Undertriage of patients requiring direct admission to intensive care from the emergency department for medical conditions: impact on prognosis and associated factors.

Objectives: To determine whether undertriage affects the outcome for patients requiring direct admission to the intensive care unit (ICU) from the emergency department due to a medical condition. To identify factors associated with undertriage.

Material And Methods: Retrospective review of patients treated in 2018 for medical emergencies requiring direct admission to the ICU from the emergency department.

Mortality in patients treated for COVID-19 in the emergency department of a tertiary care hospital during the first phase of the pandemic: Derivation of a risk model for emergency departments.

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.

Factors associated with revisits by patients with SARS-CoV-2 infection discharged from a hospital emergency department.

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.

Care Bundles after Discharging Patients with Chronic Obstructive Pulmonary Disease Exacerbation from the Emergency Department.

Chronic obstructive pulmonary disease (COPD) is the second leading cause of emergency department (ED) admissions to hospital, and nearly a third of patients with acute exacerbation (AE) of COPD are re-admitted to hospital within 28 days after discharge. It has been suggested that nearly a third of COPD admissions could be avoided through the implementation of evidence-based care interventions. A COPD discharge bundle is a set of evidence-based practices, aimed at improving patient outcomes after discharge from AE COPD; body of evidence supports the usefulness of discharge care bundles after AE of COPD, although there is a lack of consensus of what interventions should be implemented.

Triage level assignment and nurse characteristics and experience.

Objectives: To study the relation between nursing staff demographics and experience and their assignment of triage level in the emergency department.

Material And Methods: One-year retrospective observational study in the triage area of a tertiary care urban university hospital that applies the Andorran-Spanish triage model. Variables studied were age, gender, nursing experience, triage experience, shift, usual level of emergency work the nurse undertakes, number of triage decisions made, and percentage of patients assigned to each level.

Validation of a triage flowchart to rule out acute coronary syndrome.

Objective: To validate a triage flowchart to rule out acute coronary syndrome (ACS) in chest pain patients attending the emergency department (ED).

Methods: An observational cohort study of consecutive patients. In all cases, a previously derived five-step triage flowchart (age ≤ 40 years, absence of diabetes, not previously known coronary artery disease, non-oppressive and non-retrosternal pain) was applied.

Predictors and outcomes of frequent chest pain unit users.

Aim: To determine predictors of frequent chest pain unit (CPU) users and to identify characteristics and outcomes of their CPU visits.

Patients And Methods: Observational prospective case-control study. Frequent CPU user was defined by 3 or more CPU visits within the study year.

Triage flowchart to rule out acute coronary syndrome.

Aim: The aim of the study was to establish a triage flowchart to rule out acute coronary syndrome (ACS) among patients with chest pain (CP) arriving on an Emergency Department (ED).

Patients And Method: This prospective observational study included 1000 consecutive patients with CP arriving on an ED CP unit. Demographic and clinical characteristics along with vital signs were recorded as independent variables.

[Lack of association between blood pressure variability and left ventricular hypertrophy in essential hypertension].

Background And Objective: Blood pressure (BP) fluctuations may contribute to the development of target organ damage in essential hypertension. However, a possible relationship with left ventricular hypertrophy (LVH) is controversial. The aim of the present study was to analyze the association between BP variability, defined through different instrument measures, and LVH in a group of essential hypertensive patients.

Blood pressure variability and silent cerebral damage in essential hypertension.

Background: It is recognized that blood pressure (BP) variability has prognostic significance in determining target organ damage and cardiovascular mortality and morbidity. The aim of this study was to analyze the association between blood pressure variability and the presence of silent cerebral white matter lesions in middle-aged asymptomatic essential hypertensives.

Methods: We studied 43 middle-aged untreated hypertensive patients.

Silent cerebral white matter lesions and cognitive function in middle-aged essential hypertensive patients.

Background: An association between midlife blood pressure levels and late-life cognitive impairment has been reported. Hypertension is one of the most important factors related to the presence of cerebral white matter lesions, which is a prognostic factor for the development of cognitive impairment. Studies have shown a relationship between white matter lesions and cognitive decline in elderly hypertensive patients.

[Emergency department overcrowding: quantification of associated factors].

Background And Objective: Emergency department (ED) overcrowding has been increasing over the last years. The aims are to define ED overcrowding, and to determine and quantify which factors explain it.

Patients And Method: For 3 consecutive weeks throughout 3 years (2000-2002), we recorded every 3-hour period, the arrivals, the occupancy rate (OR) of patients in ED, in first aid area (FAA), and in observation area (OA) according to the reason for their stay.

[Impact of components and methods of measurement of blood pressure on damage of target organs and cardiovascular complications in arterial hypertension].

Background: The goal of this study was to evaluate the relative association of several components of blood pressure (BP), as measured in the office and by ambulatory monitoring (ABPM), with clinically useful indicators of target organ damage and cardiovascular events (CE) in essential hypertensive patients.

Patients And Method: We retrospectively included 390 hypertensives (55% men; mean age: 56 years) between 1989 and 1998. All them had a baseline office BP measurement and a valid 24-hour ABPM record, both performed while the patient was free of antihypertensive therapy.

Correlation between silent cerebral white matter lesions and left ventricular mass and geometry in essential hypertension.

Background: It has been proposed that concentric left ventricular hypertrophy (LVH) is related to a worse degree of target organ damage in hypertensives with this feature than in those without. Moreover, the presence of cerebral white matter lesions (WMLs) is considered to be an early marker of brain damage in essential hypertension. The aim of this study was to assess the association between the presence of silent WMLs and left ventricular mass and geometry in middle-aged individuals with hypertension that had never been treated.

Renin-angiotensin system genetic polymorphisms and cerebral white matter lesions in essential hypertension.

It has been reported that both the DD genotype of the angiotensin converting enzyme (ACE) gene and the presence of cerebral white matter lesions (WML) may represent risk factors for the development of stroke. The present study investigates a possible association between 3 different genetic polymorphisms of the renin-angiotensin system and the presence of WML in 60 never-treated essential hypertensive patients (36 men, 24 women), aged 50 to 60 years, without clinical evidence of target organ damage. All patients underwent brain magnetic resonance imaging to establish the presence or absence of WML.

Silent cerebral white matter lesions in middle-aged essential hypertensive patients.

Objective: Age, hypertension, diabetes mellitus and a history of cardiovascular disease are the most important factors related to the presence of cerebral white matter lesions (WML), which are a common finding in elderly people. This study investigates which factors related to hypertension per se are associated with the presence of WML in asymptomatic, middle-aged, never-treated essential hypertensive patients.

Methods: A total of 66 untreated essential hypertensive patients of both genders, aged 50-60 years, with neither diabetes mellitus nor evidence of cardiovascular disease, were studied.