scholarly journals Relationship between Clinical Outcomes of Patients Diagnosed with Pulmonary Thromboembolism in the Emergency Department and their PESI, Shock Index, Modified Shock Index and Age Shock Index Scores

2021 ◽  
Author(s):  
ozkan erarslan ◽  
Hayriye Gonullu ◽  
serhat akay ◽  
tayfun ozturk ◽  
mustafa silcan
Keyword(s):  
Emergency Department ◽  
Troponin I ◽  
Pulmonary Thromboembolism ◽  
Saturation Temperature ◽  
Scoring Systems ◽  
Severity Index ◽  
Diagnostic Value ◽  
Shock Index ◽  
Experienced Radiologist ◽  
Pulmonary Angiogram

Aim: To investigate the diagnostic value of pulmonary embolism severity index (PESI), Simplified PESI (sPESI), Shock Index (SI), Modified SI (MSI), and Age SI (ASI) scores in predicting 30-day mortality in patients diagnosed with pulmonary thromboembolism (PTE) in the emergency department. Materials and Methods: The retrospective study included 257 patients that presented to the emergency department and underwent contrast-enhanced computed tomography pulmonary angiogram (CTPA) due to the suspicion of PTE and were interpreted as PTE by an experienced radiologist between January 1, 2015 and September 20, 2018.The PESI, sPESI, SI, MSI, and ASI scores were calculated for each patient. Results: On univariate logistic regression analysis, 30-day mortality was found to be significantly associated with age, mode of presentation, SBP, DBP, MAP, heart rate, respiratory rate, O2 saturation, temperature, D-dimer, troponin I, high-sensitivity cardiac troponin (hs-cTn), lactate, and SI, MSI, ASI, PESI, and sPESI scores (p<0.05). PESI had the highest AUC value for the prediction of 30-day mortality among all scoring systems. Conclusion: PESI had the highest diagnostic value in predicting 30-day mortality in the patients diagnosed with PTE in the emergency department, followed by ASI. Our findings regarding ASI may shed light on future studies evaluating critical patient groups.”

scholarly journals Pediatric Observational Priority Score and Early Warning Scoring System to Predict Admission Status in Pediatric Patients in Haji Adam Malik General Hospital

2021 ◽  
Vol 9 (T3) ◽  
pp. 244-248
Author(s):  
Linda Wati ◽  
Ririe Fachrina Malisie ◽  
Juliandi Harahap
Keyword(s):  
Emergency Department ◽  
General Hospital ◽  
Scoring System ◽  
Pediatric Patients ◽  
Scoring Systems ◽  
Diagnostic Value ◽  
Emergency Rooms ◽  
Priority Score ◽  
Admission Status ◽  
Diagnostic Values

Background: Doctors must be able to quickly and accurately assess clinical condition of patients, especially in the emergency rooms. An easy scoring system but producing meaningful clinical conclusions is the reason for creating various scoring systems. Includes a scoring system for predicting the admission status of patients. Aim: To determine the diagnostic value of POPS and EWSS to predicting admission status of pediatric patients in the emergency department. Methods: Diagnostic tests for POPS and EWSS were done to predict the admission status of pediatric patients in the emergency department of Haji Adam Malik general hospital from May to October 2020. Subjects aged 1 month to 18 years were excluded if they left the emergency department prior to assessment, had trauma cases, died, inpatients due to social indications, and patients who came only to continue therapy were also excluded. POPS and EWSS assessments were carried out by the researcher and the admission status of the patients were determined by the doctor in charge in the emergency department. Results: There were 119 children meeting the inclusion and exclusion criteria. POPS score ≥3 had sensitivity 82.65%, specificity 85.71%, and AUC 0.88 (p <0.001). EWSS score ≥2 had sensitivity 83.67%, specificity 71.43%, and AUC 0.83 (p <0.001). Conclusion: POPS and EWSS had good diagnostic values in predicting the admission status of pediatric patients in the emergency department. POPS has a slightly higher diagnostic value than EWSS.

scholarly journals Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department

2020 ◽  
Vol 17 (13) ◽  
pp. 4904
Author(s):  
Tzu-Heng Cheng ◽  
Yi-Da Sie ◽  
Kuang-Hung Hsu ◽  
Zhong Ning Leonard Goh ◽  
Cheng-Yu Chien ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Scoring Systems ◽  
Predictive Performance ◽  
Roc Curves ◽  
Shock Index ◽  
Evaluation Tool ◽  
Advanced Cancer Patients ◽  
Term Survival

Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they are unsuitable for use in the ED. We aim to examine the use of a shock index (SI) in predicting the 60-day survival of advanced cancer patients presenting to the ED. Identified high-risk patients and their families can then be counseled accordingly. Three hundred and five advanced cancer patients who presented to the EDs of three tertiary hospitals were recruited, and their data retrospectively analyzed. Relevant data regarding medical history and clinical presentation were extracted, and respective shock indices calculated. Multivariate logistic regression analyses were performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SI. Nonsurvivors within 60 days had significantly lower body temperatures and blood pressure, as well as higher pulse rates, respiratory rates, and SI. Each 0.1 SI increment had an odds ratio of 1.39 with respect to 60-day mortality. The area under the ROC curve was 0.7511. At the optimal cut-off point of 0.94, the SI had 81.38% sensitivity and 73.11% accuracy. This makes the SI an ideal evaluation tool for rapidly predicting the 60-day mortality risk of advanced cancer patients presenting to the ED. Identified patients can be counseled accordingly, and they can be assisted in making informed decisions on the appropriate treatment goals reflective of their prognoses.

scholarly journals Pulmonary Thromboembolism in a Child with Sickle Cell Hemoglobin D Disease in the Setting of Acute Chest Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hazel Villanueva ◽  
Sandeepkumar Kuril ◽  
Jennifer Krajewski ◽  
Aziza Sedrak
Keyword(s):  
Pulmonary Artery ◽  
Sickle Cell ◽  
Pulmonary Thromboembolism ◽  
Acute Chest Syndrome ◽  
Standard Management ◽  
Pulmonary Angiogram ◽  
Right Pulmonary Artery ◽  
Ct Pulmonary Angiogram ◽  
Complete Thrombosis ◽  
The Right

Introduction. Sickle cell hemoglobin D disease (HbSD) is a rare variant of sickle cell disease (SCD). Incidence of pulmonary thromboembolism (PE) and deep venous thrombosis (DVT) in children with HbSD is unknown. PE and DVT are known complications of SCD in adults but have not been reported in the literature in children with HbSD.Case Report. We are reporting a case of a 12-year-old boy with HbSD with acute chest syndrome (ACS) complicated by complete thrombosis of the branch of the right pulmonary artery and multiple small pulmonary artery emboli seen on computed tomography (CT) pulmonary angiogram and thrombosis of the right brachial vein seen on Doppler ultrasound. Our patient responded to treatment with anticoagulant therapy.Conclusion. There are no cases reported in children with HbSD disease presenting as ACS with pulmonary thromboembolism. We suggest that PE should be suspected in patients presenting with ACS who do not show improvement with standard management. CT pulmonary angiogram should be utilized for early diagnosis and appropriate management as there is no current protocol for management of PE/DVT in pediatric patients with SCD.

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