Articles: mortality.
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Observational Study
Prehospital lactate analysis in suspected sepsis improves detection of patients with increased mortality risk: an observational study.
Rapid, adequate treatment is crucial to reduce mortality in sepsis. Risk stratification scores used at emergency departments (ED) are limited in detecting all septic patients with increased mortality risk. We assessed whether the addition of prehospital lactate analysis to clinical risk stratification tools improves detection of patients with increased risk for rapid deterioration and death in sepsis. ⋯ The addition of a prehospital lactate level > 3 mmol/l improved early recognition of individuals with increased mortality risk in a cohort with suspected sepsis admitted to the ED. This was particularly evident in patients whose risk stratification scores did not indicate severe illness. We suggest that the addition of prehospital lactate analysis could improve recognition of subjects with suspected sepsis and increased mortality risk.
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Retrospective cohort study. ⋯ Our study suggests racial disparities in outcomes and discharge disposition for acute cSCI patients.
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Acute myocardial infarction (AMI) is a critical medical emergency worldwide and a leading cause of mortality. This study aims to investigate the predictive utility of the neutrophil-to-platelet ratio (NPR) in identifying AMI patients at an increased risk of in-hospital mortality. We enrolled 664 patients, including 421 with ST-elevation myocardial infarction (STEMI) and 243 with non-ST-elevation myocardial infarction (NSTEMI), at Zhongshan Hospital, Fudan University, from January 2020 to September 2023. ⋯ The optimal cutoff values for predicting mortality were determined as 0.042 for NPR (sensitivity 80%, specificity 62.2%) and 8.02 for NLR (sensitivity 62.2%, specificity 67.5%). Bootstrap validation with 1000 iterations confirmed the robustness of these findings, with validated AUCs of 0.755 (95% CI, 0.681-0.826) for NPR and 0.674 (95% CI, 0.587-0.766) for NLR. This study identifies NPR as an independent and valuable predictor of in-hospital mortality among AMI patients, The findings underscore NPR's potential utility in clinical practice for risk stratification and early intervention strategies aimed at reducing mortality rates in this high-risk patient population.