Publications by authors named "Coll-Vinent B"
Atrial fibrillation (AF) is the most prevalent sustained arrhythmia managed in emergency departments, and the already high prevalence of this arrhythmia is increasing in Spain. This serious condition associated with increased mortality and morbidity has a negative impact on patient quality of life and the functioning of the health care system. The management of AF requires consideration of diverse clinical variables and a large number of possible therapeutic approaches, justifying action plans to coordinate the work of several medical specialties in the interest of providing appropriate care and optimizing resources.
View Article and Find Full Text PDFObjectives: To analyze the long-term benefits and safety of oral anticoagulation therapy prescribed in emergency departments for elderly patients with atrial fibrillation, and to detect any sex-related differences present.
Material And Methods: Post-hoc analysis of data compiled by the EMERG-AF group (Spanish acronym for Emergency Department Stroke Prophylaxis and Guidelines Implementation in Atrial Fibrillation). Consecutive patients aged 75 years or older with atrial fibrillation who were treated in 62 EDs were included.
Objectives: Patients with implantable cardioverter defibrillators (ICDs) are at risk of serious complications that are often treated in hospital emergency departments (EDs). The EMERG-ICD study (Emergency Department Management and Long-term Prognosis for Patients with ICDs) analysed management and long-term prognosis of ED patients with an ICD after an acute clinical event.
Material And Methods: Observational multicenter cohort study including consecutive adult patients with ICDs who came to 27 hospital EDs in Spain for treatment and were followed for 10 years.
Background: To investigate if sex is a risk factor for mortality in patients consulting at the emergency department (ED) for an unintentional fall.
Methods: This was a secondary analysis of the FALL-ER registry, a cohort of patients ≥65 years with an unintentional fall presenting to one of 5 Spanish EDs during 52 predefined days (one per week during one year). We collected 18 independent patient baseline and fall-related variables.
The teaching of emergency medicine (EM) and urgent care in Spanish universities is unregulated. This study aimed to analyze how EM is being taught in Spanish medical faculties. We visited the web pages of 46 universities that offer medical degrees.
View Article and Find Full Text PDFObjectives: To analyze the frequency and clinical characteristics associated with erroneous initial classifications of noncardiac chest pain (NCP) in men and women.
Material And Methods: We analyzed all case records in which chest pain was initially classified as noncardiac in origin according to clinical signs and electrocardiograms evaluated in our emergency department between 2008 and 2017. We considered the initial evaluation of NCP to be in error if the final diagnosis was acute coronary syndrome.
Article Synopsis
- The study aimed to determine the relationship between troponin levels and the risk of major adverse cardiovascular events (MACE) in patients with rapid atrial fibrillation (RAF) and chest discomfort thought to be coronary-related.
- A total of 574 patients were followed over several years, revealing that increased troponin levels were independently linked to a higher risk for MACE, acute coronary syndrome (ACS), type I myocardial infarction, and stroke, but not to death or revascularization.
- The findings suggest that higher troponin levels correlate with increased cardiovascular risks, indicating that troponin could be an essential marker for risk assessment in similar patients.
Objectives: The maintenance of sinus rhythm by means of antiarrhythmic drugs and/or upstream therapy to counter cardiac remodeling is fundamental to the management of atrial fibrillation (AF). This study aimed to analyze this approach and its appropriateness in the setting of hospital emergency departments.
Material And Methods: Secondary analysis of data from the multicenter observational cross-sectional HERMES-AF study carried out in 124 hospitals representative of the Spanish national health service in 2011.
Objective: We sought to identify the factors associated with a worse prognosis in Emergency Department (ED) patients with atrial fibrillation (AF), crucial information to guide management decisions.
Methods: This is a secondary analysis of a prospective, multicenter, observational cohort of consecutive AF patients attended in 62 EDs in Spain. Clinical variables were collected on enrollment.
Objectives: To develop a risk model to predict 30-day mortality after emergency department treatment for COVID-19.
Material And Methods: Observational retrospective cohort study including 2511 patients with COVID-19 who came to our emergency department between March 1 and April 30, 2020. We analyzed variables with Kaplan Meier survival and Cox regression analyses.
Objective: We investigated which factors predict late presentation (LP) to the emergency department (ED) in patients with non-traumatic chest pain (CP).
Methods: All CP cases attended at a single ED (2008-2017) were included. LP was considered if time from CP onset to ED arrival was>6 h.
Background: Atrial fibrillation (AF) is a morbid disease whose complications can be prevented if prompt and correctly treated.
Objective: To assess the usefulness of an early AF diagnosis programme in at-risk individuals in primary care centres.
Methods: In an open-label, multi-centre, controlled interventional study, individuals with one or more risk factors for AF but without known AF were enrolled.
Objectives: Cardiopulmonary resuscitation (CPR) feedback applications can facilitate learning in brief training sessions, but they have never been tested in primary care settings. We aimed to see if brief CPR training sessions that include feedback improve the skills of primary care staff.
Material And Methods: Randomized trial with a control group and 2 intervention groups (G) using the feedback app and a control group: in G1, the instructor gave spoken feedback to the trainee and both could see the app; in G2, only the instructor giving feedback could see the app; and in G3, the control group, neither the instructor nor the trainee could see the app.
Objective: Little is known regarding the specific ways personal protective equipment (PPE) has been used and reused during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to evaluate the patterns of PPE use and the impact of PPE availability on the attitudes and well-being of an international population of healthcare workers.
Methods: This was an online, cross-sectional survey of healthcare workers.
Background: There is little evidence concerning the impact of acute heart failure (AHF) on the prognosis of atrial fibrillation patients attending the emergency department (ED).
Objective: To know the influence of AHF on adverse long-term outcomes in patients presenting with atrial fibrillation in ED.
Design, Setting And Participants: Secondary analysis of a prospective, multicenter, observational cohort of consecutive atrial fibrillation patients, performed in 62 Spanish EDs.
Objectives: To analyze emergency department (ED) revisits from patients discharged with possible coronavirus disease 2019 (COVID-19).
Material And Methods: Retrospective observational study of consecutive patients who came to the ED over a period of 2 months and were diagnosed with possible COVID-19. We analyzed clinical and epidemiologic variables, treatments given in the ED, discharge destination, need to revisit, and reasons for revisits.
Article Synopsis
- This study aimed to assess the challenges of diagnosing acute coronary syndrome (ACS) in patients who have previously undergone coronary artery bypass grafting (CABG) when they present with chest pain (CP).
- The research involved 34,429 patients over 10 years, revealing that while CABG patients showed more common symptoms and ECG findings linked to ACS, their overall rates of ACS diagnosis were lower compared to non-CABG patients.
- The findings suggest that CABG impacts the reliability of symptoms and ECG results in diagnosing ACS, and longer emergency department stays for CABG patients are primarily due to their existing health conditions rather than the CABG status itself.
External validation of an emergency department triage algorithm for chest pain patients.
Eur Heart J Acute Cardiovasc Care
September 2020
Article Synopsis
- - The study aimed to validate an emergency department triage algorithm designed to identify low-risk chest pain patients using five key clinical variables, potentially allowing for delayed evaluation instead of immediate treatment.
- - Two separate cohorts were analyzed: a single-centre study with over 29,000 patients and an international multicentre study with around 4,000 patients, assessing how well the algorithm performed in predicting acute coronary syndrome.
- - Results showed that while the algorithm had very high sensitivity and negative predictive value in both studies, its effectiveness in classifying patients as low risk was low, suggesting that adjustments in the model could improve its efficacy.
Article Synopsis
- The study examines changes in patients presenting with nontraumatic chest pain at a hospital's chest pain unit over a decade, noting a significant increase in visits, especially during weekdays and working hours.
- Over the 10-year period, there was a notable rise in the number of women and younger patients, alongside a decrease in cardiovascular risk factors and history of ischemic heart disease among patients.
- The rates of acute coronary syndrome (ACS) ruling out improved over time, but the time to final diagnosis increased, particularly for those ultimately diagnosed with ACS.
Objectives: To analyze the safety of electric cardioversion performed for recent-onset atrial fibrillation in a hospital emergency department.
Material And Methods: Observational retrospective analysis of consecutive emergency department cases of atrial fibrillation of less than 48 hours' duration in hemodynamically stable patients. All included cases were either treated with emergency electric cardioversion or referred for evaluation and scheduling of outpatient cardioversion.
Objectives: To analyze heart rate control in hospital emergency departments and outcomes in patients with recent onset atrial fibrillation (AF) so that targets for improvement can be identified.
Material And Methods: Multicenter, prospective observational cross-sectional study in a representative sample of 124 hospitals of the Spanish health services, based on records in the HERMES-AF database (Hospital Emergency Department Management Strategies for AF) for May 23 to June 5, 2011. Patients with symptomatic AF within 48 hours of onset were enrolled when the decision was made to attempt restoration of sinus rhythm.