Machine learning models for predicting in-hospital mortality in patient with sepsis: Analysis of vital sign dynamics.

Purpose: To build machine learning models for predicting the risk of in-hospital death in patients with sepsis within 48 h, using only dynamic changes in the patient's vital signs.

Methods: This retrospective observational cohort study enrolled septic patients from five emergency departments (ED) in Taiwan. We adopted seven variables, i.

The Prognostic Value of Serum Soluble TREM-1 on Outcome in Adult Patients with Sepsis.

Increased soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) levels have been reported in patients with sepsis. We tested the hypotheses that serum sTREM-1 levels increase in the early phase of sepsis and decrease after sepsis under appropriate treatment and that sTREM-1 levels can predict therapeutic outcomes. One hundred and fifty-five patients prospectively underwent blood samples including biochemical data, sTREM-1, and biomarkers on endothelial dysfunction as well as clinical severity index examinations.

Predicting in-hospital mortality in adult non-traumatic emergency department patients: a retrospective comparison of the Modified Early Warning Score (MEWS) and machine learning approach.

Background: A feasible and accurate risk prediction systems for emergency department (ED) patients is urgently required. The Modified Early Warning Score (MEWS) is a wide-used tool to predict clinical outcomes in ED. Literatures showed that machine learning (ML) had better predictability in specific patient population than traditional scoring system.

Influence of the Coronavirus Disease 2019 Pandemic on Patients with ST-Segment Elevation Myocardial Infarction in Taiwan.

The outbreak of the new coronavirus disease 2019 (COVID-19) has notably affected the medical system worldwide and influenced the health-seeking behavior of people while depleting medical resources, causing a delay in ST-elevation myocardial infarction (STEMI) management. In this single-center, retrospective cohort study, we compared the clinical pictures of nontransfer patients who presented to the emergency department directly and received primary percutaneous cardiovascular intervention (PPCI) from February 1 to April 30, 2020 (group 2,  = 28), with patients who received PPCI from February 1 to April 30, 2016-2019 (group 1,  = 130). A total of 158 patients with STEMI who received PPCI were included in the study.

The timing of last hemodialysis influences the prognostic value of serum lactate levels in predicting mortality of end-stage renal disease patients with sepsis in the emergency department.

Sepsis is a life-threatening condition, and serum lactate levels have been used to predict patient prognosis. Studies on serum lactate levels in patients undergoing regular hemodialysis who have sepsis are limited. This study aimed to determine the predictive value of serum lactate levels for sepsis-related mortality among patients who underwent last hemodialysis at three different times before admission to the emergency department (ED).

Liver cirrhosis affects serum lactate level measurement while assessing disease severity in patients with sepsis.

Background: Elevated serum lactate is associated with higher mortality in sepsis, whereas liver dysfunction is associated with higher serum lactate levels. We assessed the predictive ability of serum lactate in patients with liver cirrhosis and sepsis.

Methods: This retrospective study included 12 281 cases of suspected infection with initial serum blood lactate drawn during January 2007-December 2013.

Medical Liability of Residents in Taiwan Criminal Court: An Analysis of Closed Malpractice Cases.

Objective: By analyzing closed criminal malpractice claims involving resident physicians, we aimed to clarify the characteristics of litigations and examine the litigious errors leading to guilty verdicts.

Design: A retrospective descriptive study. .

The role of blink reflex R1 latency as an electrophysiological marker in diabetic distal symmetrical polyneuropathy.

Objective: Studies showed a relatively prolonged blink R1 latency in patients with diabetic distal symmetrical polyneuropathy (DSPN) compared to that without DSPN. We tested the hypothesis that blink R1 latency would provide a diagnostic alternative to nerve conduction studies (NCS) in DSPN and act as a marker of the severity of NCS abnormalities in DSPN.

Method: A total of 109 patients with type 2 diabetes underwent blink reflex studies and NCS.

Mortality Prediction of Septic Patients in the Emergency Department Based on Machine Learning.

In emergency departments, the most common cause of death associated with suspected infected patients is sepsis. In this study, deep learning algorithms were used to predict the mortality of suspected infected patients in a hospital emergency department. During January 2007 and December 2013, 42,220 patients considered in this study were admitted to the emergency department due to suspected infection.

Sural nerve sensory response in diabetic distal symmetrical polyneuropathy.

Introduction: The sural sensory nerve action potential (SNAP) amplitude is a measure of the number of axons. We tested the hypothesis that sural SNAP amplitude can be used as a marker in screening, severity evaluation, and follow-up of diabetic distal symmetrical polyneuropathy (DSPN).

Methods: Patients with type 2 diabetes underwent nerve conduction studies and were followed for 6 years.

Early antibiotics use in young infants with invasive bacterial infection visiting emergency department, a single medical center's experience.

Background: The Surviving Sepsis Campaign (SSC) recommends that intravenous antimicrobials be administered within one hour to treat sepsis in both adult and pediatric patients. However, most studies on the timing of antibiotics have been based on adults so far. Therefore, the goal of this study was to clarify the clinical outcomes of the timing of antibiotics use in young infants diagnosed with invasive bacterial infections.

Adjunctive statin therapy reduces intracranial hemorrhage and 1-year mortality in patients with atrial fibrillation after acute ischemic stroke: A population-based epidemiological study from Taiwan.

Background: Atrial fibrillation (AF)-related stroke causes severe disability and poor prognosis. Adjunctive statin therapy has been recommended for atherosclerotic-related stroke but not AF-related stroke. This study investigated the effects of statin in AF patients who experienced acute ischemic stroke.

-1-Acid Glycoprotein Concentration as an Outcome Predictor in Adult Patients with Sepsis.

Background: -1-Acid glycoprotein (AGP) is an acute-phase protein that plays a role in first-line defense against infection and is therefore elevated in sepsis. We tested the hypothesis that AGP levels increase initially in sepsis and decrease after antimicrobial therapy and that these levels may predict treatment outcomes.

Methods: AGP, biomarkers widely used in clinical practice, and maximum 24-h acute physiology and chronic health evaluation (APACHE)-II scores upon emergency department (ED) admission were prospectively evaluated and compared.

The clinical features and therapy of community-acquired gram negative bacteremia in children less than three years old.

Background: Community-acquired Gram-Negative (GN) bacteremia caused more morbidity and mortality recently in children. The increasing drug resistance was also an important issue. However, published reference was few about children.

Impact of prior statin use on mortality in patients with type 2 diabetes mellitus and bloodstream infection.

Objective: This study assessed the effect of prior statin use on the 28-day mortality of patients with type 2 diabetes mellitus (DM) who develop bloodstream infections.

Methods: This retrospective cohort study included all adult type 2 DM patients with bacteremia and verified prior medication history who visited the emergency department of a single tertiary hospital between January 2007 and December 2013. All major adverse consequences including septic shock events, use of mechanical ventilation, intensive care unit admission, and 28-day mortality were assessed.

Long-term effects of surgical treatment on baroreflex function in patients with obstructive sleep apnea: an 18-month follow-up.

Objective: Depressed baroreflex sensitivity (BRS) is reported in obstructive sleep apnea (OSA). Improvement of BRS short-term after surgical treatment is also reported. We tested the hypothesis that surgical treatment not only improves clinical outcomes, but also improves BRS after 18 months.

The Effect of Stroke Subtypes on Baroreceptor Sensitivity, a Predict for Acute Stroke Outcome.

Background: Reduced baroreflex sensitivity (BRS) has been reported in patients with acute cardiovascular events. We tested the hypothesis that BRS varies in different subtypes of acute ischemic stroke (AIS) and that BRS is a predictor of clinical outcomes.

Methods: We examined autonomic parameters in 34 patients with AIS, including the small deep hemisphere infarction, the large hemisphere infarction, and the brainstem infarction groups on Day 1, Day 7, and Day 30 after AIS.

HbA1C Variability Is Strongly Associated With the Severity of Cardiovascular Autonomic Neuropathy in Patients With Type 2 Diabetes After Longer Diabetes Duration.

Background: Variability in the glycated hemoglobin (HbA1c) level is associated with a higher risk of microvascular complications in patients with type 2 diabetes. We tested the hypothesis that HbA1c variability is not only strongly associated with the presence but also the degree of severity of cardiovascular autonomic neuropathy (CAN) in patients with long diabetes durations (more than 10 years).

Methods: For each patient, the intrapersonal mean, standard deviation (SD), and coefficient of variation (CV) for HbA1c were calculated using all measurements obtained 3 years before the study.

Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes.

Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN.

Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS).

Diagnosis of Parapneumonia Pleural Effusion with Serum and Pleural Fluid Cell-Free DNA.

Objective: As cell-free DNA levels in the pleural fluid and serum of parapneumonic pleural effusion (PPE) patients have not been thoroughly explored, we evaluated their diagnostic potential.

Methods: Twenty-two PPE and 16 non-PPE patients were evaluated. Serum and pleural fluids were collected, and cell-free DNA was quantified.

HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes.

Variability in HbA1c is associated with a higher risk of cardiovascular disease and microvascular complications in patients with type 2 diabetes. The present study evaluated the severity of somatic nerve dysfunction at different stages of chronic glycemic impairment, and its correlation with different cardio-metabolic parameters. The study was conducted on 223 patients with type 2 diabetes.