Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias最新文献

{"title":"Current epidemiology of microbiologically documented infections and risk factors for multidrug resistance in hematologic patients presenting to the emergency department with suspected bacteremia.","authors":"Olivier Peyrony, Nicole García-Pouton, Mariana Chumbita, Tommaso Francesco Aiello, Patricia Monzó-Gallo, Christian Teijon-Lumbreras, Antonio Gallardo-Pizarro, Ana Martínez-Urrea, Maria Queralt Salas, Cristina Pitart, Gemma Martínez-Nadal, Laura Rosiñol, Josep Mensa, Alex Soriano, Carolina García-Vidal","doi":"10.55633/s3me/048.2025","DOIUrl":"10.55633/s3me/048.2025","url":null,"abstract":"<p><strong>Objective: </strong>To describe the microbiological isolates obtained from hematologic patients seen in the emergency department (ED) who had blood cultures requested and identify the risk factors associated with the isolation of multidrug-resistant bacteria (MDR).</p><p><strong>Methods: </strong>We conducted a retrospective, observational, and descriptive study of all consecutive patients with hematologic malignancies who presented to the ED and had, at least, 1 blood culture requested within the first 72 hours following admission from January 2020 through March 2022. The decision on the number of blood cultures and other requested samples was made by the attending physician. A descriptive analysis was performed on the microbiological isolates from blood cultures and, when applicable, from other requested samples. A multivariate analysis was conducted to determine the variables associated with MDR isolation.</p><p><strong>Results: </strong>A total of 679 ED visits were included. The median patient age was 66 years (IQR, 52-76), with lymphoma being the most prevalent hematologic disease (35.6%). A significant proportion of patients had prior hospitalizations (47%), were colonized by multidrug-resistant gram-negative bacilli (MDR-GNB) (14%), and/or were neutropenic (27%). In addition to blood cultures, at least, 1 more culture was requested in 556 visits, 202 of which had > 1 blood culture, resulting in a total of 1,751 microbiological cultures in the ED. Most samples came from blood (936; 53.5%), followed by urine (567; 32.4%), respiratory tract (88; 5%), and stool (88; 5%). A total of 211 (12.1%) cultures tested positive in 179 ED visits (26.4%). Of these, 99 (10.6%) blood cultures tested positive in 88 (13%) visits. Among patients with bacteremia, gram-negative bacilli (GNB) were the most common microorganisms (48%), with 12 (25%) categorized as MDR-GNB. Gram-positive microorganisms were documented in 47 (47%) episodes of bacteremia. MDR bacteria were isolated in 40 (5.9%) visits. A past medical history of MDR was associated with MDR isolation in the ED [OR, 4.13; 95%CI, 1.99-8.50].</p><p><strong>Conclusions: </strong>The proportion of positive cultures and MDR isolates is relatively high in patients with hematologic malignancies presenting to the ED. A past medical history of MDR is an independent risk factor for MDR isolation.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 4","pages":"274-280"},"PeriodicalIF":6.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983806","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":"Comparative study between two N-acetylcysteine treatment regimens in massive paracetamol poisonings.","authors":"Mònica Alemany Pagès, August Supervía Caparrós, Francisca Córdoba Ruiz, En Representación Del Grupo de Trabajo Snap","doi":"10.55633/s3me/045.2025","DOIUrl":"https://doi.org/10.55633/s3me/045.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 3","pages":"239-240"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328109","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":"Comprehensive approach to medication-related problems leading to emergency department visits from a gender perspective.","authors":"Concepción Marín-Barcena, Mireia Puig-Campmany, Jesús Ruiz-Ramos, Carmen Carazo-Díaz, Jorge Vicente-Romero, Ana Juanes-Borrego","doi":"10.55633/s3me/026.2025","DOIUrl":"10.55633/s3me/026.2025","url":null,"abstract":"<p><strong>Objective: </strong>To describe and compare the diagnosis associated with medication-related problems (MRP) that lead to emergency departments visits based on sex and type of culprit drug.</p><p><strong>Methods: </strong>We conducted a retrospective observational study included 1,611 adult patients who visited the emergency department of a tertiary referral center in Catalonia (Spain) from 2021 through 2022 for MRP. We collected sociodemographic and clinical baseline variables in addition to the diagnosis and drug associated with the MRP that caused the visit to the emergency department based on the medical history at discharge. Data analysis was performed using binomial distribution tests and binary logistic regression models.</p><p><strong>Results: </strong>More than 50% of patients who visit the emergency department for MRP are women (95%CI, 55%-60%). Additionally, as age increases, the percentage of women visiting the emergency department rises significantly vs men (P .001). Significant differences by sex were found in the MRP-related diagnosis and the type of culprit drug. The frequency of women with MRP associated with diarrhea and decreased intestinal motility was higher (P .001), as well as unintentional drug poisonings (P = .001), hypertension (P = .010), hyponatremia (P .001), and hypokalemia (P = .001). Women visit the emergency department more than men do regarding MRP associated with drugs acting on the nervous, cardiovascular, and anti-infective systems (P .001).</p><p><strong>Conclusions: </strong>Results highlight sex differences and justify the need to continue researching to minimize such differences.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 3","pages":"186-195"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328110","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 National Early Warning Score 2 (NEWS2) in prehospital care.","authors":"Vicenç Ferrés-Padró, Francesc Xavier Jiménez Fàbrega","doi":"10.55633/s3me/053.2025","DOIUrl":"https://doi.org/10.55633/s3me/053.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 4","pages":"318-319"},"PeriodicalIF":6.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983766","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":"Communications and information management in natural disasters.","authors":"Juan Luis Muñoz Fernández, Víctor W Casas Benavent","doi":"10.55633/s3me/023.2025","DOIUrl":"https://doi.org/10.55633/s3me/023.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 4","pages":"318"},"PeriodicalIF":6.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983731","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":"Vicente Chuliá, biographical sketch of a pioneer in emergency medicine.","authors":"Juan Luis Muñoz Fernández","doi":"10.55633/s3me/046.2025","DOIUrl":"https://doi.org/10.55633/s3me/046.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 4","pages":"304-306"},"PeriodicalIF":6.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983734","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":"Clinical application of the National Early Warning Score 2 in prehospital emergency care: a study of evaluating risk with an objective scoring of severity.","authors":"José Pedro Cidade, Catarina Conceição, Jorge Nunes, Ana Lufinha","doi":"10.55633/s3me/034.2025","DOIUrl":"https://doi.org/10.55633/s3me/034.2025","url":null,"abstract":"<p><strong>Objective: </strong>The National Early Warning Score 2 (NEWS2) is a tool used internationally to detect risk of clinical deterioration and promote rapid intervention. Although it has been extensively validated in hospital settings, few prospective studies have sought evidence of the score's ability to identify patients at high risk during prehospital emergency care. This study aimed to assess the ability of the NEWS2 to predict high risk for poor outcomes in out-of-hospital emergencies.</p><p><strong>Methods: </strong>Prospective cohort study of patients evaluated by emergency medical technicians before arrival for treatment at a tertiary care hospital. NEWS2 findings for all eligible patients were recorded and then analyzed according to patient survival or not.</p><p><strong>Results: </strong>We included 1307 patients (mean age 64.5 years); 51% were males, 1268 were survivors, and 39 were nonsurvivors). The median (interquartile range) NEWS2 score for survivors (3 [1-6]) was significantly lower than the median for nonsurvivors (14 [11-17]) (P .001). The areas under the receiver operating characteristic curves (AUCs) demonstrated that the NEWS2 was a significant predictor of poor outcomes such as all-cause mortality (AUC, 0.95; 95% CI, 0.93-0.98), admission to the intensive care unit (AUC, 0.93; 95% CI, 0.91-0.94), and later in-hospital mortality (AUC, 0.83; 95% CI, 0.80-0.87). Multivariate logistic regression analysis identified significant associations between the NEWS2 assessment and mortality (adjusted odds ratio, 1.599; 95% CI, 1.447-1.766; P .001). A NEWS2 score greater than 4 reliably identified patients at high risk for both early death (P .001) and later in-hospital death (P .001).</p><p><strong>Conclusions: </strong>The NEWS2 is useful for evaluating patients in prehospital emergency care, enabling responders to quickly recognize serious clinical scenarios and identify patients at high risk for early in-hospital mortality.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 3","pages":"177-185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328107","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":"Leukocyte biomarkers as a diagnostic tool in exacerbations of chronic obstructive pulmonary disease.","authors":"Esther Pulido Herrero, Amaia Fernández Alonso, Aitor Odiaga Andicoechea, Marisol Gallardo Rebollal, Jone Amigo Angulo, María Ela Santiago","doi":"10.55633/s3me/041.2025","DOIUrl":"https://doi.org/10.55633/s3me/041.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 3","pages":"236"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328207","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":"Adverse drug events associated with emergency departments visits.","authors":"Jesús Ruiz Ramos, Rosario Santolaya Perrín, María Ángeles García Martín, Yolanda Castellanos Clemente, Montserrat Alonso Díez, Ana de Lorenzo Pinto, Ana Such Díaz, Amparo Fernández de Simón Almela, Paloma Sempere Serrano, Ana Suárez-Lledó Grande, Cristina Calzón Blanco","doi":"10.55633/s3me/025.2025","DOIUrl":"10.55633/s3me/025.2025","url":null,"abstract":"<p><strong>Objective: </strong>Objective. Adverse drug events (ADEs) are a well-known cause for emergency department visits. The objective of this study is to evaluate the prevalence of these adverse events through an annual multicentcer cross-sectional registry and identify factors associated with new emergency visits within 30 days following discharge.</p><p><strong>Methods: </strong>We conducted a multicenter cross-sectional study in emergency departments of Spanish hospitals. The identification and registration of patients were obtained from the census of patients treated in emergency departments at the end of the of the 5-year registry period. We used a multivariate logistic regression model to evaluate possible risk factors for new emergency visits within 30 days of discharge.</p><p><strong>Results: </strong>A total of 10,678 patients were evaluated in 53 centers, 785 of whom (7.35%) consulted due to ADEs. Prevalence ranged from 0% up to 14.3%. Antithrombotic drugs were the therapeutic group responsible for the highest number of events, causing 96 of them (25.9%). Regarding AEs, hemorrhagic events (n = 63; 8.1%), followed by episodes of confusion (n = 42; 5.4%), were the most common ones. A total of 86 (23.5%) evaluable patients returned to the emergency department within 30 days of discharge. Chronic prescription of > 10 drugs was associated with a higher risk of new consultations [OR, 1.65 (1.07-2.56)].</p><p><strong>Conclusions: </strong>ADEs are a common reason for emergency department visits and are associated with a significant number of subsequent visits after discharge. Severe polypharmacy is a risk factor for new emergency visits within 30 days.</p>","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 3","pages":"196-202"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328104","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":"Contralateral ultrasound findings in unilateral radiological pneumonias: a multicenter study.","authors":"Marco Antonio Bustamante Araujo, Cristina Luna Pardo, Davide Bernaudo, Jorge Cumarín Solórzano, Marta Nogué Infante, Ramón Nogué Bou","doi":"10.55633/s3me/044.2025","DOIUrl":"https://doi.org/10.55633/s3me/044.2025","url":null,"abstract":"","PeriodicalId":93987,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"37 3","pages":"238-239"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328111","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}