Medicine
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Currently, many hospitals use vital signs-based criteria such as modified early warning score (MEWS) and national early warning score (NEWS) to classify high-risk patients for cardiac arrest, but there are limitations in selecting high-risk patients with a possibility of cardiac arrest. The purpose of this study is to develop a cardiac arrest classification model to identify patients at high risk of cardiac arrest based on the patient family and past history, and blood test results after hospitalization, rather than vital signs. This study used electronic medical record (EMR) data from A university hospital, and patients in the high-risk group for cardiac arrest were defined as those who underwent cardio-pulmonary resuscitation (CPR) after cardiac arrest. ⋯ In the validation data set, sensitivity 73.37%, precision 25.81%, specificity 75.03%, accuracy 74.86%, F1 score 38.19, AUC 74.2 (95% CI = 72.1-76.2, P value=<.001) were calculated. A model for classifying the high-risk group of cardiac arrest should be developed from various perspectives. In the future, in order to classify patients with high risk of cardiac arrest, a prospective study on the combined use of the model developed by this study and NEWS or MEWS should be conducted.
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Skin tear is a common problem encountered in the emergency department. If it is not properly managed, it can lead to wound infection, skin necrosis and a need for further surgical intervention and skin grafting. Current management is to cleanse the wound, replace the thin skin tear followed by coverage with a dressing that is inducive for wound healing. ⋯ We did not encounter any patients that required further surgical debridement or split-thickness skin grafting. The use of a silver-based hydrofiber dressing was well tolerated by the elderly population as it provided an easy, efficient, economical and effective form of management of skin tears. We suggest that a silver-based hydrofiber dressing can be used as a first-line treatment method for type 1 and 2 skin tears.
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Primary brainstem hemorrhage (PBH) is one of the most fatal intracranial hemorrhages, evaluating the prognosis in the early stage is vital for appropriate therapeutic planning. Our study aimed to identify risk factors for 30-day mortality and 90-day functional recovery of PBH. Data from 63 patients with PBH admitted to Beijing Chaoyang Hospital between 2016 and 2022 were retrieved for this study. ⋯ Independent risk factors of 30-day mortality and 90-day functional recovery were identified by univariate and multivariate logistic regression analyses. 31 patients (49.2%) died within 30 days and 22 patients (34.9%) achieved better functional recovery. By multivariate analysis, Glasgow coma scale <9 on admission and tachycardia were significantly associated with 30-day mortality, while the hematoma volume >5 mL was an independent risk factor for 90-day functional recovery. Initial level of consciousness, tachycardia, massive hematoma were risk factors for prognosis, which must be seriously evaluated for therapeutic planning.
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Randomized Controlled Trial
Clinical effect analysis of using medical glue versus conventional suturing to treat dog bite in children's maxillofacial region after negative pressure sealing drainage: A randomized trial.
To compare the clinical effectiveness of applying medical glue versus conventional suturing after primary suturing and continuous vacuum sealing drainage (VSD) technology in the treatment of facial wounds caused by dog bites in children's maxillofacial region, with respect to operation time, wound infection rate, treatment effect, and patient satisfaction. ⋯ In conclusion, applying medical glue after using negative pressure sealing drainage in treating maxillofacial dog bites can reduce surgeons work intensity, lessen children's pain, and improve the clinical treatment effect.
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This study aimed to investigate the effectiveness of radiological parameters used in the follow-up of patients who underwent salter innominate osteotomy (SIO) for the treatment of developmental dysplasia of the hip. ⋯ In our study, along with acetabular index, the c/b ratio, teardrop width, TDD, and acetabular teardrop angle significantly changed after SIO and could be used as a guide for patient follow-up.