Blood glucose levels as an adjunct for prehospital field triage

Glassberg, Elon; Lipsky, Ari M.; Lending, Gadi; Сергеев, И. В.; Elbaz, Avishai; Morose, Alexander; Katzenell, Udi; Ash, Nachman

doi:10.1016/j.ajem.2012.10.038

Cited by 4 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in previous studies adding blood glucose to a scoring system added modest or no benefit 12–17. None of these studies were performed in a prehospital setting.…”

Section: Discussionmentioning

confidence: 99%

“…None of these studies were performed in a prehospital setting. Blood glucose was either without categorisation or only hyperglycaemia was considered in varying degrees: Cattermole et al (blood glucose ≥7.0 mmol/L), Timotéo et al (blood glucose ≥8.9 mmol/L), Glassberg et al (blood glucose ≤11.1 mmol/L and ≥11.1 mmol/L) and McCall et al with normoglycaemia, modest hyperglycaemia (7.9–11 mmol/L) and stress-induced hyperglycaemia (≥11.1 mmol/L), respectively 12–14 16. Hence, aside from Glassberg et al and McCall et al , these previous studies used mainly normoglycaemic or modest hyperglycaemic values, which are not good markers of critical illness.…”

Section: Discussionmentioning

confidence: 99%

“…Of the previous studies, one relied on AUROC12 and one on likelihood ratio 13. Most study analyses used logistic regression analysis 14–17.…”

Section: Discussionmentioning

confidence: 99%

“…Abbott et al 17 studied adding blood glucose to NEWS. All other studies used different scoring systems: Global Registry of Acute Coronary Events, Injury Severity Score, Prince of Wales Emergency Department Score and stroke subtype, Oxford community Stroke Project classification, age and prestroke modified Rankin 12–16. These scoring systems differed so much from NEWS that any valid comparison could not be truly made.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

et al. 2020

View full text Add to dashboard Cite

BackgroundTo determine if prehospital blood glucose could be added to National Early Warning Score (NEWS) for improved identification of risk of short-term mortality.MethodsRetrospective observational study (2008–2015) of adult patients seen by emergency medical services in Helsinki metropolitan area for whom all variables for calculation of NEWS and a blood glucose value were available. Survival of 24 hours and 30 days were determined. The NEWS parameters and glucose were tested by multivariate logistic regression model. Based on ORs we formed NEWSgluc model with hypoglycaemia (≤3.0 mmol/L) 3, normoglycaemia 0 and hyperglycaemia (≥11.1 mmol/L) 1 points. The scores from NEWS and NEWSgluc were compared using discrimination (area under the curve), calibration (Hosmer-Lemeshow test), likelihood ratio tests and reclassification (continuous net reclassification index (cNRI)).ResultsData of 27 141 patients were included in the study. Multivariable regression model for NEWSgluc parameters revealed a strong association with glucose disturbances and 24-hour and 30-day mortality. Likelihood ratios (LRs) for mortality at 24 hours using a cut-off point of 15 were for NEWSgluc: LR+ 17.78 and LR− 0.96 and for NEWS: LR+ 13.50 and LR− 0.92. Results were similar at 30 days. Risks per score point estimation and calibration model showed glucose added benefit to NEWS at 24 hours and at 30 days. Although areas under the curve were similar, reclassification test (cNRI) showed overall improvement of classification of survivors and non-survivors at 24 days and 30 days with NEWSgluc.ConclusionsIncluding glucose in NEWS in the prehospital setting seems to improve identification of patients at risk of death.

show abstract

“…However, in previous studies adding blood glucose to a scoring system added modest or no benefit 12–17. None of these studies were performed in a prehospital setting.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Of the previous studies, one relied on AUROC12 and one on likelihood ratio 13. Most study analyses used logistic regression analysis 14–17.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Some investigators have reported significantly higher mortality in groups of human patients with higher plasma glucose levels (see for specific studies). In more recent studies, elevated admission glucose levels have also been associated with an increased risk of life‐threatening complications in various critically ill groups (e.g., ). In contrast, because higher‐risk individuals often exhibit hyperglycemia on admission to hospital, some investigators have suggested that elevated glucose levels are only a marker of disease severity .…”

Section: Physiological Factors During Short‐duration Vs Longer‐duratmentioning

confidence: 99%

Exposures to Conducted Electrical Weapons (IncludingTASER^®Devices): How Many and for How Long are Acceptable?

Jauchem

2014

Journal of Forensic Sciences

View full text Add to dashboard Cite

TASER(®) conducted electrical weapons (CEWs) are an important law-enforcement tool. The purposes of this study are a) to review recent literature regarding potential pathophysiological responses to applications of CEWs, and other related issues and b) to evaluate whether enough data exist to determine the acceptability of longer-duration (or repeated) exposures. This is a narrative review, using a multidisciplinary approach of analyzing reports from physiological, legal-medical, and police-strategy literature sources. In general, short-duration exposures to CEWs result in limited effects. Longer-duration or repeated exposures may be utilized with caution, although there are currently not enough data to determine the acceptability of all types of exposures. Data examined in the literature have inherent limitations. Appropriateness of specific types of CEW usage may be determined by individual police agencies, applying risk/benefit analyses unique to each organization. While more research is recommended, initial concepts of potential future long-duration or repeated CEW applications are presented.

show abstract

Trauma severity associated with stress index in emergency settings: an observational prediction‐and‐validation study

Taniguchi

Doi

Abe

et al. 2020

Acute Medicine & Surgery

View full text Add to dashboard Cite

Aim: Early judgments for treating severe trauma patients are essential for life-saving. Stress index (SI), obtained from a division of blood glucose level by serum potassium at arrival, might be useful for early prediction. However, the efficacy of SI was unknown. The purpose of this study was to identify and validate prediction models of severe trauma (ST) and the need for damage control operation (DCOP) and massive transfusion (MT) by using SI among trauma patients. Methods: This study was a retrospective and prospective observational study. The prediction models were created by 1-year retrospective data of 167 trauma patients. The prediction models were validated by 6 months of prospective data of 87 trauma patients. Results: The prediction model for ST contained respiratory rate and SI as significant factors. The prediction model for DCOP contained SI. The prediction model for MT contained systolic blood pressure and SI. The correlation of probability of MT, ST, and DCOP was r = 0.70 (P < 0.001), r = 0.46 (P < 0.001), and r = 0.15 (P = 0.196), respectively. The predicted probability of MT, ST, and DCOP showed 0.93 (95% confidence interval [CI], 0.88-0.90) and 0.80 (95% CI, 0.74-0.86), and 0.79 (95% CI, 0.70-0.88). Conclusion: We identified and validated our prediction models for ST and the need for DCOP and MT among trauma patients using SI as a main predictor. Our models indicated that fewer variables in an early phase of the treatment process can inform clinicians regarding how severe a patient is and which intervention is needed.

show abstract

Blood glucose levels as an adjunct for prehospital field triage

Cited by 4 publications

References 18 publications

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

Exposures to Conducted Electrical Weapons (IncludingTASER^®Devices): How Many and for How Long are Acceptable?

Trauma severity associated with stress index in emergency settings: an observational prediction‐and‐validation study

Contact Info

Product

Resources

About

Blood glucose levels as an adjunct for prehospital field triage

Cited by 4 publications

References 18 publications

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

Exposures to Conducted Electrical Weapons (IncludingTASER®Devices): How Many and for How Long are Acceptable?

Trauma severity associated with stress index in emergency settings: an observational prediction‐and‐validation study

Contact Info

Product

Resources

About

Exposures to Conducted Electrical Weapons (IncludingTASER^®Devices): How Many and for How Long are Acceptable?