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Báo cáo y học: "Risk assessment in the first fifteen minutes: a prospective cohort study of a simple physiological scoring system in the emergency department"

Merz et al. Critical Care 2011, 15:R25 http://ccforum.com/content/15/1/R25 Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Risk assessment in the first fifteen minutes: a prospective cohort study of a simple physiological scoring system in the emergency department. | Merz et al. Critical Care 2011 15 R25 http ccforum.eom content 15 1 R25 KS CRITICAL CARE RESEARCH Open Access Risk assessment in the first fifteen minutes a prospective cohort study of a simple physiological scoring system in the emergency department 1 1 1 1 1 2 1 Tobias M Merz Reto Etter Ludger Mende Daniel Barthelmes Jan Wiegand Luca Martinolli Jukka Takala Abstract Introduction The survival of patients admitted to an emergency department is determined by the severity of acute illness and the quality of care provided. The high number and the wide spectrum of severity of illness of admitted patients make an immediate assessment of all patients unrealistic. The aim of this study is to evaluate a scoring system based on readily available physiological parameters immediately after admission to an emergency department ED for the purpose of identification of at-risk patients. Methods This prospective observational cohort study includes 4 388 consecutive adult patients admitted via the ED of a 960-bed tertiary referral hospital over a period of six months. Occurrence of each of seven potential vital sign abnormalities threat to airway abnormal respiratory rate oxygen saturation systolic blood pressure heart rate low Glasgow Coma Scale and seizures was collected and added up to generate the vital sign score VSS . VSSinitial was defined as the VSS in the first 15 minutes after admission VSSmax as the maximum VSS throughout the stay in ED. Occurrence of single vital sign abnormalities in the first 15 minutes and VSSinitialand VSSmax were evaluated as potential predictors of hospital mortality. Results Logistic regression analysis identified all evaluated single vital sign abnormalities except seizures and abnormal respiratory rate to be independent predictors of hospital mortality. Increasing VSSinitialand VSSmax were significantly correlated to hospital mortality odds ratio OR 2.80 95 confidence interval CI 2.50 to 3.14 P 0.0001 for VSSinitial OR 2.36 95 CI 2.15 to 2.60 P