Annals of emergency medicine
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Observational Study
Major Adverse Events One Year After Acute Kidney Injury After Contrast-Enhanced Computed Tomography.
Recent studies have demonstrated that a single episode of acute kidney injury from a number of causes can increase the risk of severe long-term outcomes, including major cardiovascular events and death. We tested the hypothesis that patients who develop acute kidney injury consistent with contrast-induced nephropathy after contrast-enhanced computed tomography (CT) imaging are at increased risk of major adverse events at 1 year. ⋯ The development of acute kidney injury after contrast-enhanced CT was associated with a 2-fold increase in 1-year major adverse events. Further research is needed to validate this observation.
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The current outbreak of Ebola virus disease in West Africa is the largest on record and has overwhelmed the capacity of local health systems and the international community to provide sufficient isolation and treatment of all suspected cases. The goal of this study is to develop a clinical prediction model that can help clinicians risk-stratify patients with suspected Ebola virus disease in the context of such an epidemic. ⋯ The Ebola Prediction Score can be used by clinicians as an adjunct to current Ebola virus disease case definitions to risk-stratify patients with suspected Ebola virus disease. Clinicians can use this new tool for the purpose of cohorting patients within the suspected-disease ward of an Ebola treatment unit or community-based isolation center to prevent nosocomial infection or as a triage tool when patient numbers overwhelm available capacity. Given the inherent limitations of clinical prediction models, however, a low-cost, point-of-care test that can rapidly and definitively exclude Ebola virus disease in patients should be a research priority.