Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The electrocardiograph (ECG) is an essential tool in initial management and risk stratification of patients with suspected acute coronary syndrome (ACS). A six-point reporting criterion has been proposed to facilitate standardized clinical assessment of patients presenting to the emergency department (ED) with suspected ACS. We set out to evaluate the efficacy of these criteria in identifying patients with major adverse cardiac events (MACE), Type 1 myocardial infarction (T1MI), Type 2 myocardial infarction (T2MI), and 1-year mortality in a cohort of emergency patients with chest pain. ⋯ The rates of MACE, T1MI, and 1-year death can be stratified according to standardized ECG criteria in patients presenting to the ED with chest pain. The ECG findings in patients with T2MI are variable, and the ECG is less helpful in defining risk in this group.
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Review Meta Analysis
Prioritizing systemic corticosteroid treatments to mitigate relapse in adults with acute asthma. A systematic review and network meta-analysis.
While systemic corticosteroids (SCS) are widely used to prevent relapse in adults with acute asthma discharged from the emergency department, the most effective route of administration is unclear. The objective of this review was to examine the effectiveness of SCS in adults and to identify the most effective route of SCS to preventing relapse. ⋯ The network analysis identified IM corticosteroids and PO long-course corticosteroids as the most effective strategies to prevent relapse among adults with acute asthma, compared to PO short-course corticosteroids. The lack of significant findings with PO short-course corticosteroids is likely due to the paucity of research. Further comparative studies are required to determine the safety and effectiveness of briefer PO SCS treatment options in adults.
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Observational Study
The effect of frailty on 30-day mortality risk in older patients with acute heart failure attended in the Emergency Department.
The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). ⋯ The presence of frailty is an independent risk factor of 30-day mortality in nonsevere dependent older patients attended with AHF in EDs.