Abstract:
BACKGROUND:Recently, the concept of sepsis was redefined by an international task force. This international task force of experts recommended using the quick Sequential Organ Failure Assessment (qSOFA) criteria instead of the systemic inflammatory response syndrome (SIRS) criteria to classify patients at high risk for death. However, the added value of these new criteria in the emergency department (ED) remains unclear. Thus, we performed this meta-analysis to determine the diagnostic accuracy of the qSOFA criteria in predicting mortality in ED patients with infections and compared the performance with that of the SIRS criteria. METHODS:PubMed, EMBASE and Google Scholar (up to April 2018) were searched for related articles. A 2 × 2 contingency table was constructed according to mortality and qSOFA score (< 2 and ≥ 2) or SIRS score (< 2 and ≥ 2) in ED patients with infections. Two investigators independently assessed study eligibility and extracted data. We used a bivariate meta-analysis model to determine the prognostic value of qSOFA and SIRS in predicting mortality. We used the I2 index to test heterogeneity. The bivariate random-effects regression model was used to pool the individual sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). The summary receiver operating characteristic curve (SROC) was constructed to assess the overall diagnostic accuracy. RESULTS:Eight studies with a total of 52,849 patients were included. A qSOFA score ≥ 2 was associated with a higher risk of mortality in ED patients with infections, with a pooled risk ratio (RR) of 4.55 (95% CI, 3.38-6.14) using a random-effects model (I2 = 91.1%). A SIRS score ≥ 2 was a prognostic marker of mortality in ED patients with infections, with a pooled RR of 2.75 (95% CI, 1.96-3.86) using a random-effects model (I2 = 89%). When comparing the performance of qSOFA and SIRS in predicting mortality, a qSOFA score ≥ 2 was more specific; however a SIRS score ≥ 2 was more sensitive. The initial qSOFA values were of limited prognostic value in ED patients with infections. CONCLUSIONS:A qSOFA score ≥ 2 and SIRS score ≥ 2 are strongly associated with mortality in ED patients with infections. However, it is also clear that qSOFA and SIRS have limitations as risk stratification tools for ED patients with infections.
journal_name
Scand J Trauma Resusc Emerg Medauthors
Jiang J,Yang J,Mei J,Jin Y,Lu Ydoi
10.1186/s13049-018-0527-9subject
Has Abstractpub_date
2018-07-11 00:00:00pages
56issue
1issn
1757-7241pii
10.1186/s13049-018-0527-9journal_volume
26pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Motor vehicle collisions (MVCs) are a common cause of major trauma and death. Following an MVC, up to 40% of patients will be trapped in their vehicle. Extrication methods are focused on the prevention of secondary spinal injury through movement minimisation and mitigation. This approach is time consuming an...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-020-00818-6
更新日期:2021-01-14 00:00:00
abstract::Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard backboard has been considered to be the most appropriate procedure to prevent secondary spinal cord injuries dur...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1186/s13049-019-0655-x
更新日期:2019-08-19 00:00:00
abstract:BACKGROUND:Non-technical skills are seen as an important contributor to reducing adverse events and improving medical management in healthcare teams. Previous research on the effectiveness of teams has suggested that shared mental models facilitate coordination and team performance. The purpose of the study was to inve...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-18-47
更新日期:2010-08-31 00:00:00
abstract:BACKGROUND:Drowning patients may benefit from the advanced airway management capabilities that can be provided by physician staffed helicopter emergency medical services. The aim of this study is to describe paediatric drowning patients treated by such a service examining tasking systems, initial physiology at the inci...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0177-0
更新日期:2015-11-06 00:00:00
abstract:BACKGROUND:As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-r...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-017-0353-5
更新日期:2017-02-28 00:00:00
abstract:BACKGROUND:Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-020-00820-y
更新日期:2021-01-06 00:00:00
abstract::The European HEMS and Air ambulance Committee's Medical working group recently published Best Practice advice on pre-hospital emergency anaesthesia and advanced airway management. We believe that this initiative is important. In our opinion however, the competence requirements recommended by the authors do not meet th...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 信件
doi:10.1186/s13049-019-0613-7
更新日期:2019-03-18 00:00:00
abstract:BACKGROUND:Major trauma often comprises fractures of the thoracolumbar spine and these are often accompanied by relevant thoracic trauma. Major complications can be ascribed to substantial simultaneous trauma to the chest and concomitant immobilization due to spinal instability, pain or neurological dysfunction, impair...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-020-00737-6
更新日期:2020-05-24 00:00:00
abstract:BACKGROUND:Severely injured trauma patients are exposed to clinically significant radiation doses from computed tomography (CT) imaging in the emergency department. Moreover, this radiation exposure is associated with an increased risk of cancer. The purpose of this study was to determine some effects of a radiation do...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-67
更新日期:2011-11-03 00:00:00
abstract:BACKGROUND:Major bile leak after blunt liver trauma is rare but challenging. It usually requires endoscopic retrograde cholangiography (ERC) for management. However, there is still lack of specific indications. The aim of this study is to elucidate risk factors for major bile leak and indications for early ERC after bl...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-22-26
更新日期:2014-04-15 00:00:00
abstract::Authors Wagner et al. in your journal demonstrated effectiveness of mechanical chest compressions in the coronary catheterization laboratory to facilitate coronary intervention and survival in patients requiring prolonged resuscitation efforts. We dare to comment on this article and advocate to use mechanical chest co...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 信件
doi:10.1186/s13049-016-0293-5
更新日期:2016-08-17 00:00:00
abstract:BACKGROUND:Occupational stress is an undesired factor causing discomfort for healthcare workers. Stressors in work can lead to dissatisfaction and in turn, this may affect patient care adversely. The aim of this study was to evaluate the occupational stress among residents and faculty physicians of various medical spec...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0225-4
更新日期:2016-03-22 00:00:00
abstract:BACKGROUND:There are three different types of ambulance systems, all of which can manage the same secondary intensive care patient transport mission: road ambulance, rotor-wing ambulance, and fixed-wing ambulance. We hypothesized that costs for specific transport distances would differ between systems. We aimed to anal...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-22-36
更新日期:2014-06-05 00:00:00
abstract:BACKGROUND:This study prospectively assesses clinical characteristics and management of consecutive minimal, mild and moderate head injury patients referred for CT scans. Compliance with the Scandinavian head injury guidelines and possible reasons for non-compliance is explored. METHODS:From January 16th 2006 to Janua...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-20-62
更新日期:2012-09-04 00:00:00
abstract:BACKGROUND:Single-pass, contrast-enhanced whole body multidetector computed tomography (MDCT) emerged as the diagnostic standard for evaluating patients with major trauma. Modern iterative image algorithms showed high image quality at a much lower radiation dose in the non-trauma setting. This study aims at investigati...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1757-7241-22-15
更新日期:2014-03-03 00:00:00
abstract::After the early implementation of Emergency Medicine (EM) 25 years ago, Iceland became the first Nordic country to nationally realize the benefits of this specialty. However, the road has been rocky as in many other countries. The early years of EM in Iceland were characterized by a significant shortage of resources, ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-017-0467-9
更新日期:2018-01-03 00:00:00
abstract:BACKGROUND:Survival after out-of-hospital cardiac arrest is closely linked to the quality of CPR, but in real life, resuscitation during prehospital care and ambulance transport is often suboptimal. Mechanical chest compression devices deliver consistent chest compressions, are not prone to fatigue and could potentiall...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1757-7241-18-58
更新日期:2010-11-05 00:00:00
abstract:BACKGROUND:Report a nationwide epidemic of Shiga toxin-producing E. coli (STEC) O103:H25 causing hemolytic uremic syndrome (D+HUS) in children. METHODS:Description of clinical presentation, complications and outcome in a nationwide outbreak. RESULTS:Ten children (median age 4.3 years) developed HUS during the outbrea...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-44
更新日期:2011-07-28 00:00:00
abstract:BACKGROUND:A national Helicopter Emergency Medical Service (HEMS) was introduced in Denmark in 2014 to ensure the availability of physician-led critical care for all patients regardless of location. Appropriate dispatch of HEMS is known to be complex, and resource utilisation is a highly relevant topic. Population-base...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-019-0672-9
更新日期:2019-11-07 00:00:00
abstract:BACKGROUND:Blood products are a lifesaving commodity in the treatment of major trauma. Although there is little evidence for use of pre-hospital blood products (PHBP) in seriously injured patients, an increasing number of emergency medical services have started using PHBP for treatment of major haemorrhage. The primary...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-020-00774-1
更新日期:2020-08-14 00:00:00
abstract:BACKGROUND:Search and rescue (SAR) operations constitute a significant proportion of Norwegian ambulance helicopter missions, and they may limit the service's capacity for medical operations. We compared the relative contribution of the different helicopter resources using a common definition of SAR-operation in order ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s13049-016-0302-8
更新日期:2016-09-13 00:00:00
abstract:BACKGROUND:Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events. OBJECTIVE:To identify the scope and types of medical services required by asylum-seekers and the relationship between delayed medical care to development of post-traumatic stress disorder (PTSD...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-019-0665-8
更新日期:2019-09-06 00:00:00
abstract:BACKGROUND:Haemorrhagic shock is a major cause of death in the acute care setting. Since 2009, our emergency department has used intra-aortic balloon occlusion (IABO) catheters for resuscitative endovascular balloon occlusion of the aorta (REBOA). METHODS:REBOA procedures were performed by one or two trained acute car...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0205-8
更新日期:2016-02-09 00:00:00
abstract::In patients with traumatic injury of an upper limb it is often necessary to both secure intravenous (IV) access and record blood pressure noninvasively in the other upper limb. This may cause intermittent obstruction to the flow of IV fluids during cuff inflation. Also backflow of blood into the IV tubing when the cuf...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-18-53
更新日期:2010-10-13 00:00:00
abstract:BACKGROUND:Penetrating cardiac injuries in Europe have been poorly studied. We present a 10-year outcome for patients with penetrating heart injuries at Oslo University Hospital. METHODS:Data from 01.01.2001 until 31.12.2010 was collected from the Oslo University Hospital Trauma Registry and from the patients' records...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-015-0125-z
更新日期:2015-06-03 00:00:00
abstract:BACKGROUND:Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED. METHODS:ME...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-017-0370-4
更新日期:2017-03-06 00:00:00
abstract:BACKGROUND:The 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number a...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/1757-7241-22-2
更新日期:2014-01-08 00:00:00
abstract:BACKGROUND:The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD. METHODS:A searc...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-018-0488-z
更新日期:2018-03-22 00:00:00
abstract:BACKGROUND:Prehospital advanced airway management, including prehospital endotracheal intubation is challenging and recent papers have addressed the need for proper training, skill maintenance and quality control for emergency medical service personnel. The aim of this study was to provide data regarding airway managem...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-10
更新日期:2011-02-08 00:00:00
abstract:BACKGROUND:The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We h...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-019-0688-1
更新日期:2019-12-10 00:00:00