International Journal of Emergency Medicine最新文献

{"title":"Coexistence of adenomyomatosis in a left-sided gallbladder: a case report.","authors":"Mohamed Tolba, Hadeer Hafez, John Adel","doi":"10.1186/s12245-024-00785-0","DOIUrl":"https://doi.org/10.1186/s12245-024-00785-0","url":null,"abstract":"<p><strong>Introduction: </strong>The coexistence of gallbladder (LSG) and adenomyomatosis (ADM) is extremely uncommon presenting a novel clinical dilemma that has not been previously documented. LSG refers to a anomaly where the gallbladder is situated to the left of the round ligament deviating from its usual position. This anomaly is rare, with reported occurrences ranging between 0.04% and 1.1%. Identifying LSG before surgery poses challenges. It is often discovered incidentally during procedures necessitating surgical expertise to safely manage anatomical variations.</p><p><strong>Case presentation: </strong>We report an old man with a history of hepatitis C, carcinoma and liver cirrhosis complained of sudden epigastric pain. A CT scan revealed the presence of an LSG, which's a congenital anomaly. During the cholecystectomy procedure surgeons encountered variations and observed the existence of ADM complicating the operation. The patient recovered smoothly post surgery.</p><p><strong>Discussion: </strong>This case shows how complicated it can be to diagnose and treat the combination of LSG and ADM. Identifying these conditions before surgery is tough so surgeons often have to adjust their approach during the operation. Although laparoscopic cholecystectomy for LSG is usually safe it requires care to avoid problems like bile duct injuries. For patients at risk a conservative treatment approach might be better. In cases where surgery is necessary surgeons need to adapt their techniques to address the unique anatomical issues.</p><p><strong>Conclusion: </strong>The combination of LSG and ADM in a setting poses an intricate challenge. Surgeons need to be ready to recognize and address these abnormalities effectively for the well being of the patient and favorable results. This particular case highlights the importance of staying alert and flexible during surgery when dealing with gallbladder variations.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"5"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926975","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":"From thrombosis to tamponade: unveiling severe pericardial effusion in a misdiagnosis case.","authors":"Amin Bagheri, Morteza Sheikhi Nooshabadi, Pouya Ebrahimi, Roozbeh Nazari, Pedram Ramezani, Toktam Alirezaei","doi":"10.1186/s12245-024-00794-z","DOIUrl":"https://doi.org/10.1186/s12245-024-00794-z","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulants increase the risk of cardiac tamponade in patients with pericardial effusion (PE). Therefore, inappropriate administration of them in the presence of PE can lead to a catastrophic outcome. This study presents a patient with a provisional misdiagnosis of venous thromboembolism (VTE).</p><p><strong>Case presentation: </strong>An 83-year-old Iranian female was transferred to the emergency department of a tertiary cardiology hospital complaining of neck swelling concomitant with chest pain and dyspnea. The patient had been diagnosed with jugular vein thrombosis in another local center, and since the chief complaint was neck swelling, she underwent Doppler sonography, and the diagnosis was confirmed. Subsequently, the treatment with unfractionated heparin was started. After 5 h, considering the worsening of symptoms with the suspicious diagnosis of COVID-19 based on her symptoms and laboratory data, a chest computed tomography scan was requested, which showed a massive PE. Subsequently, transthoracic echocardiography confirmed the diagnosis. The patient was immediately transferred to the operating room and underwent pericardiotomy. The post-surgery period was uneventful, and she was discharged 5 days later.</p><p><strong>Conclusion: </strong>Patients with viral infections, specifically COVID-19, are at risk of undiagnosed severe pericardial effusions. Venous stasis in the jugular veins due to PE can mimic jugular vein thromboembolism, causing a wrong diagnosis. Since treating thrombosis can exacerbate tamponade to hemodynamic instability and collapse, sufficient investigation before starting anticoagulants is necessary.</p><p><strong>Clinical key message: </strong>Distinguishing VTE from PE is not always straightforward. Therefore, it is important to ensure physicians have reached an appropriate level of certainty about their diagnosis by performing precise diagnostics before using anticoagulants. Mismanagement with anti-thrombotics can result in catastrophic consequences. Therefore, taking an accurate history, performing a precise physical examination, and using rapid and available diagnostic modalities can avoid delays in definitive management.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"4"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926987","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":"Seizure aggravation by ampicillin/sulbactam in an elderly patient with status epilepticus.","authors":"Kaoru Obata, Masako Kinoshita, Akiyo Shinde, Toshihiko Suenaga","doi":"10.1186/s12245-024-00793-0","DOIUrl":"10.1186/s12245-024-00793-0","url":null,"abstract":"<p><strong>Background: </strong>Ampicillin/sulbactam (ABPC/ SBT) is one of the most common β-lactam antibiotics for patients with status epilepticus complicated with aspiration pneumonia. It is known that β-lactam antibiotics such as penicillin aggravate epileptic seizures or status epilepticus. Here, we investigated whether ABPC/SBT aggravates seizures using electroencephalography (EEG) monitoring.</p><p><strong>Case presentation: </strong>An 84-year-old male with status epilepticus who presented with a new onset of clonic seizures mainly of his left side and underwent continuous video EEG was analyzed. He had been suffering from severe ulcerative colitis and infectious enteritis, delirium, atrial fibrillation and deep venous thrombosis. His cerebrospinal fluid analysis was unremarkable. Four days after starting levetiracetam, he had a cluster of seizures with impaired consciousness, consistent with status epilepticus. We started fosphenytoin and phenobarbital. We also administered ABPC/SBT twice a day, ten times in total, for aspiration pneumonia while monitoring the patient. He died twelve days after the seizure onset. We analyzed the number and duration of seizures in two hours before and after starting ABPC/SBT for each administration using EEG with trendgraph. After administration of ABPC/SBT, number of seizures significantly increased from 3.2 ± 4.7 to 7.3 ± 9.7 (mean ± SD, p = 0.047, Wilcoxson's signed-rank test) per 2 h. Duration of seizures showed a tendency of increase from 199 ± 275 to 406 ± 536 s (p = 0.079).</p><p><strong>Conclusions: </strong>In this elderly male patient with status epilepticus, administration of ABPC/SBT aggravated his seizures. EEG monitoring using a trendgraph is useful for evaluation of seizure severity and for analysis of causative factors.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"2"},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921322","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":"Traumatic head injuries in children: demographics, injury patterns, and outcomes in Saudi Arabia.","authors":"Hussin Albargi, Rayan Jafnan Alharbi, Ateeq Almuwallad, Naif Harthi, Yahya Khormi, Hari Krishnan Kanthimathinathan, Sharfuddin Chowdhury","doi":"10.1186/s12245-024-00808-w","DOIUrl":"10.1186/s12245-024-00808-w","url":null,"abstract":"<p><strong>Background: </strong>Traumatic head injuries (THIs) are among the leading cause of mortality and intensive care unit (ICU) admission in children worldwide. Most of the published literature concerning THIs arises predominantly from North America and Europe. However, only limited data about the incidence, characteristics and impact on children in Saudi Arabia exists.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of THIs in children (≤ 18 years of age) using data from the Saudi TraumA Registry (STAR) from August 2017 to December 2022. Data included patient demographic characteristics, the mechanism, type and severity of injury. We used multivariable logistic regression to assess the association between outcomes and clinical factors.</p><p><strong>Results: </strong>We identified 466 children with THI. Most children were over six years of age (69.5%) and male (76.6%). Motor vehicle crashes (MVCs) were the most common cause of THIs (51.9%), with falls being more common in infants (69.8%). Over half of the children required ICU admission. Children with higher injury severity score, heart rate at presentation to the ED, hospital stay duration, respiratory assistance and need for surgery were more likely to require ICU admission. The overall mortality rate was 7.7%, with schoolchildren (age: 6-12 years) having the highest mortality rate (10.8%). Higher rates of ICU admission were associated with increases in the injury severity score (ISS), hospital stay duration, respiratory assistance and the need for surgery.</p><p><strong>Conclusions: </strong>Children in the 6-12 year age-group had the highest mortality rate, reflecting high injury severities associated with increased ICU admissions. These findings highlight the importance of targeting preventive measures for MVCs in older children and improving trauma care for severe cases.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"3"},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921371","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":"Early diagnosis and treatment of Ramsay Hunt syndrome: a case report.","authors":"Chen Yu, Haw-Yu Lee, Yen-Chia Chen","doi":"10.1186/s12245-024-00807-x","DOIUrl":"10.1186/s12245-024-00807-x","url":null,"abstract":"<p><strong>Background: </strong>Ramsay Hunt syndrome (RHS), a rare complication of varicella-zoster virus (VZV) reactivation, presents with ipsilateral facial paralysis, ear pain, and vesicular rash. Early recognition is crucial for prompt treatment and optimal outcomes.</p><p><strong>Case presentation: </strong>We report a case of a 67-year-old woman with RHS who presented with right-sided facial palsy, severe ear pain, and fluid-filled blisters. Prompt diagnosis and initiation of antiviral and glucocorticoid therapy led to significant symptom improvement.</p><p><strong>Conclusions: </strong>Healthcare providers should consider RHS in patients with facial palsy, especially when accompanied by ear pain and vesicular rash, to facilitate early intervention and prevent long-term complications.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921314","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":"Non-invasive management of severe subcutaneous emphysema in a pediatric asthma exacerbation: a case report and review.","authors":"Amal H Aljohani, Hamdi Alsufiani, Ghousia Ahmed","doi":"10.1186/s12245-024-00804-0","DOIUrl":"10.1186/s12245-024-00804-0","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SE) are rare, severe, and potentially life-threatening complications associated with asthma exacerbation. Most of these conditions are benign and self-limiting. However, the overlapping symptoms between asthma exacerbation and pneumomediastinum (PM) may delay diagnosis. These conditions can usually be managed through conservative treatment, although unfamiliarity with this presentation may lead some physicians to consider surgical intervention.</p><p><strong>Case presentation: </strong>We report a unique case involving a 9-year-old patient experiencing a severe bronchial asthma attack and right lobe atelectasis complicated by PM and severe SE that extended to his left eye. The condition was successfully treated conservatively, with aggressive management of asthma exacerbation and close monitoring in the intensive care unit.</p><p><strong>Conclusion: </strong>This case highlights the effectiveness of conservative management of PM and SE with appropriate asthma exacerbation treatment. Early diagnosis and management can lead to a favorable prognosis and a relatively brief hospital stay.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"203"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909641","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":"Examining the association of elevated initial serum lactate with mortality and morbidity in trauma patients: a retrospective study.","authors":"Pablo Rodríguez-Ortiz, Kyara Berríos-Toledo, Ediel O Ramos-Meléndez, Lourdes Guerrios-Rivera","doi":"10.1186/s12245-024-00798-9","DOIUrl":"10.1186/s12245-024-00798-9","url":null,"abstract":"<p><strong>Background: </strong>Elevated initial serum lactate (iSL) levels are frequently employed to assess trauma severity, but their predictive value for mortality and morbidity remains inconsistent. We evaluated the association of iSL with mortality and morbidity at Puerto Rico Trauma Hospital (PRTH).</p><p><strong>Methods: </strong>This IRB-approved retrospective study included trauma patients ≥ 18 years with iSL measured within the first 48 h of admission to PRTH (July 2014-June 2019). Patients were classified as normal (4.5-19.8 mg/dL) or elevated (≥ 19.9 mg/dL) iSL levels. Group comparisons were conducted using t-tests, Wilcoxon rank-sum tests, Pearson's chi-squared, or Fisher's exact tests. Associations were evaluated with regression and ROC analyses.</p><p><strong>Results: </strong>Among 536 patients, 54.3% had elevated iSL levels. Initially, elevated iSL was associated with in-hospital mortality (OR: 2.18, 95%CI: 1.36-3.51, p < 0.001), traumatic intensive care unit (TICU) admission (OR: 2.06, 95%CI: 1.46-2.92, p < 0.001), and need for mechanical ventilation (MV) (OR: 2.80, 95%CI: 1.97-3.98, p < 0.001). However, adjusted analyses showed no significant associations (Mortality-AOR: 1.72, 95%CI: 0.97-3.04, p = 0.06; TICU-AOR: 1.11, 95%CI: 0.71-1.75, p = 0.65; MV-AOR: 1.49, 95%CI: 0.89-2.49, p = 0.13). Both iSL (AUC: 0.59, 95%CI: 0.54-0.64) and ISS (AUC: 0.59, 95%CI: 0.54-0.64) demonstrated limited ability to predict mortality, with no statistically significant difference between them (p > 0.99). Patients with elevated iSL experienced prolonged hospital and TICU stays and severe injuries.</p><p><strong>Conclusions: </strong>Elevated iSL levels may not independently predict mortality, TICU admission, or the need for MV in trauma patients. However, their rapid availability supports their use alongside other clinical markers to guide trauma care decision-making and improve trauma outcomes.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"204"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909639","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":"Limited use of opioid prescribing guidelines in Dutch emergency departments: results of a nationwide survey.","authors":"Nicole Kraaijvanger, Cees Kramers, Albert Dahan, Arnt F A Schellekens","doi":"10.1186/s12245-024-00799-8","DOIUrl":"10.1186/s12245-024-00799-8","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the Netherlands has experienced a notable increase in opioid prescriptions and associated fatalities. Emergency department (ED) patients exhibit relatively high rates of opioid use (15%) and misuse (23% of patients who present to the ED and use prescription opioids test positive for misuse). To mitigate opioid-related harm, the American College of Emergency Physicians (ACEP) advocates for the use of non-opioid analgesics and minimal opioid prescriptions. In the Netherlands, the Society for Anesthesiology has issued a guideline for appropriate opioid use, which are also relevant to EDs. However, the extent of implementation in EDs remains unclear. This study utilized an online survey to assess the implementation of opioid-prescribing guidelines in Dutch EDs. Chief medical officers from various EDs across the Netherlands were invited via email to complete questionnaires. These questionnaires gathered general information about the EDs, details on the application of opioid-prescribing guidelines, management of problematic opioid use, and specifics of the guidelines in practice.</p><p><strong>Results: </strong>Questionnaires were completed by chief medical officers from 33 Dutch EDs, yielding a 52.4% response rate. Nineteen EDs (57.6%) used guidelines for opioid prescribing, predominantly local protocols, with only two of them (10.5%) using the national guideline. The guidelines varied in content, with 68.4% advising on specific opioids (mainly preferring oxycodone) and dosage, and in 63.2% giving advice on prescription duration (typically 3-7 days). Patient education with opioid prescriptions was specified in the guidelines at 57.9% (11/19) of EDs, with brochures provided at 17.6% (6/19) of EDs. The primary focus of patient education was on adverse effects, with addiction risks mentioned at 36.4% (4/11) EDs.</p><p><strong>Conclusions: </strong>This study reveals significant variability and gaps in opioid prescribing guidelines across Dutch EDs. Compared to US guidelines, Dutch practices are less cautious, highlighting the need for improvement. This study underscores the necessity for a Dutch guideline tailored for EDs to manage opioid prescriptions and problematic opioid use.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"202"},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906525","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":"Case report: a case of AL amyloidosis with spontaneous giant retroperitoneal hematoma.","authors":"Yaqi Sheng, Huadong Zhu","doi":"10.1186/s12245-024-00801-3","DOIUrl":"10.1186/s12245-024-00801-3","url":null,"abstract":"<p><strong>Background: </strong>Systemic amyloidosis is a kind of clinical syndrome in which amyloid is deposited between the cells of various organs in the body, resulting in gradual failure of the function of the affected organs. Depending on the site of amyloid deposition, it may show various clinical symptoms of multiple system involvement.</p><p><strong>Patient concerns: </strong>A 44-years-old female with spontaneous giant retroperitoneal hematoma was admitted to the emergency department of Peking Union Medical College Hospital in Mar 2023.</p><p><strong>Diagnoses: </strong>She was found with a extremely X-factor deficiency and diagnosed with AL amyloidosis according to pathological findings finally.</p><p><strong>Interventions and outcomes: </strong>She received a variety of treatments to improve her coagulation function and underwent chemotherapy for AL in the hematology department which improved her coagulation function and was discharged to her local hospital for follow-up treatment.</p><p><strong>Conclusion: </strong>This case provides a new reference for emergency doctors in the diagnosis and treatment of acute severe hemorrhagic diseases.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"200"},"PeriodicalIF":2.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894297","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":"Performance of A-DROP, NEWS2, and REMS in predicting in-hospital mortality and mechanical ventilation in pneumonia patients in the emergency department: a retrospective cohort study.","authors":"Netiporn Thirawattanasoot, Brandon Chongthanadon, Onlak Ruangsomboon","doi":"10.1186/s12245-024-00792-1","DOIUrl":"10.1186/s12245-024-00792-1","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is a potentially life-threatening respiratory tract infection. Many Early Warning Scores (EWS) were developed to detect patients with high risk for adverse clinical outcomes, but few have explored the utility of these EWS for pneumonia patients in the Emergency Department (ED) setting. We aimed to compare the prognostic utility of A-DROP, NEWS2, and REMS in predicting in-hospital mortality and the requirement for mechanical ventilation among ED patients with pneumonia.</p><p><strong>Methods: </strong>A retrospective study was conducted at the ED of Siriraj Hospital, Thailand. Adult patients diagnosed with non-COVID-19 pneumonia between June 1, 2021, and May 31, 2022, were included. We calculated and analyzed their EWS at ED arrival. The primary outcome was all-cause in-hospital mortality. The secondary outcome was mechanical ventilation.</p><p><strong>Results: </strong>We enrolled 735 patients; 272 (37%) died at hospital discharge, and 75 (10.2%) required mechanical ventilation. A-DROP had the highest discrimination capacity for in-hospital mortality (AUROC: 0.698, 95% CI 0.659-0.737) compared to NEWS2 (AUROC 0.657; 95%CI 0.617, 0.698) and REMS (AUROC 0.637; 95%CI 0.596, 0.678). A-DROP also had superior performances than NEWS2 and REMS in terms of calibration, overall model performance, and balanced diagnostic accuracy indices at its optimal cut point (A-DROP ≥ 2). No EWS could perform well in predicting mechanical ventilation.</p><p><strong>Conclusion: </strong>A-DROP had the highest prognostic utility for predicting in-hospital mortality in non-COVID-19 pneumonia patients in the ED compared to NEWS2 and REMS.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"198"},"PeriodicalIF":2.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894302","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}