Acute Medicine最新文献_第4页

Improving Telemetry use in the Acute Assessment Unit. 改善急性评估病房遥测技术的使用。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0969

Patrick Timmons, Lindsay Reid, Kathleen Clare, Daniel Beckett, Tegan Thomson, Lisa Fabisiak

引用次数: 0

Do tools aimed at avoiding hospital admission operate at different mortality thresholds? A systematic review. 旨在避免入院的工具在不同的死亡率阈值下是否有效？系统回顾。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0990

Ciara Harris, Agnieszka Ignatowicz, Thomas Knight, Brian Willis, Daniel Lasserson

引用次数: 0

The intensive care population profile in Denmark before and during the first wave of the SARS-CoV-2 pandemic; a national register-based study. SARS-CoV-2 第一波大流行之前和期间丹麦重症监护人群概况；一项基于国家登记册的研究。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0977

Peter Biesenbach, Søren Bie Bogh, Marianne Fløjstrup, Christian Fynbo Christiansen, Anne Craveiro Brøchner, Erika Christensen, Anders Perner, Thomas Strøm, Mikkel Brabrand

引用次数: 0

Point-of-care ultrasound for the diagnosis of an atypical small bowel obstruction in a cannabis user: a case report. 用于诊断大麻使用者非典型小肠梗阻的护理点超声波：病例报告。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0971

Alaa Beshir, Jonas Bruyns, Maximilien Thoma, Florence Dupriez

引用次数: 0

An unexpected case of acute intermittent porphyria. 一个意外的急性间歇性卟啉症病例。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0972

Aaron Jesuthasan, Michael Wride, Harriet Esdaile, Adam Daneshmend

引用次数: 0

Performance of AI-powered chatbots in diagnosing acute pulmonary thromboembolism from given clinical vignettes. 人工智能聊天机器人根据给定的临床案例诊断急性肺血栓栓塞症的性能。

Acute Medicine Pub Date : 2024-01-01

Banu Arslan, Mehmet Necmeddin Sutasir, Ertugrul Altinbilek

{"title":"Performance of AI-powered chatbots in diagnosing acute pulmonary thromboembolism from given clinical vignettes.","authors":"Banu Arslan, Mehmet Necmeddin Sutasir, Ertugrul Altinbilek","doi":"","DOIUrl":"","url":null,"abstract":"Background: Chatbots hold great potential to serve as support tool in diagnosis and clinical decision process. In this study, we aimed to evaluate the accuracy of chatbots in diagnosing pulmonary embolism (PE). Furthermore, we assessed their performance in determining the PE severity.Method: 65 case reports meeting our inclusion criteria were selected for this study. Two emergency medicine (EM) physicians crafted clinical vignettes and introduced them to the Bard, Bing, and ChatGPT-3.5 with asking the top 10 diagnoses. After obtaining all differential diagnoses lists, vignettes enriched with supplemental data redirected to the chatbots with asking the severity of PE.Results: ChatGPT-3.5, Bing, and Bard listed PE within the top 10 diagnoses list with accuracy rates of 92.3%, 92.3%, and 87.6%, respectively. For the top 3 diagnoses, Bard achieved 75.4% accuracy, while ChatGPT and Bing both had 67.7%. As the top diagnosis, Bard, ChatGPT-3.5, and Bing were accurate in 56.9%, 47.7% and 30.8% cases, respectively. Significant differences between Bard and both Bing (p=0.000) and ChatGPT (p=0.007) were noted in this group. Massive PEs were correctly identified with over 85% success rate. Overclassification rates for Bard, ChatGPT-3.5 and Bing at 38.5%, 23.3% and 20%, respectively. Misclassification rates were highest in submassive group.Conclusion: Although chatbots aren't intended for diagnosis, their high level of diagnostic accuracy and success rate in identifying massive PE underscore the promising potential of chatbots as clinical decision support tool. However, further research with larger patient datasets is required to validate and refine their performance in real-world clinical settings.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 2","pages":"66-74"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917612","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}

引用次数: 0

Additional value of geriatric parameters to Quick Sepsis Related Organ Failure Assessment score for predicting clinical deterioration in older emergency department patients with a suspected infection: post-hoc analysis of a prospective observational study. 快速败血症相关器官功能衰竭评估评分的老年参数对预测急诊科疑似感染的老年患者临床病情恶化的额外价值：一项前瞻性观察研究的事后分析。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0989

Agneta H Calf, Hjalmar R Bouma, Liann Weil, Emma M de Jong, Marije de Haan, Barbara C van Munster, Jan C Ter Maaten

{"title":"Additional value of geriatric parameters to Quick Sepsis Related Organ Failure Assessment score for predicting clinical deterioration in older emergency department patients with a suspected infection: post-hoc analysis of a prospective observational study.","authors":"Agneta H Calf, Hjalmar R Bouma, Liann Weil, Emma M de Jong, Marije de Haan, Barbara C van Munster, Jan C Ter Maaten","doi":"10.52964/AMJA.0989","DOIUrl":"10.52964/AMJA.0989","url":null,"abstract":"Aim: To investigate the additional value of geriatric parameters such as physical impairment to the quick Sequential Organ Failure Assessment (qSOFA) tool for predicting clinical deterioration in older ED patients with a suspected infection and to validate the final prediction model.Methods: Post-hoc multivariable regression analysis from a prospective observational cohort study of adult patients visiting the ED of a university hospital to develop a prediction model. External validation of the prediction model was performed using the prospective data-biobank Acutelines.Results: In older patients, qSOFA (OR 1.47 (95% CI 1.12-1.95)) and physical impairment (OR 1.84 (95% CI 1.20-2.82)) were independently associated with clinical deterioration within 72 hours. This resulted in a prediction model with an area under the curve of 0.62 (95% CI 0.56-0.68) in the derivation cohort, and of 0.62 (95% CI 0.56-0.68) in the validation cohort. Calibration of the model was poor.Conclusion: In older ED patients with a suspected infection, not only disease severity scores, but also presence of physical impairment is independently associated with clinical deterioration.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"140-151"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606658","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}

引用次数: 0

Incidence, predictors and outcomes associated with acute pulmonary embolism in patients hospitalized with pneumonia: Insights from the National Inpatient Sample. 肺炎住院患者急性肺栓塞的发病率、预测因素和预后：来自全国住院患者样本的见解

Acute Medicine Pub Date : 2024-01-01

Chun Shing Kwok, Adnan I Qureshi, Yanshan Lin, Fanna Liu, Eric Holroyd, Gregory Y H Lip, Anteo Bradaric, Josip A Borovac

{"title":"Incidence, predictors and outcomes associated with acute pulmonary embolism in patients hospitalized with pneumonia: Insights from the National Inpatient Sample.","authors":"Chun Shing Kwok, Adnan I Qureshi, Yanshan Lin, Fanna Liu, Eric Holroyd, Gregory Y H Lip, Anteo Bradaric, Josip A Borovac","doi":"","DOIUrl":"","url":null,"abstract":"Background: The prevalence of acute pulmonary embolism (PE) among patients hospitalized with pneumonia and its association with adverse outcomes remain uncertain.Methods: Data from the US National Inpatient Sample between 2016 to 2020 was used to determine the proportion of patients with chief diagnosis of pneumonia that had concomitant PE and to examine the relationship between PE and in-hospital outcomes such as mortality, mechanical ventilation, thrombolysis, length of stay (LoS), and inpatient costs.Results: A total of 13,956,485 patients with a diagnosis of pneumonia were included and 2.6% had a concomitant diagnosis of PE. The median LoS for patients with PE was 7 days, compared to 5 days for those without PE. The median hospitalization cost was higher for patients with a diagnosis of PE compared to those without PE ($16,917 vs. $10,656). The strongest factors associated with a diagnosis of PE were other venous thromboembolism (Odds Ratio (OR) 11.65, 95%CI 11.42-11.88, p<0.001), arterial thrombosis (OR 2.64, 95%CI 2.40-2.89, p<0.001), previous venous thromboembolism (OR 1.72, 95%CI 1.68-1.77, p<0.001), cardiac arrest (OR 1.69, 95%CI 1.62-1.77, p<0.001) and cancer (OR 1.45, 95%CI 1.42-1.48, p<0.001). Co-diagnosis of PE was associated with greater in-hospital mortality (OR 1.50, 95%CI 1.46-1.54), mechanical ventilation (OR 1.12, 95%CI 1.10-1.15), thrombolysis use (OR 6.69, 95%CI 6.31-7.09), and major bleeding (OR 1.48, 95%CI 1.39-1.57).Conclusions: A diagnosis of PE occurs in 2.6% of patients hospitalized with a principal diagnosis of pneumonia. Having concomitant PE was associated with greater risks of in-hospital mortality, increased use of mechanical ventilation and thrombolysis, extended hospital stay, and higher inpatient costs.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 4","pages":"181-190"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721816","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}

引用次数: 0

Implementing a Digital Deteriorating Patient Pathway to improve the safety and effectiveness of care of the adult deteriorating patient. 实施 "数字化病情恶化患者路径"，提高对病情恶化的成年患者的护理安全性和有效性。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0968

Adrian Jennings, Philip Brammer, Sian Annakin, Helen Bromage, Tom Cook, Michele Hickey, Jagjit Dhami, Fhezan Ashraf, Ravi Sahota-Thandi, Stephen Borrington

引用次数: 0

Evaluating dynamic patterns in mortality before and after reconfiguration of the Danish emergency healthcare system. 评估丹麦急诊医疗系统重组前后死亡率的动态模式。

Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0967

Marianne Fløjstrup, Anna Kollerup, Søren B Bogh, Mickael Bech, Daniel Henriksen, Søren P Johnsen, Mikkel Brabrand

引用次数: 0