QJM : monthly journal of the Association of Physicians
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Meta Analysis
Predicting mortality with severity assessment tools in out-patients with community-acquired pneumonia.
In community-acquired pneumonia, severity assessment tools, such as CRB65, CURB65 and Pneumonia Severity Index (PSI), have been promoted to increase the proportion of patients treated in the community. The prognostic accuracy of these scores is established in hospitalized patients, but less is known about their use in out-patients. We aimed to study the accuracy of these severity tools to predict mortality in patients managed as out-patients. ⋯ The limited data available suggest that CRB65 and PSI can identify groups of patients at low risk of mortality that can be safely managed in the community.
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Multicenter Study
Do centres with well-developed protocols, training and infrastructure have higher rates of thrombolysis for acute ischaemic stroke?
The introduction of intravenous thrombolysis with recombinant tissue Plasminogen Activator (rt-PA) has greatly improved the effectiveness of acute ischaemic stroke care. However, in most hospitals only 2-10% of all admitted stroke patients are treated with thrombolysis. ⋯ Extramural training and intramural protocols are important tools to increase thrombolysis rates for acute ischaemic stroke in hospitals. Intramural protocols and extramural training should be aimed at all relevant professionals.
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Hospital admissions for acute recreational drug toxicity are coded using the International Classification of Diseases (ICD-10) coding system. It is unclear how these admissions are coded, as often there are no specific ICD-10 codes for the drug(s) involved. This study was undertaken to determine how acute recreational drug toxicity admissions are routinely coded. ⋯ Hospital admissions due to recreational drugs without specific ICD-10 codes are assigned a wide variety of primary codes and/or the use of recreational drugs may not be coded. Further work is needed to look at methods of capturing presentations to hospital with acute recreational drug toxicity, either by updating the ICD codes or using a more time-responsive data capture system in sentinel hospitals in the UK to monitor trends in acute recreational drug toxicity.