauma patients over 15 years old who had clinical evidence of injury to UCL of thumb and were admitted to the emergency department. All patients were evaluated regarding injury to the mentioned ligament via ultrasonography and MRI and finally, the accuracy of ultrasonography in this regard was measured considering MRI as the reference test. Results: 20 individuals with the mean age of 38.60 ± 13.45 (16 – 64) years were evaluated (60% male). Based on ultrasonography and MRI findings 7 (35%) individuals and 7 (35%), respectively had complete ligament rupture (kappa: 0.560 (95% CI: 0.179 – 0.942)). Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio of ultrasonography in detecting injuries of the mentioned ligament were 71.42 (30.25 – 94.88), 84.61 (53.66 – 97.28), 71.42 (30.25 – 94.88), 84.61 (53.66 – 97.28), 2.5 (0.71 – 8.82), and 0.18 (0.04 – 0.67), respectively. Conclusion: Based on the findings of the present study, performance of ultrasonography by a radiologist in the emergency department has 80% accuracy in detecting traumatic injuries of UCL of the thumb.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44388282","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":"Brain Natriuretic Peptides in Screening of Syncope with Cardiac Origin; a Commentary","authors":"Hamideh Feiz Disfani, M. Kamandi, Kazem Rahmani","doi":"10.22037/EMERGENCY.V6I1.19718","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.19718","url":null,"abstract":"Syncope is a serious problem with life-time prevalence of 35%. It is estimated that 1 -3% of referrals to emergency departments and in-patient admissions are due to syncope. The underlying conditions can be cardiac or neurologic. Considering the completely different circumstances ruling the encounters with cardiac and neurologic syncope, in recent years many attempts have beenmade to find the proper tool for differentiating cardiac and non-cardiac causes of syncope. The result of which is formation of some clinical decision rules including San Francisco Syncope Rule (SFSR), Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL), Evaluation of Guidelines in Syncope Study (EGSYS), risk stratification of syncope in the emergency department (Rose), and Boston Syncope Rules. The serum marker brain natriuretic peptide (BNP), which is becoming increasingly established in emergency departments for diagnosis of acute heart failure, can reflect the presence of a structural heart disease. It seems that BNP could be considered as a screening tool in detection of syncope with cardiac origin. In a study by Wojtowicz J et al. who evaluated BNP in children and adolescents with syncope, there was no significant difference in terms of BNP level between the syncope and control groups. In contrast, Zhang Q et al. concluded that serum BNP is helpful in differentiating cardiac (958.78 § 2443.41 pg/mL) and non-cardiac (31.05 § 22.64 pg/mL) syncope. Tanimoto K et al. considered the cut-off value of 40 pg/ml for BNP in differentiating cardiac and non-cardiac syncope and found that it had 82% sensitivity and 92% specificity. A significant difference was observed in BNP level of the cardiac group (514 pg/ml) compared to the non-cardiac ones (182 pg/ml) in Pfister et al. study. It seems that, more research is needed to clarify this relationship and the variables that might play the role of confounders in a causal inference. More studies on children are required because there is some controversy regarding this relationship. Running studies with accurate methodology, large sample sizes, and in a multicentric fashion could be helpful in this regard.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42512623","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":"Key Performance Indicators of Chest Pain Management in Emergency Department; a Letter to the Editor","authors":"Mehrdad Taghizadeh, Roghayeh Taghipour, K. Heydari","doi":"10.22037/EMERGENCY.V6I1.20462","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.20462","url":null,"abstract":"Chest pain is a common complaint among those presenting to emergency department (ED) and is associated with a high rate of mortality. Based on National Center for Health Statistics, chest pain leads to about 6 million visits to EDs in United State. In Iran, ischemic cardiac diseases are the second cause of death in people aged 15 to 49 years. While less than 10% of the patients presenting to ED with chest pain are affected with myocardial infarction (MI), 33% of MI cases are silent. Timely diagnosis and revascularization of ischemic part, using thrombolytic agents or percutaneous coronary intervention (PCI), can save cardiac function and the patient’s life. Therefore, in this regard the emphasis is on rapid referral of the patients to treatment centers, initiation of diagnostic measures such as electrocardiography (ECG) and in case of meeting the required criteria, transfer to cat lab for PCI. American Heart Association (AHA) has introduced the proper door to ECG time as 10 minutes if it has not been done in the ambulance. Based on this recommendation, AHA has defined the aims of coronary reperfusion as prescription of thrombolytic in the initial 30 minutes after admission of the patient to ED or PCI in the initial 90 minutes after admission to ED.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47090776","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":"Emergency Department Bedside Ultrasonography for Diagnosis of Acute Cholecystitis; a Diagnostic Accuracy Study","authors":"B. Shekarchi, Seyed Zia Hejripour Rafsanjani, Nima Shekar Riz Fomani, M. Chahardoli","doi":"10.22037/EMERGENCY.V6I1.19647","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.19647","url":null,"abstract":"Introduction: Using bedside ultrasound in diagnosing acute cholecystitis in the emergency department (ED) can save time, help the decision making process and allocate resources wisely. This study aimed to evaluate the diagnostic accuracy of bedside right upper quadrant (RUQ) ultrasonography in detection of acute cholecystitis. Method: In this diagnostic accuracy study, patients presenting to ED, suffering from RUQ pain in favor of acute cholecystitis underwent RUQ ultrasonography in emergency and radiology departments and interrater agreement between reports was calculated. Results: 342 patients with the mean age of 53.92 ± 11.18 (20 – 83) years were studied (63.2% female). The number of patients with at least one sonographic finding of acute cholecystitis were 53 (15.50%) and 48 (14.00%) based on ED and radiology reports (Kappa = 0.826). Sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios of bedside sonography were 89.58 (95%CI: 76.55 – 96.10), 96.59 (95%CI: 93.63 – 98.29), 81.13 (95%CI: 67.58 – 90.11), 98.26 (95%CI: 95.77 – 99.36), 4.30 (95%CI: 2.42 – 7.62) and 0.017 (95%CI: 0.007 – 0.041), respectively. Conclusion: There was a very good agreement between ED and radiology departments’ sonography reports regarding the presence or absence of acute cholecystitis. Sensitivity and specificity of bedside RUQ sonography were 89.58 and 96.59, respectively.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41667241","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":"Accuracy of Neck stiffness, Kernig, Brudzinski, and Jolt Accentuation of Headache Signs in Early Detection of Meningitis","authors":"A. Ala, F. Rahmani, S. Abdollahi, Z. Parsian","doi":"10.22037/AAEM.V6I1.51","DOIUrl":"https://doi.org/10.22037/AAEM.V6I1.51","url":null,"abstract":"Introduction: The diagnostic value of clinical signs in early diagnosis of meningitis has been evaluated but the existing results are contradicting. The present study aimed to evaluate the accuracy of Kernig, Brudzinski, neck stiffness, and Jolt Accentuation of Headache (JAH) signs in this regard. Methods: In this diagnostic accuracy study, patients with suspected meningitis who were referred to the emergency department were examined regarding presence or absence of the mentioned clinical signs and screening performance characteristics of the signs were calculated. Cerebrospinal fluid analysis was used as the reference test. Results: 120 cases with mean age of 48.79 ± 21.68 years (18 – 93) were studied (63.3% male). Diagnosis of meningitis was confirmed for 45 (37.5%) cases. Neck stiffness (p < 0.001), Kernig (p < 0.001), Brudzinski (p < 0.001), and JAH (p < 0.001) had significantly higher frequency among patients with meningitis. The accuracy of neck stiffness, Kernig, Brudzinski, and JAH signs in early detection of meningitis were 0.676 (95% CI: 0.575-0.776), 0.667 (95% CI: 0.552-0.782), 0.720 (95% CI: 0.619-0.821), 0.749 (95% CI: 0.659-839), respectively. Conclusions: It seems that diagnostic value of JAH is higher than other clinical signs but the accuracy of all signs is in poor to fair range. JAH had the highest sensitivity and Kernig and Brudzinski had the highest specificity.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41353230","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":"Dexmedetomidine-Fentanyl versus Midazolam-Fentanyl in Pain Management of Distal Radius Fractures Reduction; a Randomized Clinical Trial","authors":"Ali Arhami Dolatabadi, Elham Memary, Majid Shojaee, Hossein Kamalifard","doi":"10.22037/EMERGENCY.V6I1.19907","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.19907","url":null,"abstract":"Introduction: Currently, using various combinations of narcotic and analgesic drugs has received attention for induction of sedation and analgesia due to their synergy in controlling pain and anxiety. The present study was designed with the aim of comparing dexmedetomidine-fentanyl combination with midazolam-fentanyl in this regard.  Methods: In this randomized clinical trial, patients diagnosed with distal radius fracture who had visited the emergency department (ED) were allocated to either the group receiving the combination of fentanyl-midazolam or the one receiving dexmedetomidine-fentanyl for procedural sedation and analgesia (PSA) and were compared regarding analgesic characteristics, time to recovery and side effects.  Results: 80 patients with the mean age of 42.08 ± 12.17 (18 - 60) years were randomly allocated to 2 groups of 40 (83.80% male). The 2 groups did not have a significant difference regarding baseline characteristics as well as pain severity.  Mean pain score at the time of procedure was 3.47 ± 1.37 in dexmedetomidine and 2.85 ± 1.05 in midazolam group (p = 0.025). In addition, time to recovery in dexmedetomidine and midazolam groups was 6.60 ± 1.86 minutes and 12.70 ± 1.70 minutes, respectively (p < 0.001). Out of the 9 patients who experienced treatment failure, 8 (88.90%) patients were in dexmedetomidine group and 1 (11.10%) was in midazolam group (p = 0.029). Absolute risk increase rate of treatment failure in case of using dexmedetomidine instead of midazolam was 17.50% (95%CI: 4.19 – 30.81) and number needed to harm was 6.00 (95% CI: 3.20 – 23.80).  Conclusion: Although the combination of dexmedetomidine-fentanyl had a shorter time to recovery compared to midazolam-fentanyl for induction of sedation and analgesia, the treatment failure rate in case of using dexmedetomidine with 1 µg/kg increased 17.5% and about 1 out of each 6 patients needed a rescue dose.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45029435","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":"Dissimilarity in the Frequency of Venous Thromboembolism Risk Factors among Studies, a Commentary","authors":"Meghdad Sedaghat, Mahsa Soltani, M. Solooki","doi":"10.22037/EMERGENCY.V6I1.20152","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.20152","url":null,"abstract":"Venous Thromboembolism (VTE) is the 3rd most prevalent vascular disease behind myocardial infarction and cerebrovascular ischemic attack. This disorder has received attention from health policy makers because of its major complications including recurrent VTE, post thrombotic syndrome, sudden cardiac death and high mortality rate. In the United States, VTE was reported in approximately 201000 cases annually, 25% of which expired within 7 days after diagnosis and 22% of mortalities did not have a definitive diagnosis. Despite the progression in diagnosis and treatment of VTE since 1979, its incidence did not decrease dramatically. This gap declares that VTE risk factors, especially transient ones, have not been detected completely. Obesity, history of VTE, family history of VTE, recent surgery, malignancy, myeloproliferative disorders, trauma, pregnancy, post-menopausal hormone therapy, hereditary syndromes like anti phospholipid syndrome (APS), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), blood transfusion and older age are determined as major risk factors. These factors can be categorized into two major subgroups as intrinsic and predisposing. Recent investigations focused on predisposing ones, which can be justified. Designing a cross sectional study in Imam Hossein Hospital, Tehran, Iran, from 2016 to 2017, we found that inactivity due to disability (30.9%), smoking (29.3%), and active malignancy (18.1%), were the most prevalent transient risks factor of VTE in our sample, respectively. Similar to our results, Kesieme et al. and Cushman et al. declared that VTE is more diagnosed in the elderly. Park MS et al. introduced recent surgery, trauma (73%), and disability to walk (62%) as major independent risk factors of VTE. Fuji T et al. introduced malignancy, recent infectious disease, and obesity as the factors predisposing patients who were admitted for orthopedic surgery to VTE. As can be seen, despite the risk factors of VTE being the same in various studies, their frequency varied between the studies. Population and cultural characteristics and various habits may have an effect in this regard. Therefore, it is suggested to performa multi-center, comprehensive study considering all the racial and ethnic in order to have a correct pattern of the frequency of predisposing factors of this disease in the Iranian population for health and prevention programs.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45215298","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":"Workplace Violence against Residents in Emergency Department and Reasons for not Reporting Them; a Cross Sectional Study","authors":"Gilava Hedayati Emam, H. Alimohammadi, Akram Zolfaghari Sadrabad, H. Hatamabadi","doi":"10.22037/EMERGENCY.V6I1.19430","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.19430","url":null,"abstract":"Introduction: Due to the stressful nature of emergency Department (ED), residents in ED are at risk of violence from patients or their associates. This study aimed to determine the prevalence of workplace violence against ED residents and the reasons for not reporting them. Methods: This cross-sectional study was conducted on ED residents of three educational hospitals, Tehran, Iran, during 2015. The national questionnaire about workplace violence was used for data gathering. In addition, prevalence of reporting the violence and the reasons for not reporting them were determined. Results: 280 questionnaires were analyzed. The mean age of residents was 32.2 ± 4.6 years (58.4% female). 224 (80%) residents stated that they had not passed any educational courses on violence management. The most prevalent type of violence was verbal (90.7%) and patients’ associates (85.4%) were the most common source of aggression. The frequency of physical violence was higher in male aggressors (p = 0.001), resident age > 30 years (p = 0.044), aggressor age > 30 years (p = 0.001), and night shift (p = 0.001). The same trend was observed regarding verbal and racial-ethnic violence. There was no significant relationship between residents’ sex, resident's specialty, and presence of security and police with frequency of violence. 214 (76.4%) residents did not report the violence, and the main reasons for not reporting from their viewpoint were uselessness of reporting (37.4%) and insignificance of the violence (36.9%). Conclusion: Based on the findings of the present study more than 90% of ED residents had experienced at least one type of verbal, physical, or racial-ethnic violence during their shifts. It is necessary for residents in EDs to be trained about violence control and also report and follow these issues through legal channels.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22037/EMERGENCY.V6I1.19430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41809366","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":"Specialist Physicians’ Attitude towards Emergency Medicine; a Semi-Structured Qualitative Study","authors":"S. Tabrizi, A. Nejati, S. Nedjat, S. Aghili","doi":"10.22037/EMERGENCY.V6I1.17006","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.17006","url":null,"abstract":"Introduction: The present study is a survey to assess the pros and cons of emergency medicine (EM) from the viewpoint of the scholars from other medicine disciplines to improve the efficiency of EM in the healthcare system. Methods: This is a semi-structured qualitative study. Face-to-face interviews with various physicians with different specialties were performed to gather information on their viewpoints. Study population was selected mainly based on their history of collaboration with emergency medicine specialists in several educational hospitals in Tehran, Iran. All interviews were recorded and then transcribed to paper. Data were mainly categorized and reported into four themes: 1) general aspects of emergency medicine, goals and policies 2) Management of emergency department 3) Educational aspects 4) therapeutic aspects. Results: 22 specialist physicians with the mean age of 47.3±7.6 years were studied (77.3% male). The average of their work experience as a specialist was 13.6±7.5 years. From the viewpoint of other experts, the establishment of EM and training of EM specialists is accompanied with relative disadvantages and advantages regarding goals and policies, patient management, therapeutic interventions and student education in the emergency department. Initiating resuscitation and maintaining hemodynamic stability and appropriate triage of the patients can add to the benefits of EM by preventing unreasonable hospitalization, and reducing the workload and difficulty of the work of other professionals working in the hospital. Conclusions: Based on the results of the current study, it seems that most Iranian specialist physicians have a positive attitude towards emergency medicine and think that emergency medicine could have beneficial effects for the health system and hospital management system.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22037/EMERGENCY.V6I1.17006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47918362","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":"Pro-BNP versus MEDS Score in Determining the Prognosis of Sepsis Patients; a Diagnostic Accuracy Study","authors":"Majid Shojaee, Saeed Safari, Anita Sabzghabaei, M. Alavi-Moghaddam, Ali Arhami Dolatabadi, Hamid Kariman, S. Soltani","doi":"10.22037/EMERGENCY.V6I1.19286","DOIUrl":"https://doi.org/10.22037/EMERGENCY.V6I1.19286","url":null,"abstract":"Introduction: Pro-brain natriuretic peptide (Pro-BNP) can act as an independent predictor of mortality in septic patients. This study aimed to compare the diagnostic accuracy of pro-BNP and Mortality in Emergency Department Sepsis (MEDS) score in this regard. Method: This cross-sectional study was conducted on > 14 years old sepsis patients of an emergency department (ED), during 2 years. The level of Pro-BNP and MEDS score were measured for all eligible patients and considering one month mortality as reference, screening performance characteristics of the two tests were compared using SPSS 21 and STATS 11. Results: 121 patients with the mean age of 75.87±11.82 years were studied (55.4% male). 85 (70.25%) patients had moderate to high probability of mortality according to MEDS score. The mean Pro-BNP levels of survivor and non-survivor patients were 489.69 ± 327.47 and 3954.98 ± 2717.85 pg/ml, respectively (p < 0.0001). Sensitivity and specificity of Pro-BNP (in 1000 pg/ml cut off) and MEDS score (in level 3) in prediction of 1-month mortality were 93.6 (83.7-97.9), 94.8 (84.7-98.6), 65.0 (51.9-76.3), and 98.2 (89.5-99.9), respectively. Area under the ROC curve of the two tests were 97.36 (95% CI: 92.92-94.48) and 92.31 (95% CI: 86.35-96.53), respectively (p = 0.0543). Conclusion: Pro-BNP and MEDS score both have excellent diagnostic accuracy in predicting 1-month mortality of sepsis patients. However, considering the higher sensitivity as well as availability and ease of calculation, it seems that Pro-BNP can be considered an appropriate tool for screening patients with high risk of mortality following sepsis in ED.","PeriodicalId":11681,"journal":{"name":"Emergency","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.22037/EMERGENCY.V6I1.19286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49161900","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}