ΔN and ΔF showed a significant association with 30-day mortality, suggesting a prognostic value. However, this was a small pilot study with few events. Larger studies are warranted for confirmation of these findings.
Introduction: Quick and reliable assessment of acute patients is required for accurate triage. The temperature gradient between core and peripheral temperature could possibly instantly provide information on circulatory status. Methods: Adult medical patients, who did not receive supplementary oxygen, attending two emergency departments, had a thermographic image taken on arrival. The association between 30-day mortality and gradients was tested using logistic regression. Results: 726 patients were studied, median age was 64 years and 14 (1.9%) died within 30 days. There was a significant association between mortality and temperature gradient, comparable to vital signs, age, and clinical intuition. Conclusion: Temperature gradient between nose and eye had an acceptable discriminatory power for 30-day all-cause mortality.
The results of a prospective 5-year study of a medically staffed ambulance service are presented. There was a total of 558 turn-outs distributed among a mixed patient material. In 192 cases, resuscitation was attempted and this proved primarily successful in 59 patients. A total of 23 of these resuscitated patients could be discharged, 19 without cerebral sequelae, two with slight brain damage and two with severe brain damage. In 44 further cases, other relevant forms of emergency treatment were administered. It is concluded that prehospital treatment at the scene of accident seems beneficial to patients with life-threatening conditions.
Background Definitions and clinical criteria for sepsis have been revised in 2016. A simple bedside score ('qSOFA' , for quick Sequential [Sepsis-Related] Organ Failure Assessment) has been proposed, which incorporates hypotension (systolic blood pressure ≤100 mmHg), altered mental status and respiratory rate ≥ 22/min: the presence of at least two of these criteria has been associated with poor outcomes typical of sepsis. The aim of this study was to evaluate qSOFA as a predictor of 30-day mortality in a model with other predictors of death among patients admitted to a single-centre emergency department (ED). Methods A historical cohort study among prospectively registered patients with suspected or documented infection. The admission period was from 1 st of November 2013 to 31 th of October 2014. Baseline clinical data and data for survival were obtained from a standard sepsis admission form, the patient records and The Danish Civil Registration System. Logistic regression analysis was used to adjust for potential confounders and to determine whether the predictive factors for death in the crude analyses were independently associated with 30-day mortality. Results A total of 434 patients were included in the study. Fifty-seven (13.1%; 95% confidence interval [CI] 9.9-16.3%) patients died during the first 30 days. Among several potential confounders tested in the model we found that age (odds ratio [OR] 1.29; 95% CI 1.03-1.61), Charlson Comorbidity Score ≥ 3 (OR 3.83; 95% CI 1.41-10.37), qSOFA score ≥2 (OR 4.78; 95% CI 2.09-10.91) and lactate values (lactate values < 2.0 as reference) within the interval 2.00-3.99 (OR 2.21; 95% CI 1.06-4.62) and lactate values ≥ 4.0 (OR 3.97; 95% CI 1.44-2,92) were associated with 30-day mortality. Conclusion qSOFA can be helpful to identify infectious patients in an ED with increased risk of 30-day mortality.
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