Predicting unfavorable outcome in subjects with diagnosis of chest pain of undifferentiated origin.

Background: Subjects with chest pain and a negative diagnostic workup constitute a problem for emergency physicians. We tested the usefulness of clinical variables in predicting 30-day and 6-month outcome in subjects with chest pain of undifferentiated origin after a negative workup.

Methods: Chest pain of undifferentiated origin was diagnosed by negative first-line (serial electrocardiograms, troponins assays, and 12- to 24-hour observation) and second-line evaluation (echocardiography, exercise tolerance test, stress scintigraphy, stress echocardiography, coronary angiography).

Predicting intracranial lesions by antiplatelet agents in subjects with mild head injury.

Background: The effect of pre-injury antiplatelet treatment in the risk of intracranial lesions in subjects after mild head injury (Glasgow Coma Scale (GCS) 14-15) is uncertain.

Methods: The potential risk was determined, considering its increasing use in guidelines on cardiovascular disease prevention, and ageing of the trauma population in Europe.

Patients: The interaction of antiplatelet therapy with the prediction variables of main decision aids was analysed in 14,288 consecutive adolescent and adult subjects with mild head injury.

Analysis of different decision aids for clinical use in pediatric head injury in an emergency department of a general hospital.

Introduction: The diagnostic algorithm in children with head injury remains uncertain. The National Emergency X-Radiography Utilization Study II (NEXUS II) recently proposed a new decision aid. We analyzed the data prospectively recorded in a local database to evaluate the sensitivity and specificity of the variables proposed by NEXUS II, by comparing with an Italian proposal.

The changing face of mild head injury: temporal trends and patterns in adolescents and adults from 1997 to 2008.

Objective: To explore the temporal trend of incidence, causes of injury and main characteristics of adolescent and adult subjects with mild head injury (MHI).

Design: This study had a retrospective design.

Setting: The study was conducted in a longitudinal database of an Italian Emergency Department (ED).

Risk stratification of non-traumatic headache in the emergency department.

Objective: To determine the diagnostic accuracy of an algorithm structured in four clinical scenarios to discriminate benign primary headaches from serious secondary non-traumatic headaches (NTH) in the emergency department (ED).

Background: NTH is usually a benign symptom but can occasionally result in serious outcome making the disposition of patients with NTH difficult in the ED.

Design And Methods: Consecutive adults patients referring to 8 EDs of the Emilia-Romagna region in Italy for NTH as the chief complaint were recruited in the study for a 30-day period.

Monitoring intervention programmes for out-of-hospital cardiac arrest in a mixed urban and rural setting.

Background: Only a few data are available on the survival rate following out-of-hospital cardiac arrest in different Italian settings. We report an analysis of a 10-year experience in a mixed rural/urban setting, the main variables associated with survival, and the preliminary results of the implementation of an automated external defibrillator (AED) programme operated by lay volunteers on the effectiveness of the existing Emergency Medical Service (EMS).

Methods: We report data from an observational cohort study on all adults, resuscitated from witnessed cardiac arrest between 1994 and 2004 in the district area of Forlì (Italy).

Clinical performance of NICE recommendations versus NCWFNS proposal in patients with mild head injury.

Recommendations on treatment of patients with head injury were recently proposed by the National Institute for Clinical Excellence (NICE). We tested the clinical performance of NICE variables versus the proposal of the Neurotraumatology Committee of the World Federation of Neurosurgical Societies (NCWFNS). Over a 5-year period, the clinical data of 7,955 adolescent and adult patients with mild head injury were prospectively collected and patients were managed according to the NCWFNS proposal.

A positive blood alcohol concentration is the main predictor of recurrent motor vehicle crash.

Study Objective: The identification of risk factors for recurrent motor vehicle crashes is the basis for prevention, but few studies have been published on predictors of recurrence. Our objective is to determine the main variables predicting recurrent crashes in subjects attending an emergency department (ED) for injuries after motor vehicle crash.

Methods: During a 5-year follow-up period, we studied 2,354 consecutive adult subjects treated in the ED after a motor vehicle crash in 1998.

Evidence-based diagnosis of nontraumatic headache in the emergency department: a consensus statement on four clinical scenarios.

Objective: To provide to emergency department (ED) physicians with guidelines for diagnosis of patients with nontraumatic headaches.

Background: Many patients present to an ED with the chief complaint of headache. Causes of nontraumatic headache include life-threatening illnesses, and distinguishing patients with such ominous headaches from those with a primary headache disorder can be challenging for the ED physician.

Which type of observation for patients with high-risk mild head injury and negative computed tomography?

Objective: Current guidelines suggest hospital admission followed by home monitoring for high-risk patients with mild head injury and negative computed tomography scan. We tested early home monitoring under the care of a competent observer.

Methods: A total of 1480 patients with mild head injury and negative computed tomography scan were prospectively studied.