The American journal of emergency medicine
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Comparative Study
Comparison of MPL-ANN and PLS-DA models for predicting the severity of patients with acute pancreatitis: An exploratory study.
Acute pancreatitis (AP) is a common inflammatory disorder that may develop into severe AP (SAP), resulting in life-threatening complications and even death. The purpose of this study was to explore two different machine learning models of multilayer perception-artificial neural network (MPL-ANN) and partial least squares-discrimination (PLS-DA) to diagnose and predict AP patients' severity. ⋯ The results demonstrated that the MPL-ANN model based on routine blood and serum biochemical indexes provides a reliable and straightforward daily clinical practice tool to predict AP patients' severity.
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Fill rates and access to self-injectable epinephrine prescribed in a pediatric emergency department.
Despite its life-saving potential in anaphylaxis, self-injectable epinephrine (SIE) is frequently not administered by caregivers prior to arrival in the emergency department (ED). Prescriptions from the ED often go unfilled which may contribute to the failure to receive SIE when needed. ⋯ A majority of patients prescribed SIE from the ED fill their prescription; however, less than half have unexpired SIE readily available despite high rates of recurrent anaphylactic emergencies. Focusing on post-discharge planning, particularly follow-up, may prevent children with allergies from being left dangerously unprepared.
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The neutrophil-to-lymphocyte ratio (NLR) is an effective predictor of mortality in patients with various conditions. To the best of our knowledge, there have been no previous studies on the NLR as a prognostic marker for small bowel obstruction (SBO), especially on admission to the emergency department (ED). ⋯ The NLR was positively associated with poor SBO prognosis. An elevated NLR was an independent predictive factor for in-hospital mortality in SBO patients. Emergency physicians should consider the NLR for SBO prognosis, and timely, aggressive, and prompt treatment is required, especially in patients with an NLR >10.6.
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Observational Study
The effect of mild hypercapnia on hospital mortality after cardiac arrest may be modified by chronic obstructive pulmonary disease.
The main objective was to evaluate the effect of carbon dioxide on hospital mortality in chronic obstructive pulmonary disease (COPD) and non-COPD patients with out-of-hospital cardiac arrest (OHCA). ⋯ The effect of carbon dioxide on hospital mortality differed between COPD and non-COPD patients. Mild hypercapnia was associated with increased hospital mortality for non-COPD patients but reduced hospital mortality for COPD patients. It would be reasonable to adjust PaCO2 targets in OHCA patients with COPD.