Journal of Critical Care Medicine最新文献

{"title":"Hypercoagulopathy in Overweight and Obese COVID-19 Patients: a Single-Center Case Series","authors":"A. Sarfraz, Z. Sarfraz, Aman Siddiqui, Ali Totonchian, S. A. Bokhari, Hafiza Hussain, Muzna Sarfraz, Gaurav Patel, Muhammad Hassaan Amjad, S. Tebha, I. Chérrez-Ojeda, P. Dreyer, H. Amin, Jack Michel","doi":"10.2478/jccm-2021-0032","DOIUrl":"https://doi.org/10.2478/jccm-2021-0032","url":null,"abstract":"Abstract A case series is presented of five overweight or obese patients with confirmed coronavirus disease 2019 (COVID-19) in South Miami, Florida, United States. A multitude of coagulation parameters was suggestive of a hypercoagulable state among the hospitalized COVID-19 patients. This article reports various manifestations of hypercoagulable states in overweight and obese patients, such as overt bleeding consistent with disseminated intravascular coagulation, venous thromboembolism, gastrointestinal bleeding as well as retroperitoneal hematoma. All of the required admission to the intensive care unit and subsequently patients died. The characteristics of COVID-19-associated coagulopathy are atypical and warrant a further understanding of the pathophysiology to improve clinical outcomes, specifically in overweight or obese patients.","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"8 1","pages":"41 - 48"},"PeriodicalIF":1.1,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46842009","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":"The Predictive Potential of Elevated Serum Inflammatory Markers in Determining the Need for Intubation in CoVID-19 Patients","authors":"S. Windham, Kellen Hirsch, R. Peterson, David Douin, Lakshmi Chauhan, Lauren M Heery, Connor Fling, Nemanja Vukovic, F. Holguin, Shanta Zimmer, Kristine M. Erlandson","doi":"10.2478/jccm-2021-0035","DOIUrl":"https://doi.org/10.2478/jccm-2021-0035","url":null,"abstract":"Abstract Introduction The predictive potential of demographics, clinical characteristics, and inflammatory markers at admission to determine future intubation needs of hospitalised CoVID-19 patients is unknown. The study aimed to determine the predictive potential of elevated serum inflammatory markers in determining the need for intubation in CoVID-19 Patients. Methods In a retrospective cohort study of hospitalised SARS-CoV2 positive patients, single and multivariable regression analyses were used to determine covariate effects on intubation odds, and a minimax concave penalty regularised logistic regression was used to build a predictive model. A second prospective independent cohort tested the model. Results Systemic inflammatory markers obtained at admission were higher in patients that required subsequent intubation, and adjusted odds of intubation increased for every standard deviation above the mean for c-reactive protein (CRP) OR:2.8 (95% CI 1.8-4.5, p<0.001) and lactate dehydrogenase OR:2.1 (95% CI 1.33.3, p=0.002). A predictive model incorporating C-reactive protein, lactate dehydrogenase, and diabetes status at the time of admission predicted intubation status with an area under the curve (AUC) of 0.78 with corresponding sensitivity of 86%, specificity of 63%. This predictive model achieved an AUC of 0.83, 91% sensitivity, and 41% specificity on the validation cohort. Conclusion In patients hospitalised with CoVID-19, elevated serum inflammatory markers measured within the first twenty-four hours of admission are associated with an increased need for intubation. Additionally, a model of C-reactive protein, lactate dehydrogenase, and the presence of diabetes may play a predictive role in determining the future need for intubation.","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"8 1","pages":"14 - 22"},"PeriodicalIF":1.1,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47472400","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":"Pheochromocytoma, Fulminant Heart Failure, and a Phenylephrine Challenge. the Perioperative Management of Adrenalectomy in a Jehovah’s Witness Patient: a Case Report","authors":"Sarah A. Bachman, Ryan S. Peterson, P. Burrage, Leigh C. Hickerson","doi":"10.2478/jccm-2021-0038","DOIUrl":"https://doi.org/10.2478/jccm-2021-0038","url":null,"abstract":"Abstract Perioperative management of pheochromocytoma in the setting of catecholamine-induced heart failure requires careful consideration of hemodynamic optimization and possible mechanical circulatory support. A Jehovah’s Witness patient with catecholamine-induced acutely decompensated heart failure required dependable afterload reduction for a cardio-protective strategy. This was emphasized due to the relative contraindication to perioperative anticoagulation required for mechanical circulatory support. A phenylephrine challenge clearly demonstrated adequate alpha blockade after only 24 hours of phenoxybenzamine treatment. This resulted in advancement of the surgery date. This case also highlights management of beta blockade, volume and salt loading, autologous blood transfusion, and profound post-operative vasoplegia in the setting of cardiogenic shock. Careful attention to hemodynamic optimization and cardio-protective strategies ultimately resulted in positive outcome for this challenging clinical scenario.","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"8 1","pages":"55 - 60"},"PeriodicalIF":1.1,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43478679","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":"Acute Kidney Injury following Rhabdomyolysis in Critically Ill Patients.","authors":"Alvin Saverymuthu,&nbsp;Rufinah Teo,&nbsp;Jaafar Md Zain,&nbsp;Saw Kian Cheah,&nbsp;Aliza Mohamad Yusof,&nbsp;Raha Abdul Rahman","doi":"10.2478/jccm-2021-0025","DOIUrl":"https://doi.org/10.2478/jccm-2021-0025","url":null,"abstract":"<p><strong>Introduction: </strong>Rhabdomyolysis, which resulted from the rapid breakdown of damaged skeletal muscle, potentially leads to acute kidney injury.</p><p><strong>Aim: </strong>To determine the incidence and associated risk of kidney injury following rhabdomyolysis in critically ill patients.</p><p><strong>Methods: </strong>All critically ill patients admitted from January 2016 to December 2017 were screened. A creatinine kinase level of > 5 times the upper limit of normal (> 1000 U/L) was defined as rhabdomyolysis, and kidney injury was determined based on the Kidney Disease Improving Global Outcome (KDIGO) score. In addition, trauma, prolonged surgery, sepsis, antipsychotic drugs, hyperthermia were included as risk factors for kidney injury.</p><p><strong>Results: </strong>Out of 1620 admissions, 149 (9.2%) were identified as having rhabdomyolysis and 54 (36.2%) developed kidney injury. Acute kidney injury, by and large, was related to rhabdomyolysis followed a prolonged surgery (18.7%), sepsis (50.0%) or trauma (31.5%). The reduction in the creatinine kinase levels following hydration treatment was statistically significant in the non- kidney injury group (Z= -3.948, p<0.05) compared to the kidney injury group (Z= -0.623, p=0.534). Significantly, odds of developing acute kidney injury were 1.040 (p<0.001) for mean BW >50kg, 1.372(p<0.001) for SOFA Score >2, 5.333 (p<0.001) for sepsis and the multivariate regression analysis showed that SOFA scores >2 (p<0.001), BW >50kg (p=0.016) and sepsis (p<0.05) were independent risk factors. The overall mortality due to rhabdomyolysis was 15.4% (23/149), with significantly higher incidences of mortality in the kidney injury group (35.2%) vs the non- kidney injury (3.5%) [ p<0.001].</p><p><strong>Conclusions: </strong>One-third of rhabdomyolysis patients developed acute kidney injury with a significantly high mortality rate. Sepsis was a prominent cause of acute kidney injury. Both sepsis and a SOFA score >2 were significant independent risk factors.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"267-271"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/52/jccm-07-267.PMC8647668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834455","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":"Shock due to an Obstructed Endotracheal Tube.","authors":"Stefanie Foong Ling Chua,&nbsp;Chi Ho Chan,&nbsp;Suhitharan Thangavelautham","doi":"10.2478/jccm-2021-0027","DOIUrl":"https://doi.org/10.2478/jccm-2021-0027","url":null,"abstract":"<p><p>Endotracheal tube obstruction by a mucus plug causing a ball-valve effect is a rare but significant complication. The inability to pass a suction catheter through the endotracheal tube with high peak and plateau pressure differences are classical features of an endotracheal tube obstruction. A case is described of endotracheal tube obstruction from a mucus plug that compounded severe respiratory acidosis and hypotension in a patient who simultaneously had abdominal compartment syndrome. The mucus plug was not identified until a bronchoscopic assessment of the airway was performed. Due to the absence of classical signs, the delayed identification of the obstructing mucus plug exacerbated diagnostic confusion. It resulted in various treatments being trialed whilst the patient continued to deteriorate from the evasive offending culprit. We suggest that earlier and more routine use of bronchoscopy should be employed in an intensive care unit, especially as a definitive way to rule out endotracheal obstruction.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"308-311"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/83/jccm-07-308.PMC8647666.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834461","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":"The Use of Hydroxyurea in the Treatment of COVID-19.","authors":"Melissa Robin Bowman Foster,&nbsp;Ali Atef Hijazi,&nbsp;Rebecca Opoku,&nbsp;Priya Varghese,&nbsp;Chun Li","doi":"10.2478/jccm-2021-0019","DOIUrl":"https://doi.org/10.2478/jccm-2021-0019","url":null,"abstract":"<p><strong>Introduction: </strong>The rapid worldwide spread of COVID-19 motivated medical professionals to pursue and authenticate appropriate remedies and treatment protocols. This article aims to analyze the potential benefits of one treatment protocol developed by a group of care providers caring for severe COVID-19 patients.</p><p><strong>Methods: </strong>The clinical findings of COVID-19 patients who were transferred to a specialized care hospital after unsuccessful treatment in previous institutions, were analyzed. The specialized care hospital used a treatment protocol including hydroxyurea, a medication commonly used for sickle cell treatment, to improve respiratory distress in the COVID-19 patients. None of the COVID-19 patients included in the analyzed data were diagnosed with sickle cell, and none had previously taken hydroxyurea for any other conditions.</p><p><strong>Results: </strong>In all presented cases, patients reverted to their baseline respiratory health after treatment with the hydroxyurea protocol. There was no significant difference in the correlation between COVID-19 and hydroxyurea. However, deaths were extremely low for those taking hydroxyurea.</p><p><strong>Conclusions: </strong>Fatality numbers were extremely low for those taking hydroxyurea; death could be attributed to other underlying issues.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"312-317"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/76/jccm-07-312.PMC8647674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834918","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":"Inhaled Nitric Oxide in Patients with Severe COVID-19 Infection at Intensive Care Unit - A Cross Sectional Study.","authors":"Laura Herranz,&nbsp;Juliana Gurgel da Silveira,&nbsp;Luis Filipe Lannes Trocado,&nbsp;Anna Luiza Alvaraes,&nbsp;Juliana Fittipaldi","doi":"10.2478/jccm-2021-0033","DOIUrl":"https://doi.org/10.2478/jccm-2021-0033","url":null,"abstract":"In adults with severe hypoxemia, inhaled nitric oxide (iNO) is known to reduce pulmonary shunt and pulmonary hypertension, improving V/Q matching [1]. Studies in refractory hypoxemia among patients with severe acute respiratory distress syndrome (ARDS) suggest that iNO may be allied to other ventilatory strategies as a bridge to clinical improvement [2, 3]. A trial from the 2004 Beijing Coronavirus Outbreak showed that low dose iNO could shorten the time of ventilatory support [4]. Additionally, preclinical studies suggest an inhibitory effect of iNO on viral replication [5]. To date, the role of iNO in COVID19 infection is still unclear. Our study is a retrospective cross-sectional study of adults admitted with severe COVID-19 undergoing mechanical ventilation, at least 48 hours, in our quaternary ICU at Quinta D’or Hospital, Rio de Janeiro, Brazil, from March 13th to June 19th 2020. Were excluded patients with non-assisted cardiac arrest, refractory shock, extracorporeal membrane oxygenation or palliative care. Were considered eligible for iNO therapy patients with persistent hypoxemia, defined as Pa02/Fi02 ratio ≤150 or FiO2≥ 80% for at least 12 hours, in association with optimal ventilatory strategy. Our aim was to evaluate the association between iNO and improvement of hypoxemia in those critically ill patients, defined as an increase of 20% or more in the PaO2/FiO2 ratio for over 48 hours after iNO initiation. Secondary outcomes include time under mechanical ventilation, hospitalization, and mortality. Survival of patients undergoing mechanical ventilation with and without iNO was compared. Sides effects, such as severe hypotension and amine use, coagulopathy, increase in nitrogen dioxide &gt;3ppm or methemoglobin &gt;8%, were investigated. Nitric oxide was initially given at 20-30ppm and increased up to a 40ppm maximal dose, according to PaO2 in arterial blood gas analysis. Titred dose was mantained for at least 24 hours, except when not tolerated. Once clinical improvement was archieved, named PaO2/fiO2 ratio &gt;250, gas was slowly and gradually withdrawn, every 6 to 12 hours, reduced in 5ppm accourding to blood gas analysis, in order to avoid rebound effect. Other therapeutic strategies were used apart from iNO, according to clinical judgment. Were enrolled to this cohort 34 critically ill patients– we analysed 12 patients with iNO and 15 patients without iNO were analysed. Seven patients were excluded. Seventy percent of the participants were men, median age was 60 years. Computed Tomography (CT) imaging and laboratory results were heterogeneous among patients. A large majority of our study population used neuromuscular blockage to treat hypoxemia. Likewise, a substantial majority needed vasoactive support, as well as renal replacement support. Regarding pharmacological approach, most of them received antibiotics, corticoid, and adjusted dose of heparin. Patients elected to iNO therapy had a statistically prolonged time under mechanical ventila","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"318-319"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/73/jccm-07-318.PMC8647665.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39745614","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":"Should we go \"Regional\" in Intensive Care?","authors":"Alexandra Lazar","doi":"10.2478/jccm-2021-0042","DOIUrl":"https://doi.org/10.2478/jccm-2021-0042","url":null,"abstract":"","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"255-256"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/9c/jccm-07-255.PMC8647671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39746706","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 Sleep Architecture using 24-hour Polysomnography in Patients Recovering from Critical Illness in an Intensive Care Unit and High Dependency Unit: a Longitudinal, Prospective, and Observational Study.","authors":"Brijesh Prajapat,&nbsp;Nitesh Gupta,&nbsp;Dhruva Chaudhry,&nbsp;Ario Santini,&nbsp;A S Sandhya","doi":"10.2478/jccm-2021-0023","DOIUrl":"https://doi.org/10.2478/jccm-2021-0023","url":null,"abstract":"<p><strong>Background and objective: </strong>The sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is frequently unsettled and inadequate both qualitatively and quantitatively. The study aimed to investigate and elucidate factors influencing sleep architecture and quality in ICU and HDU in a limited resource setting with financial constraints, lacking human resources and technology for routine monitoring of noise, light and sleep promotion strategies in ICU.</p><p><strong>Methods: </strong>The study was longitudinal, prospective, hospital-based, analytic, and observational. Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS) pre hospitalisation scores were recorded. Patients underwent 24-hour polysomnography (PSG) with the simultaneous monitoring of noise and light in their environments. Patients stabilised in ICU were transferred to HDU, where the 24-hour PSG with the simultaneous monitoring of noise and light in their environments was repeated. Following PSG, the Richards-Campbell Sleep Questionnaire (RCSQ) was employed to rate patients' sleep in both the ICU and HDU.</p><p><strong>Results: </strong>Of 46 screened patients, 26 patients were treated in the ICU and then transferred to the HDU. The mean (SD) of the study population's mean (SD) age was 35.96 (11.6) years with a predominantly male population (53.2% (n=14)). The mean (SD) of the ISI and ESS scores were 6.88 (2.58) and 4.92 (1.99), respectively. The comparative analysis of PSG data recording from the ICU and HDU showed a statistically significant reduction in N1, N2 and an increase in N3 stages of sleep (p<0.05). Mean (SD) of RCSQ in the ICU and the HDU were 54.65 (7.70) and 60.19 (10.85) (p-value = 0.04) respectively. The disease severity (APACHE II) has a weak correlation with the arousal index but failed to reach statistical significance (coeff= 0.347, p= 0.083).</p><p><strong>Conclusion: </strong>Sleep in ICU is disturbed and persisting during the recovery period in critically ill. However, during recovery, sleep architecture shows signs of restoration.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"257-266"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/67/jccm-07-257.PMC8647672.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39746707","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 National Early Warning Scores and Rapid Emergency Medicine Scores with the APACHE II Scores as a Prediction of Mortality in Patients with Medical Emergency Team Activation: a Single-centre Retrospective Cohort Study.","authors":"Junpei Haruna,&nbsp;Hiroomi Tatsumi,&nbsp;Satoshi Kazuma,&nbsp;Hiromitsu Kuroda,&nbsp;Yuya Goto,&nbsp;Wakiko Aisaka,&nbsp;Hirofumi Terada,&nbsp;Tomoko Sonoda,&nbsp;Yoshiki Masuda","doi":"10.2478/jccm-2021-0040","DOIUrl":"https://doi.org/10.2478/jccm-2021-0040","url":null,"abstract":"<p><strong>Introduction: </strong>The medical emergency team enables the limitation of patients' progression to critical illness in the general ward. The early warning scoring system (EWS) is one of the criteria for medical emergency team activation; however, it is not a valid criterion to predict the prognosis of patients with MET activation.</p><p><strong>Aim: </strong>In this study, the National Early Warning Score (NEWS) and Rapid Emergency Medicine Score (REMS) was compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting the prognosis of patients who had been treated a medical emergency team.</p><p><strong>Material and methods: </strong>In this single-centre retrospective cohort study, patients treated by a medical emergency team between April 2013 and March 2019 and the 28-day prognosis of MET-activated patients were assessed using APACHE II, NEWS, and REMS.</p><p><strong>Results: </strong>Of the 196 patients enrolled, 152 (77.5%) were men, and 44 (22.5%) were women. Their median age was 68 years (interquartile range: 57-76 years). The most common cause of medical emergency team activation was respiratory failure (43.4%). Univariate analysis showed that APACHE II score, NEWS, and REMS were associated with 28-day prognostic mortality. There was no significant difference in the area under the receiver operating characteristic curve of APACHE II (0.76), NEWS (0.67), and REMS (0.70); however, the sensitivity of NEWS (0.70) was superior to that of REMS (0.47).</p><p><strong>Conclusion: </strong>NEWS is a more sensitive screening tool like APACHE II than REMS for predicting the prognosis of patients with medical emergency team activation. However, because the accuracy of NEWS was not sufficient compared with that of APACHE II score, it is necessary to develop a screening tool with higher sensitivity and accuracy that can be easily calculated at the bedside in the general ward.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"7 4","pages":"283-289"},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/2a/jccm-07-283.PMC8647673.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834457","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}