[Utility of the medial region of pro-adrenomodulin for the detection of true bacteremia in elderly patients treated in the emergency department for suspected infection].

Objective: The prediction of bacteremia in the emergency department (ER) is important for initial decision-making. The elderly population is a diagnosis challenge. The objective was to evaluate the accuracy of mid regional pro-adrenomedullin (MR-proADM) to identify true bacteremia (BV) in elderly patients attended in 3 hospital emergency departments.

Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19.

Background: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia.

Objectives: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d).

Methods: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020.

High-titre methylene blue-treated convalescent plasma as an early treatment for outpatients with COVID-19: a randomised, placebo-controlled trial.

Background: Convalescent plasma has been proposed as an early treatment to interrupt the progression of early COVID-19 to severe disease, but there is little definitive evidence. We aimed to assess whether early treatment with convalescent plasma reduces the risk of hospitalisation and reduces SARS-CoV-2 viral load among outpatients with COVID-19.

Methods: We did a multicentre, double-blind, randomised, placebo-controlled trial in four health-care centres in Catalonia, Spain.

[Current situation of sepsis care in Spanish emergency departments].

Objective: To describe the approach to the patients with suspected sepsis in the Spanish emergency department hospitals (ED) and analyze whether there are differences according to the size of the hospital and the number of visits to the emergency room.

Methods: Structured survey of those responsible for the 282 public EDs that serve adults 24 hours a day, 365 days a year. It was asked about assistance and management in the emergency room in the care of patients with suspected sepsis.

Validation of a predictive model for bacteraemia (MPB5-Toledo) in the patients seen in emergency departments due to infections.

Objective: To validate a simple risk score to predict bacteremia (MPB5-Toledo) in patients seen in the emergency departments (ED) due to infections.

Methods: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered in 74 Spanish ED for adults (aged 18 or older) seen from October 1, 2019, to February 29, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC).

A bacteraemia risk prediction model: development and validation in an emergency medicine population.

Objective: Design a risk model to predict bacteraemia in patients attended in emergency departments (ED) for an episode of infection.

Methods: This was a national, prospective, multicentre, observational cohort study of blood cultures (BC) collected from adult patients (≥ 18 years) attended in 71 Spanish EDs from October 1 2019 to March 31, 2020. Variables with a p value < 0.

Incidence, clinical characteristics, risk factors and outcomes of meningoencephalitis in patients with COVID-19.

We investigated the incidence, clinical characteristics, risk factors, and outcome of meningoencephalitis (ME) in patients with COVID-19 attending emergency departments (ED), before hospitalization. We retrospectively reviewed all COVID patients diagnosed with ME in 61 Spanish EDs (20% of Spanish EDs, COVID-ME) during the COVID pandemic. We formed two control groups: non-COVID patients with ME (non-COVID-ME) and COVID patients without ME (COVID-non-ME).

Validation of a predictive model for bacteraemia (MPB5-Toledo) in the patients seen in emergency departments due to infections.

Objective: To validate a simple risk score to predict bacteremia (MPB5-Toledo) in patients seen in the emergency departments (ED) due to infections.

Methods: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered in 74 Spanish ED for adults (aged 18 or older) seen from from October 1, 2019, to February 29, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC).

Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.

Background: Recent reports of patients with coronavirus disease 2019 (COVID-19) developing pneumothorax correspond mainly to case reports describing mechanically ventilated patients. The real incidence, clinical characteristics, and outcome of spontaneous pneumothorax (SP) as a form of COVID-19 presentation remain to be defined.

Research Question: Do the incidence, risk factors, clinical characteristics, and outcomes of SP in patients with COVID-19 attending EDs differ compared with COVID-19 patients without SP and non-COVID-19 patients with SP?

Study Design And Methods: This case-control study retrospectively reviewed all patients with COVID-19 diagnosed with SP (case group) in 61 Spanish EDs (20% of Spanish EDs) and compared them with two control groups: COVID-19 patients without SP and non-COVID-19 patients with SP.

A multidrug-resistant microorganism infection risk prediction model: development and validation in an emergency medicine population.

The aim was to develop a predictive model of infection by multidrug-resistant microorganisms (MDRO). A national, retrospective cohort study was carried out including all patients attended for an infectious disease in 54 Spanish Emergency Departments (ED), in whom a microbiological isolation was available from a culture obtained during their attention in the ED. A MDRO infection prediction model was created in a derivation cohort using backward logistic regression.

Biomarkers and clinical scores to identify patient populations at risk of delayed antibiotic administration or intensive care admission.

Background: The performance of blood biomarkers (mid-regional proadrenomedullin (MR-proADM), procalcitonin (PCT), C-reactive protein (CRP), and lactate) and clinical scores (Sequential Organ Failure Assessment (SOFA), National Early Warning Score (NEWS), and quick SOFA) was compared to identify patient populations at risk of delayed treatment initiation and disease progression after presenting to the emergency department (ED) with a suspected infection.

Methods: A prospective observational study across three EDs. Biomarker and clinical score values were calculated upon presentation and 72 h, and logistic and Cox regression used to assess the strength of association.

[Characteristics of acute bacterial prostatitis in elderly patients attended in the Emergency Department].

Objective: To compare the characteristics of acute bacterial prostatitis between patients ≥75 years old with those <75 years old attended in the Emergency Department.

Material And Methods: A descriptive and observational study was conducted with a prospective follow-up including all consecutive patients with acute bacterial prostatitis that were admitted during one year to the Emergency Department of a tertiary-care hospital. Data were collected for demographic variables, comorbidities, clinical and microbiological findings, treatment, outcome, and re-consultation at 30 days follow-up.

Prognostic power of biomarkers for short-term mortality in the elderly patients seen in Emergency Departments due to infections.

Objectives: To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate, suPAR and pro-adremomedullin) in elderly patients seen in Emergency Departments (ED) due to infections. Secondly, if these could improve the prognostic accuracy of sepsis criteria (systemic inflammatory response syndrome and quick Sepsis-related Organ Failure Assessment [qSOFA]).

Methods: A prospective, observational, multicentre and analytical study.

[Factors associated with emergency department revisits for acute bacterial prostatitis].

Objectives: To analyze factors associated with revisits by patients with acute bacterial prostatitis treated in a hospital emergency department.

Material And Methods: Descriptive analysis and prospective follow-up of a cohort of patients with acute bacterial prostatitis treated in an emergency department.

Results: We included 241 episodes of acute bacterial prostatitis.

Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department.

The aim of this study was to determine the accuracy of systemic inflammatory response syndrome (SIRS), quick Sepsis-related Organ Failure Assessment (qSOFA) score and GYM score to predict 30-day mortality in older non-severely dependent patients attended for an episode of infection in the emergency department (ED). We performed an analytical, observational, prospective cohort study including patients 75 years of age or older, without severe functional dependence, attended for an infectious process in 69 Spanish EDs for 2-day three-seasonal periods. Demographic, clinical and analytical data were collected.

[Profile and initial management of infection in elderly patients in an Emergency Department].

Objective: To determine the clinical profile and the initial management of elderly patients with acute infections attending Spanish Emergency Departments (EDs), and to analyse whether there are any differences compared to younger adults.

Material And Methods: A descriptive, cross-sectional, multicentre study using the data recorded in the INFURG-SEMES register. It included a total of 79,654 of 15 years or over treated for an acute infection in 49 Spanish EDs between 10 October 2010 and 20 September 2011.

GYM score: 30-day mortality predictive model in elderly patients attended in the emergency department with infection.

Objective: To determine the validity of the classic sepsis criteria or systemic inflammatory response syndrome (heart rate, respiratory rate, temperature, and leukocyte count) and the modified sepsis criteria (systemic inflammatory response syndrome criteria plus glycemia and altered mental status), and the validity of each of these variables individually to predict 30-day mortality, as well as develop a predictive model of 30-day mortality in elderly patients attended for infection in emergency departments (ED).

Methods: A prospective cohort study including patients at least 75 years old attended in three Spanish university ED for infection during 2013 was carried out. Demographic variables and data on comorbidities, functional status, hemodynamic sepsis diagnosis variables, site of infection, and 30-day mortality were collected.

[Hospitalization of 780 episodes of infection in 10 Spanish emergency departments. Admission to conventional wards or short stay units?].

Background: To study the clinical characteristics of patients with infection attending the emergency department (ED) and compare those admitted to a short stay unit (SSU) with those admitted to a conventional hospital ward (CHW).

Methods: A descriptive multicenter cross-sectional analysis of infected patients requiring admission from 10 ED with SSU. Data were collected for age, gender, comorbidities, risk factors for multiresistant pathogens, type of infection, sepsis criteria, microbiology and antibiotic treatment.

[Spanish short-stay-units: results according to department designated to manage the unit].

Objectives: To compare the efficiency of short-stay units (SSUs) managed by different departments within hospitals.

Material And Methods: Cross-sectional study in 40 hospitals with SSUs. From June 1 to December 31, 2012,we gathered data on clinical caseloads and management.

[The short stay unit as an alternative to conventional hospitalisation in the treatment of community acquired pneumonia in the over 75 year-old population].

Introduction: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients. The short stay units can be an alternative for patients who need admission with acute illness.

Material And Methods: Descriptive and retrospective study in an Short-Stay Unit (SSU) of a 900-bed tertiary-care teaching hospital in the metropolitan area of Barcelona, Spain.