Publications by authors named "Narani Sivayoham"

Background: Hospitalised patients are at risk of deterioration and death. Delayed identification and transfer to the intensive care unit (ICU) are known to be associated with increased mortality rates. The Risk-stratification of Emergency Department suspected Sepsis (REDS) score was derived and validated in emergency department patients with suspected sepsis.

View Article and Find Full Text PDF

Background: Patients admitted to hospital with sepsis are at persistent risk of poor outcome after discharge. Many tools are available to risk-stratify sepsis patients for in-hospital mortality. This study aimed to identify the best risk-stratification tool to prognosticate outcome 180 days after admission the emergency department (ED) with suspected sepsis.

View Article and Find Full Text PDF

Purpose: Monocyte distribution width (MDW) is a biomarker for the early identification of sepsis. We assessed its accuracy in patients presenting with suspected sepsis in the emergency department (ED).

Methods: This was a single gate, single centre study in consecutive adults (≥ 18 years) admitted to the ED with suspected sepsis and clinical history compatible with infection, between 01 January and 31 December 2020 (n = 2570).

View Article and Find Full Text PDF

Objective: To compare the performance of the Risk-stratification of Emergency Department suspected Sepsis (REDS) score to the SIRS criteria, NEWS2, CURB65, SOFA, MEDS and PIRO scores, to risk-stratify Emergency Department (ED) suspected sepsis patients for mortality.

Method: A retrospective observational cohort study of prospectively collected data. Adult patients admitted from the ED after receiving intravenous antibiotics for suspected sepsis in the year 2020, were studied.

View Article and Find Full Text PDF

Background: Early treatment is advocated in the management of patients with suspected sepsis in the emergency department (ED). We sought to understand the association between the ED treatments and outcome in patients admitted with suspected sepsis. The treatments studied were: (i) the time to antibiotics, where time zero is the time the patient was booked in which is also the triage time; (ii) the volume of intravenous fluid (IVF); (iii) mean arterial pressure (MAP) after 2000 ml of IVF and (iv) the final MAP in the ED.

View Article and Find Full Text PDF

Objective: To derive and validate a new clinical prediction rule to risk-stratify emergency department (ED) patients admitted with suspected sepsis.

Design: Retrospective prognostic study of prospectively collected data.

Setting: ED.

View Article and Find Full Text PDF

Background: The MISSED score was derived and validated in emergency department (ED) patients with sepsis who were admitted to the ICU. This score has now been refined and simplified. The independent variables associated with mortality are age at least 65 years, serum albumin 27 g/l or less, and an international normalized ratio at least 1.

View Article and Find Full Text PDF

Objective: To derive and validate a new scoring system to predict in-hospital mortality in septic patients in the emergency department (ED).

Patients And Method: Septic patients admitted to the ICU and those in whom early goal-directed therapy (EGDT) was carried out in the ED were identified from the ED record. Univariate and multivariate regression analyses identified independent variables associated with mortality.

View Article and Find Full Text PDF

Objectives: The aim of this study was to determine the outcome of patients with severe sepsis and septic shock who did and did not receive early goal-directed therapy (EGDT) in the emergency department (ED). The primary end point was the in-hospital mortality rate. The secondary end points were lengths of stay in the ICU and in hospital.

View Article and Find Full Text PDF

Aim: To identify the extent to which emergency departments (EDs) in England are involved in the initiation of the pathway to early goal-directed therapy (EGDT) in patients with severe sepsis and septic shock.

Method: A survey of 173 EDs in England was carried out over a 2-month period starting in March 2006.

Results: 117 (67.

View Article and Find Full Text PDF