International Journal of Critical Illness and Injury Science最新文献

{"title":"Risk factors and clinical outcomes of carbapenem-resistant <i>Klebsiella pneumonia</i> infection in intensive care unit: A retrospective observational study in a tertiary care hospital in Eastern India.","authors":"Sagarika Panda,&nbsp;Abhilash Dash,&nbsp;Pritam Chhotray,&nbsp;Biswajit Nayak,&nbsp;Tatikonda Chandra Mouli,&nbsp;Shakti Bedanta Mishra","doi":"10.4103/ijciis.ijciis_34_22","DOIUrl":"10.4103/ijciis.ijciis_34_22","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Enterobacteriaceae, especially <i>Klebsiella pneumonia</i>, have become a severe global problem with a significant threat to public health, but few studies have investigated the risk factors and epidemiology of carbapenem-resistant <i>K. pneumonia</i> (CRKP) infections in India.</p><p><strong>Methods: </strong>We performed a retrospective observational study of 224 participants with <i>K. pneumoniae</i> who were admitted to the medical intensive care unit (ICU) of Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India, between January 1 and December 30, 2020. Antibiotic susceptibility testing was done by automated broth microdilution VITEK^® 2 (BioMerieux, Inc., Hazelwood, USA). The Clinical and Laboratory Standards Institute document M100-S22 (January 2020) was used to interpret antimicrobial susceptibility testing. Data were obtained from paper medical records.</p><p><strong>Results: </strong>Two hundred and twenty-four subjects with culture-positive for <i>K. pneumonia</i> were retrieved during the study period, out of which 108 had CRKP. The risk factors for univariate analysis were Acute Physiology and Chronic Health Evaluation II, ICU length of stay (LOS), invasive mechanical ventilator days, central venous catheter days, and arterial line days. The multivariate analysis showed invasive mechanical ventilation and ICU LOS were independent risk factors for CRKP infection. Mortality in the CRKP group was 48 (44%) compared to 27 (23%) in the carbapenem-sensitive <i>K. pneumonia</i> (CSKP) group, which was statistically significant (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Infection due to CRKP in the ICU was associated with 1.9 times higher mortality as compared to CSKP. Invasive mechanical ventilation and ICU LOS were found to be independent risk factors for CRKP infection.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 4","pages":"217-221"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10705134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between serum surfactant protein-D level with respiratory compliance and acute respiratory distress syndrome in critically ill COVID-19 Patients: A retrospective observational study.","authors":"Jayadi,&nbsp;Prananda Surya Airlangga,&nbsp;Edward Kusuma,&nbsp;Christrijogo Soemartono Waloejo,&nbsp;Agustina Salinding,&nbsp;Pudji Lestari","doi":"10.4103/ijciis.ijciis_27_22","DOIUrl":"10.4103/ijciis.ijciis_27_22","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) is one of the manifestations of severe coronavirus disease 2019 (COVID-19) with low respiratory compliance and poor oxygenation as main characteristics and mortality rate of 50%-94%. Surfactants, including surfactant protein D (SP-D), have a role in maintaining respiratory compliance. This study aimed to analyze the relationship between serum SP-D levels with respiratory compliance and ARDS in patients with critically ill COVID-19 pneumonia.</p><p><strong>Methods: </strong>This study was a cross-sectional study. Subjects were adult reverse transcription-polymerase chain reaction-confirmed COVID-19 patients who had ARDS treated with invasive mechanical ventilation. All data were obtained from medical records. Statistical analysis was done using Spearman test, Mann-Whitney test, and receiver operating characteristic curve.</p><p><strong>Results: </strong>Serum level of SP-D was significantly correlated with static respiratory compliance (<i>P</i> = 0.009; correlation coefficient [rs] = 0.467). Serum SP-D levels correlated with ARDS severity (<i>P</i> < 0.001). SP-D levels had a very strong diagnostic value for ARDS severity, with an optimal cutoff value of 44.24 ng/mL (sensitivity 92.3%; specificity 94.1%). ARDS severity also correlated significantly with respiratory compliance (<i>P</i> = 0.005; correlation coefficient 0.496).</p><p><strong>Conclusion: </strong>Higher serum SP-D levels were associated with lower respiratory compliance, ARDS severity, and may be utilized diagnostically to identify patients with severe ARDS.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 4","pages":"204-210"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10714129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic thrombolytics as rescue therapy for COVID-19 patients with acute respiratory distress syndrome: A retrospective observational study.","authors":"Prathibha Gowda Ashwathappa,&nbsp;Ipe Jacob,&nbsp;Pradeep Rangappa,&nbsp;Karthik Rao","doi":"10.4103/ijciis.ijciis_45_22","DOIUrl":"10.4103/ijciis.ijciis_45_22","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) pneumonia with severe acute respiratory distress syndrome (ARDS) is often associated with a progressive respiratory failure that is refractory to maximal ventilatory support and other ARDS strategies. Studies show evidence of a hypercoagulable state in COVID-19 patients, including capillary thrombosis and alveolar fibrin deposits which impede normal gas exchange. In this context, thrombolysis is considered as a salvage therapy to rescue critically hypoxemic patients.</p><p><strong>Methods: </strong>In this retrospective observational study, the efficacy of thrombolysis on outcome of COVID-19 ARDS with respiratory failure was analyzed. Patients with severe ARDS and d-dimer levels of 5 μg/ml or above were initiated on alteplase, as a 25 mg bolus followed by a 25 mg infusion over 22 h. Primary outcome was intensive care unit (ICU) mortality and secondary outcomes were change in PaO2/FiO2 24 h after thrombolysis, avoidance of intubation, ventilator free days (VFD), and ICU and hospital length-of-stay (LOS).</p><p><strong>Results: </strong>Thirteen out of 34 patients with severe COVID ARDS underwent thrombolysis. They had lower ICU mortality than non-thrombolysed patients (23.1% vs. 71.4%, <i>P</i> = 0.006), greater percentage improvement in PaO2/FiO2 (116% vs. 31.5%, <i>P</i> = 0.002), more VFDs (13 days vs. 0 day, <i>P</i> = 0.004), and lesser requirement for intubation (23.1% vs. 76.2%, <i>P</i> = 0.004). ICU and hospital LOS were similar.</p><p><strong>Conclusion: </strong>Thrombolysis can be considered as a rescue therapy for nonintubated COVID-19 ARDS patients with severe hypoxemic respiratory failure, who show evidence of a procoagulant state. Larger studies are needed before inclusion into the regular treatment protocol for COVID-19 patients.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 4","pages":"197-203"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10714131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effects of vitamin C and thiamine on refractory hypotension in patients with sepsis: A randomized controlled trial.","authors":"N Nandhini,&nbsp;Deepak Malviya,&nbsp;Samiksha Parashar,&nbsp;Chandrakant Pandey,&nbsp;Soumya Sankar Nath,&nbsp;Manoj Tripathi","doi":"10.4103/ijciis.ijciis_107_21","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_107_21","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to compare the effect of thiamine and ascorbic acid (AA) on mortality, sequential organ failure assessment (SOFA) score, duration and dose of vasopressor support, and need for renal replacement therapy (RRT) in patients with septic shock with refractory hypotension.</p><p><strong>Methods: </strong>Consenting adult patients with septic shock and refractory hypotension were included in this study. Patients were divided into three groups: Group A received 100 ml of balanced salt solution 8 hourly, Group B received 2 mg/kg of thiamine 8 hourly, Group C received 25 mg/kg of AA 8 hourly intravenous (IV) for 72 h. All patients received IV infusion of hydrocortisone 200 mg/day for 72 h. Serum lactate, dose and duration of vasopressor support, SOFA score, need for RRT and hospital mortality were analyzed.</p><p><strong>Results: </strong>The SOFA Score was significantly lower in Group B than in Group A and C at 24, 48, and 72 h. Dosage of norepinephrine was lower in Group B at 66 h and after that, whereas in Groups A and C, it was comparable at all time points. Mortality in Group B was significantly lower but comparable in Groups A and C. The need for RRT was significantly lower in Group B (44%) compared to the control group (88%) but comparable in Group C (76%).</p><p><strong>Conclusion: </strong>In patients with septic shock treated with hydrocortisone, co-treatment with thiamine led to earlier correction of organ dysfunction, reduced need for RRT, and improved mortality compared to patients treated with AA or balanced salt solution. The addition of AA did not yield measurable benefits beyond hydrocortisone alone.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"138-145"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care versus central laboratory measurements of electrolytes and hemoglobin: A prospective observational study in critically ill patients in a tertiary care hospital.","authors":"Sangeeta Sahoo,&nbsp;Jyotiranjan Sahoo,&nbsp;Neha Singh,&nbsp;Upendra Hansda,&nbsp;Satyabrata Guru,&nbsp;Nitish Topno","doi":"10.4103/ijciis.ijciis_2_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_2_22","url":null,"abstract":"<p><strong>Background: </strong>A blood gas analyzer is a point-of-care (POC) testing device used in the Emergency Department (ED) to manage critically ill patients. However, there were differences in results found from blood gas analyzers for hemoglobin (Hgb) and electrolytes parameters. We conducted a comparative validity study in ED in patients who had requirements of venous gas analysis, complete blood count, and electrolytes. The objective was to find the correlation of Hgb, sodium (Na⁺), and potassium (K⁺) values between the blood gas analyzer and laboratory autoanalyzer.</p><p><strong>Methods: </strong>A total of 206 paired samples were tested for Hgb, Na⁺, and K⁺. Total 4.6 ml of venous blood was collected from each participant, 0.6 ml was used for blood gas analysis as POC testing and 4 ml was sent to the central laboratory for electrolyte and Hgb estimation.</p><p><strong>Results: </strong>The mean difference between POC and laboratory method was 0.608 ± 1.41 (95% confidence interval [CI], 0.41-0.80; <i>P</i> < 0.001) for Hgb, 0.92 ± 3.5 (95% CI, 0.44-1.40) for Na⁺, and 0.238 ± 0.62 (95% CI, -0.32-0.15; <i>P</i> < 0.001) for K⁺. POC testing and laboratory method showed a strong positive correlation with Pearson correlation coefficient (<i>r</i>) of 0.873, 0.928, and 0.793 for Hgb, Na⁺, and K⁺, respectively (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Although there was a statistical difference found between the two methods, it was under the United States Clinical Laboratory Improvement Amendment range. Hence, starting the therapy according to the blood gas analyzer results may be beneficial to the patient and improve the outcome.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"160-164"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of time to death after admission to an intensive care unit and factors associated with mortality: A retrospective longitudinal study.","authors":"Ana Luiza Mezzaroba,&nbsp;Alexandre S Larangeira,&nbsp;Fernanda K Morakami,&nbsp;Jair Jesus Junior,&nbsp;Amanda A Vieira,&nbsp;Marina M Costa,&nbsp;Fernanda M Kaneshima,&nbsp;Giovana Chiquetti,&nbsp;Ulisses E Colonheze,&nbsp;Giovanna C S Brunello,&nbsp;Lucienne T Q Cardoso,&nbsp;Tiemi Matsuo,&nbsp;Cintia M C Grion","doi":"10.4103/ijciis.ijciis_98_21","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_98_21","url":null,"abstract":"<p><strong>Background: </strong>Among nonsurvivors admitted to the intensive care unit (ICU), some present early mortality while other patients, despite having a favorable evolution regarding the initial disease, die later due to complications related to hospitalization. This study aims to identify factors associated with the time until death after admission to an ICU of a university hospital.</p><p><strong>Methods: </strong>Retrospective longitudinal study that included adult patients admitted to the ICU between January 1, 2008, and December 31, 2017. Nonsurviving patients were divided into groups according to the length of time from admission to the ICU until death: Early (0-5 days), intermediate (6-28 days), and late (>28 days). Patients were considered septic if they had this diagnosis on admission to the ICU. Simple linear regression analysis was performed to evaluate the association between time to death over the years of the study. Multivariate cox regression was used to assess risk factors for the outcome in the ICU.</p><p><strong>Results: </strong>In total, 6596 patients were analyzed. Mortality rate was 32.9% in the ICU. Most deaths occurred in the early (42.8%) and intermediate periods (47.9%). Patients with three or more dysfunctions on admission were more likely to die early (<i>P</i> < 0.001). The diagnosis of sepsis was associated with a higher mortality rate. The multivariate analysis identified age >60 years (hazard ratio [HR] 1.009), male (HR 1.192), mechanical ventilation (HR 1.476), dialysis (HR 2.297), and sequential organ failure assessment >6 (HR 1.319) as risk factors for mortality.</p><p><strong>Conclusion: </strong>We found a higher proportion of early and intermediate deaths in the study period. The presence of three or more organ dysfunctions at ICU admission was associated with early death. The diagnosis of sepsis evident on ICU admission was associated with higher mortality.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"121-126"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's new in critical illness and injury science? Resource allocation and very short intensive care unit stays.","authors":"Andrew C Miller","doi":"10.4103/ijciis.ijciis_61_22","DOIUrl":"10.4103/ijciis.ijciis_61_22","url":null,"abstract":"","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"119-120"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10682383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal histopathology of acute colchicine toxicity after lower dose treatment of pericarditis: A case report.","authors":"Lisa Liu,&nbsp;Steven Tessier,&nbsp;Rodrigo Duarte-Chavez,&nbsp;Daniel Marino,&nbsp;Anish Kaza,&nbsp;Santo Longo,&nbsp;Sudip Nanda","doi":"10.4103/ijciis.ijciis_105_21","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_105_21","url":null,"abstract":"<p><p>Colchicine is an anti-inflammatory alkaloid drug with anti-microtubule activity. Colchicine toxicity is a serious and potentially fatal complication associated with hallmark histopathological features most conspicuous in proliferative tissues such as the gastrointestinal tract. These features have only been reported in patients treated with high doses. We report a patient who experienced acute colchicine toxicity with gastrointestinal histologic changes after treatment with the lowest dose of colchicine. Knowledge of drug-drug interactions and the organs involved in colchicine metabolism is imperative when using colchicine, even when administered at its lowest dose.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"174-176"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective cohort study of short-stay admissions to the medical intensive care unit: Defining patient characteristics and critical care resource utilization.","authors":"Pooja N Pandit, Mark Mallozzi, Rahed Mohammed, Gregory McDonough, Taylor Treacy, Nathaniel Zahustecher, Erika J Yoo","doi":"10.4103/ijciis.ijciis_6_22","DOIUrl":"10.4103/ijciis.ijciis_6_22","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the mortality and utilization outcomes of short-stay intensive care unit (ICU) patients who require <24 h of critical care. We aimed to define characteristics and outcomes of short-stay ICU patients whose need for ICU level-of-care is ≤24 h compared to nonshort-stay patients.</p><p><strong>Methods: </strong>Single-center retrospective cohort study of patients admitted to the medical ICU at an academic tertiary care center in 2019. Fisher's exact test or Chi-square for descriptive categorical variables, <i>t</i>-test for continuous variables, and Mann-Whitney two-sample test for length of stay (LOS) outcomes.</p><p><strong>Results: </strong>Of 819 patients, 206 (25.2%) were short-stay compared to 613 (74.8%) nonshort-stay. The severity of illness as measured by the Mortality Probability Model-III was significantly lower among short-stay compared to nonshort-stay patients (<i>P</i> = 0.0001). Most short-stay patients were admitted for hemodynamic monitoring not requiring vasoactive medications (77, 37.4%). Thirty-six (17.5%) of the short-stay cohort met Society of Critical Care Medicine's guidelines for ICU admission. Nonfull-ICU LOS, or time spent waiting for transfer out to a non-ICU bed, was similar between the two groups. Hospital mortality was lower among short-stay patients compared to nonshort-stay patients (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Despite their lower illness severity and fewer ICU-level care needs, short-stay patients spend an equally substantial amount of time occupying an ICU bed while waiting for a floor bed as nonshort-stay patients. Further investigation into the factors influencing ICU triage of these subacute patients and contributors to system inefficiencies prohibiting their timely transfer may improve ICU resource allocation, hospital throughput, and patient outcomes.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"127-132"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of National Early Warning Score 2 to risk-stratify coronavirus disease of 2019 patients in the emergency department: A retrospective cohort study.","authors":"Sweta Khuraijam,&nbsp;Alok Gangurde,&nbsp;Vridhi Shetty","doi":"10.4103/ijciis.ijciis_8_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_8_22","url":null,"abstract":"<p><strong>Background: </strong>The application of a risk stratification pathway is necessary for the emergency department (ED) to assess the severity of the disease and the need for escalation of therapy. We aimed to implement the National Early Warning Score 2 (NEWS2) pathway at triage to differentiate patients who are stable or critically ill with no invasive investigations at the time of admission during the coronavirus disease of 2019 (COVID-19) era in comparison to other clinical risk scores.</p><p><strong>Methods: </strong>One hundred and four patients were collected from April 1, 2021, to June 1, 2021, during the second wave of the COVID-19 pandemic at an academic medical center in India. The NEWS2 scoring system and the quick sepsis-related organ failure assessment (qSOFA) score were introduced as part of the initial assessment in the triage area of the ED. Data were assessed using the area under the receiving operating characteristic (AUROC) curve for NEWS2 and qSOFA scores, respectively.</p><p><strong>Results: </strong>In the study, NEWS2 classification indicated that 25% of patients required continuous monitoring, of which 12.7% subsequently deteriorated within 24 h of admission and 7% died. Both, NEWS2 (threshold 0; 1, AUROC 0.883; 95%; confidence interval [CI] 0.8-0.966) and qSOFA (threshold 0; 1, AUROC 0.851; 95% CI 0.766-29 0.936) effectively identified COVID-19 patients in the ED at risk for clinical deterioration. There was no significant difference in the diagnostic performance of qSOFA and NEWS2 (DeLong's test <i>P</i> = 0.312).</p><p><strong>Conclusion: </strong>Both NEWS2 and qSOFA effectively-identified COVID-19 patients in the ED at risk for clinical deterioration with no significant statistical difference. However, a triage level risk stratification score can be developed with the inclusion of blood parameters on admission to further validate the practice.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"12 3","pages":"133-137"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10682382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}