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 Diagnostic Value of Serum Procalcitonin in Patients with Convulsion in Emergency Department, an Observational Study

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 683
Author(s):  
Hisashi Murakami ◽  
Hiromu Naraba ◽  
Takashi Gondo ◽  
Masaki Mochizuki ◽  
Hidehiko Nakano ◽  
...  
Keyword(s):  
Emergency Department ◽  
Bacterial Infection ◽  
Likelihood Ratio ◽  
Bacterial Infections ◽  
Care Center ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnostic Values ◽  
Group Members

Procalcitonin (PCT), a widely used biomarker for bacterial infections, is sometimes measured in convulsion patients to distinguish bacterial infections including bacterial meningitis. However, serum PCT elevation is reported in several other conditions. This study assessed the diagnostic value of serum PCT concentrations in convulsion patients. This study examined a convulsion group: patients admitted to our critical care center during April 2018 through September 2019 via the emergency department presenting with convulsions. Randomly sampled patients admitted without convulsions were categorized as a non-convulsion group. Serum PCT analysis was performed with consideration of whether or not the patient had an infection. Diagnostic values of serum PCT for bacterial infection were evaluated for convulsion and non-convulsion patients using the positive likelihood ratio of PCT. This study found 84 patients as eligible for the convulsion group; 1:2 matched 168 control patients were selected as non-convulsion group members. The positive likelihood ratio for bacterial infection was found to be significantly lower in the convulsion group than in the control group (1.94 vs. 2.65) when setting the positive cut-off for PCT as 0.5 ng/mL. Convulsion patients had a higher PCT value. The positive likelihood ratio for patients without bacterial infection was lower.

Triage of Mechanical Ventilation for Pediatric Patients During a Pandemic

2012 ◽  
Vol 6 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Kristin M. Kim ◽  
Sandro Cinti ◽  
Steven Gay ◽  
Susan Goold ◽  
Andrew Barnosky ◽  
...  
Keyword(s):  
Critical Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Scoring System ◽  
Pediatric Patients ◽  
Scoring Systems ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Logistic Organ Dysfunction ◽  
Triage Protocol

ABSTRACTObjective: The novel H1N1 influenza pandemic renewed the concern that during a severe pandemic illness, critical care and mechanical ventilation resources will be inadequate to meet the needs of patients. Several published protocols address the need to triage patients for access to ventilator resources. However, to our knowledge, none of these has addressed the pediatric populations.Methods: We used a systematic review of the pediatric critical care literature to evaluate pediatric critical care prognosis and multisystem organ failure scoring systems. We used multiple search engines, including MEDLINE and EMBASE, using a search for terms and key words including including multiple organ failure, multiple organ dysfunction, PELOD, PRISM III, pediatric risk of mortality score, pediatric logistic organ dysfunction, pediatric index of mortality pediatric multiple organ dysfunction score, “child+multiple organ failure + scoring system. ” Searches were conducted in the period January 2010-February 2010.Results: Of the 69 papers reviewed, 22 were used. Five independently derived scoring systems were evaluated for use in a respiratory pandemic ventilator triage protocol. The Pediatric Logistic Organ Dysfunction (PELOD) scoring system was the most appropriate for use in such a triage protocol.Conclusions: We present a pediatric-specific ventilator triage protocol using the PELOD scoring system to complement the NY State adult triage protocol. Further evaluation of pediatric scoring systems is imperative to ensure appropriate triage of pediatric patients.(Disaster Med Public Health Preparedness. 2012;6:131–137)

scholarly journals RIPASA score or Alvarado score: diagnosing acute appendicitis

2021 ◽  
Vol 8 (3) ◽  
pp. 879
Author(s):  
Talabadi Parmeshwar ◽  
Geeta Sandeep Ghag ◽  
Vipul Versi Nandu
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Imaging Techniques ◽  
Scoring Systems ◽  
Diagnostic Value ◽  
Early Years ◽  
P Value ◽  
Alvarado Score ◽  
Patient Admissions ◽  
Ripasa Score

Background: Appendicitis is a much studied about topic since the early years. Even with the advances in imaging techniques, appendicitis still relies upon clinical examination as a main resort of diagnosis. To aid this, several scoring systems have been developed taking into account various symptoms, signs and some basic laboratory investigations. Many studies have been done worldwide to check the sensitivity and specificity of each of these clinical scoring systems in the diagnosis of acute appendicitis. Though the most famous one is the Alvarado scoring system, there is none universally accepted scoring system used for diagnosis so far.Methods: 100 patients with RIF pain and who were suspected of acute appendicitis were evaluated for a period of 24 months. Evaluation was done with regards to RIPASA and Alvarado scoring in all these patients. All the results of both the scoring systems were reported and correlated with histopathological findings. Statistical test were applied to calculate the p value for the association between the variables of studied.Results: There was definitive agreement that both the scoring systems are positively correlating with each other with respect to the diagnosis of the disease (p value 0.0001). The difference in diagnostic accuracy of 25% between the RIPASA score and Alvarado score was statistically significant (p<0.0001). On analysis with chi-square test, both scores are significant at level 1 (p=0.0001). But RIPASA score has higher sensitivity and diagnostic value when compared to Alvarado score.Conclusions: The use of RIPASA scoring would help in decreasing the unwarranted patient admissions and also expensive radiological investigations. 

scholarly journals Predicting mortality in patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review.

2020 ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Multiple Biomarkers ◽  
Clinical Scoring

Abstract Introduction Sepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED.Methods We performed a systematic search using MEDLINE, PubMed, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the diagnostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. Results We found 18 articles in this systematic review. In these 18 articles, a total of 35 combinations of biomarkers and clinical scoring systems were studied of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. Conclusion In this systematic review, the combination of PCT, IL-6, lactate and the SAPS-2 score had the highest AUC on 1-month mortality in patients with sepsis in the ED. The studies we found in this review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis.

scholarly journals Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients

2021 ◽  
Vol 10 (16) ◽  
pp. 3657
Author(s):  
Julieta González-Flores ◽  
Carlos García-Ávila ◽  
Rashidi Springall ◽  
Malinalli Brianza-Padilla ◽  
Yaneli Juárez-Vicuña ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mechanical Ventilation ◽  
Scoring System ◽  
Positive Likelihood Ratio ◽  
Scoring Systems ◽  
Adverse Outcomes ◽  
Obesity And Diabetes ◽  
Diagnostic Characteristics ◽  
Risk Scoring ◽  
Risk Scoring System

Background: Several easy-to-use risk scoring systems have been built to identify patients at risk of developing complications associated with COVID-19. However, information about the ability of each score to early predict major adverse outcomes during hospitalization of severe COVID-19 patients is still scarce. Methods: Eight risk scoring systems were rated upon arrival at the Emergency Department, and the occurrence of thrombosis, need for mechanical ventilation, death, and a composite that included all major adverse outcomes were assessed during the hospital stay. The clinical performance of each risk scoring system was evaluated to predict each major outcome. Finally, the diagnostic characteristics of the risk scoring system that showed the best performance for each major outcome were obtained. Results: One hundred and fifty-seven adult patients (55 ± 12 years, 66% men) were assessed at admission to the Emergency Department and included in the study. A total of 96 patients (61%) had at least one major outcome during hospitalization; 32 had thrombosis (20%), 80 required mechanical ventilation (50%), and 52 eventually died (33%). Of all the scores, Obesity and Diabetes (based on a history of comorbid conditions) showed the best performance for predicting mechanical ventilation (area under the ROC curve (AUC), 0.96; positive likelihood ratio (LR+), 23.7), death (AUC, 0.86; LR+, 4.6), and the composite outcome (AUC, 0.89; LR+, 15.6). Meanwhile, the inflammation-based risk scoring system (including leukocyte count, albumin, and C-reactive protein levels) was the best at predicting thrombosis (AUC, 0.63; LR+, 2.0). Conclusions: Both the Obesity and Diabetes score and the inflammation-based risk scoring system appeared to be efficient enough to be integrated into the evaluation of COVID-19 patients upon arrival at the Emergency Department.

scholarly journals The Ability of Early Warning Scores to Predict in Hospital Mortality and ICU Admission for Patients with Covid 19 Pneumonia in the Emergency Department

2021 ◽  
Author(s):  
Yunus Arik ◽  
Hatice Topçu ◽  
Mustafa Altınay
Keyword(s):  
Emergency Department ◽  
Early Warning ◽  
Early Recognition ◽  
Demographic Data ◽  
Scoring Systems ◽  
Early Warning Score ◽  
Youden Index ◽  
Icu Admission ◽  
Admission Rates ◽  
Diagnostic Values

Introduction: Early recognition of critical patients in crowded environments such as emergency departments is required in Covid 19 pandemic and many early recognition scoring systems are used. In this study, we aimed to determine the prognostic values of these scoring systems. Material and method: This retrospective study was performed between March 2020 -May 2020 and 212 patient who have Covid 19 pneumonia were enrolled the study. National Early Warning Score (NEWS), Modified Early Warning Score (MEWS) and quick Sequential Organ Failure Assessment (qSOFA) scores were calculated at the time of admission to the emergency department. Demographic data, mortality, intensive care unit (ICU) admission rates and the prognostic values of the scores were calculated. Receiver operating characteristic (ROC) analysis was used to determine the diagnostic values of scores and the optimum cut-off values were determined by using Youden Index. Results: 23 (10.8%) of 212 patients died and 34 (16%) were admitted to ICU. The AUC values of MEWS, NEWS, and qSOFA for predicting mortality in < 65 years old were 0.852 (95% confidence interval 0.708-0.997), 0.882(0.741-1.000) and 0.879(0.768-0.990) and >65 years old, 0.854(0.720-0.987), 0.931(0.853-1.000), 0.776(0.609-0.944) respectively. For ICU admission AUC values of MEWS, NEWS and qSOFA in <65 years old followed as; 0.882(0.783-0.981), 0.914(0.817-1.000), 0.868(0.764-0.973) and 0.845(0.725-0.965), 0.926(0.854-0.998), 0.815(0.676-0.954) in ≥ 65 years old. While < 65 years old; MEWS and qSOFA’s optimal cut-off values for mortality were ≥2 with %90.0 sensitivity %74.7 specificity and ≥1 with %90.0 sensitivity %74.7 specificity, for ≥ 65 years NEWS optimal cut-off is ≥6 with 91.7% sensitivity and 76.7% specificity. Conclusion: All these three scores have good predictive value for mortality and ICU admission, but NEWS is better than MEWS and qSOFA especially in ≥ 65 years old patient with Covid 19 pneumonia.

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 Predicting mortality in adult patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Prognostic Accuracy ◽  
Clinical Scoring ◽  
Qsofa Score

Abstract Background Sepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED. Methods We performed a systematic search using MEDLINE, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the prognostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. We did not define biomarker cut-off values in advance. Results We included 18 articles in which a total of 35 combinations of biomarkers and clinical scoring systems were studied, of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. Conclusion The studies we found in this systematic review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis. Future studies should focus on clinical scoring systems which require a limited amount of clinical parameters, such as the qSOFA score in combination with a biomarker that is already routinely available in the ED.

Sensitivity Level of Placenta Accreta Index (PAI) Score and Placenta Accreta Spectrum (PAS) Stage as Preoperative Diagnostic Tools for Placenta Accreta Spectrum Disorders (PASD) at Haji Adam Malik General Hospital Medan Indonesia

2021 ◽  
Vol 17 ◽  
Author(s):  
Utari Purnama ◽  
Makmur Sitepu ◽  
Deri Edianto ◽  
Sarma Nursani Lumbanraja ◽  
Yudha Sudewo ◽  
...  
Keyword(s):  
General Hospital ◽  
Ultrasound Examination ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Predictive Values ◽  
Diagnostic Values ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders

Background: The incidence of Placenta Accreta Spectrum Disorders (PASD) increases by 10-fold in 50 years along with the number of cesarean sections. Ultrasound examination using Placenta Accreta Index (PAI) score and Placenta Accreta Spectrum (PAS) stage as a predictor of PASD has been used worldwide at the antenatal screening. The high diagnostic value of these tools will help the physician to diagnose PASD early and minimize the rate of maternal neonatal mortality and morbidity. Objectives: To evaluate the value of PAI score and PAS stage in diagnosing PASD. Methods: This study is a diagnostic test study using the medical records of mothers who gave birth at Haji Adam Malik General Hospital Medan Indonesia between September 2017 to September 2020, who were diagnosed preoperatively as placenta previa suspected PASD through ultrasound examination using PAI score or PAS stage. The results of these two diagnostic tests were compared to clinical diagnostic criteria of PASD from The International Federation of Obstetrics and Gynecology (FIGO) with or without histopathological confirmation. Results: Of the 177 placenta previa cases, there were 142 women with PASD (80.2%). The diagnostic values of PAI score with 4.6 as an optimal cut-off point were 75% sensitivity, 83% specificity, 94% positive predictive values (PPV), and 47% negative predictive values (NPV). The diagnostic values of the PAS stage were 90% sensitivity, 83%, specificity, 96% PPV, and 68% NPV. Conclusion: PAI score and PAS stage have a diagnostic value that looks equally good when used as a diagnostic tool for PASD.

scholarly journals Evaluating Outcome in Perforated Peptic Ulcer by Boey and POMPP Score

2021 ◽  
Vol 12 (1) ◽  
pp. 14
Author(s):  
Elvin Nuzulistina ◽  
Mamiek Dwi Putro ◽  
Dyah Fauziah
Keyword(s):  
Peptic Ulcer ◽  
General Hospital ◽  
Mortality Risk ◽  
Scoring System ◽  
Care Facility ◽  
Scoring Systems ◽  
Perforated Peptic Ulcer ◽  
Mortality And Morbidity ◽  
Advantages And Disadvantages ◽  
Risk Of Mortality

Introduction: Perforated peptic ulcer (PPU) is able to increase the risk of mortality and morbidity. This study used Boey and practical scoring system of mortality in patients with perforated peptic ulcer (POMPP) scoring systems to assess risk mortality of the patients. Every parameter has a value to add up 1 point in Boey and POMPP score. Methods: This observational study used medical records of PPU patients who came to Dr. Soetomo General Hospital in emergency state and being operated and treated at surgical inpatient care facility in 2016. The data were analyzed retrospectively. The sampling technique in this study was done by total sampling. Results: Most of PPU patients had the average age of 59.56 years old and 71.79% of the patients were male. Both analyzing results of Boey and POMPP scoring systems were not statistically significant to predict mortality risk of the patients. Even so, the results of Boey scoring system tended to have a positive correlation with mortality risk (0%, 37.50%, 52.94%, and 100%) with 17 patients (43.59%) had mortality. Conclusion: While Boey and POMPP score are most commonly used to predict outcome for PPU patients in Dr. Soetomo General Hospital, considerable variations in risk of mortality were shown. Therefore, both Boey and POMPP score had its own advantages and disadvantages. Further prospective research is needed to test the validity of Boey and POMPP scoring systems, thus the scoring systems can be used in daily hospital practice in patients with PPU. 

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