Emergencias
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Multicenter Study Observational Study
180-day risk of mortality in older patients admitted to short-stay units: the 6-Month Short-Stay Unit (6M UCE) Score.
To develop a multidimensional score to assess risk of death for patients of advanced age 180 days after their admission to short-stay units (SSUs). ⋯ The SSU score could be useful for stratifying risk of death within 6 months of SSU admission of older patients, so that type of care can be tailored to risk.
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The aim of this study was to describe the level of nurse burnout in critical care units and emergency departments and to analyze the relation between intensity of burnout and sociodemographic, workplace, and psychological factors. ⋯ More than a third of emergency and critical care nurses experience a high level of burnout. Personality factors and high levels of depression are associated with burnout in nurses.
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Diagnosing or ruling out acute myocardial infarction (AMI) is a challenge faced daily in emergency departments. AMI evaluation usually requires the measurement of the cardiac troponin (cTn) concentration. The use of this biomarker improves AMI diagnosis provided the concentrations are properly interpreted in the context of the patient's condition and according to standard recommendations. ⋯ The authors recommend measuring the cTn concentration if AMI is suspected in emergency patients, whether the newest high-sensitivity cTn assays or the so-called contemporary ones are used. Diagnostic algorithms based on up-to-date evidence are also presented. The consensus statement aims to serve as a clinical practice guideline for using cTn assays to enhance the efficient differential diagnosis of acute coronary syndromes in the emergency department.
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. The main purpose was to assess our emergency department's level of adherence to clinical practice guidelines (CPGs) for the diagnosis of pulmonary embolism in different age groups. The secondary aims were to study the utility and estimated the number of avoidable CT angiography with this approach of age-adjusted D-dimer concentrations in combination with the Wells score in the diagnosis of pulmonary embolism. ⋯ We observed different degrees of age-related adherence to CPGs in cases in which pulmonary embolism was suspected. Using the simplified Wells score combined with an age-adjusted cut-point for D-dimer assay positivity improved the specificity and positive predictive value of the D-dimer assessment in comparison with standard practice. Using age-adjusted D-dimer cut-points could decrease the number of pulmonary artery CT angiograms required.