Point-of-care testing improves care timeliness in the emergency department. A multicenter randomized clinical trial (study POCTUR).

Objectives: Emergency department (ED) crowding is a widespread problem that positions patients at risk. The desire to improve the ED throughput requires novel approaches. Point-of-care testing (POCT) has emerged as useful technology that could contribute to create more efficient patient flow and better timeliness in the ED.

[Ability of qSOFA1-lactate to predict 30-day mortality in patients seen for infection in the Emergency Department].

Objective: To evaluate lactate and the Quick Sepsis-Related Organ Failure Assessment (qSOFA) and compare their ability to predict 30-day mortality in patients treated for infection in emergency departments (ED).

Methods: Prospective multicenter observational cohort study. We enrolled a convenience sample of patients aged 18 years or older attended in 71 Spanish ED from October 1, 2019, to March 31, 2020.

Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with urinary tract infections in the emergency department.

Objective: To analyze the usefulness of a new predictive model of bacteremia (5MPB-Toledo) in patients treated for urinary tract infection (UTI) in the emergency department (ED).

Methods: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered for patients with UTIs in 65 Spanish ED from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC).

Ability of lactate, procalcitonin, and criteria defining sepsis to predict 30-day mortality, bacteremia, and microbiologically confirmed infection in patients with infection suspicion treated in emergency departments.

Objectives: To evaluate lactate, procalcitonin, criteria defining systemic inflammatory response syndrome (SIRS), and the Quick Sepsis-Related Organ Failure Assessment (qSOFA) and compare their ability to predict 30-day mortality, infection with microbiologic confirmation, and true bacteremia in patients treated for infection in hospital emergency departments.

Material And Methods: Prospective multicenter observational cohort study. We enrolled a convenience sample of patients aged 18 years or older attended in 71 Spanish emergency departments from October 1, 2019, to March 31, 2020.

Evaluation of emergency department visits prior to an HIV diagnosis: Missed opportunities.

Objective: There is a high rate of occult infection and late diagnosis in HIV. Hospital emergency departments (ED) are an important point of health care. The present work aims to know the number of missed opportunities for HIV diagnosis occurring in the ED.

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).

Emergency severity level-3 patient flow based on point-of-care testing improves patient outcomes.

Background: Overcrowding of the Emergency Department is rapidly becoming a global challenge and a major source of concern for emergency physicians. The desire to improve Emergency Department throughput requires novel approaches to patient flow.

Materials And Methods: We conducted a prospective and cluster-randomized study, to evaluate the impact in patient outcomes of a new patient flow based on Point-of-Care Testing (POCT).

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.

Socio-Demographic Health Determinants Are Associated with Poor Prognosis in Spanish Patients Hospitalized with COVID-19.

Introduction: Social vulnerability is a known determinant of health in respiratory diseases. Our aim was to identify whether there are socio-demographic factors among COVID-19 patients hospitalized in Spain and their potential impact on health outcomes during the hospitalization.

Methods: A multicentric retrospective case series study based on administrative databases that included all COVID-19 cases admitted in 19 Spanish hospitals from 1 March to 15 April 2020.

[Usefulness of the 5MPB-Toledo model to predict bacteremia in patients with community-acquired pneumonia in the Emergency Department].

Objective: To analyse a new risk score to predict bacteremia in the patients with Community-acquired Pneumonia (CAP) in the emergency departments.

Methods: Prospective and multicenter observational cohort study of the blood cultures ordered in 74 Spanish emergency departments for patients with CAP seen from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC).

[Delayed administration of thrombolytic therapy in minor stroke].

Introduction: Minor strokes are considered to be those that present with few symptoms, although up to 40% of them entail long-term disability. The rate of thrombolysis in these patients is also lower than in other strokes. The aim of this study is to explore whether there are any differences in intravenous thrombolysis care times in minor strokes.

Midregional proadrenomedullin safely reduces hospitalization in a low severity cohort with infections in the ED: a randomized controlled multi-centre interventional pilot study.

Introduction: The midregional fragment of proadrenomedullin (MR-proADM) is known to provide accurate short-, mid- and long term prognostic information in the triage and multi-dimensional risk assessment of patients in the emergency department (ED). In two independent observational cohorts MR-proADM values identified low disease severity patients without risk of disease progression in the ED with no 28 days mortality that wouldn´t require hospitalization. In this interventional study we want to show that the combination of an MR-proADM algorithm with clinical assessment is able to identify low risk patients not requiring hospitalization to safely reduce the number of hospital admissions.

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).

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.

180-day risk of mortality in older patients admitted to short-stay units: the 6-Month Short-Stay Unit (6M UCE) Score.

Objectives: To develop a multidimensional score to assess risk of death for patients of advanced age 180 days after their admission to short-stay units (SSUs).

Material And Methods: Prospective, multicenter, observational and analytical study of a cohort of patients aged 75 years or older who were admitted to 5 Spanish SSUs between February 1 and April 30, 2014. We recorded demographic and clinical data as well as geriatric assessment scores.

Analysis of quality antimicrobial agent use in the emergency department of a tertiary care hospital.

Objectives: To describe modifiable factors related to inappropriate antimicrobial treatment in the observation area of an emergency department to explore practices that can be targeted for change through a program to improve emergency use of antimicrobial agents, the PROA program in its spanish observations.

Material And Methods: Cross-sectional serial point-prevalence study of all antimicrobial prescriptions for patients under observation in the department in February and March 2015.The main outcome measure was the frequency of antimicrobial treatment that was inappropriate according the center's guidelines.

Infection and systemic inflammatory response syndrome in older patients in the emergency department: a 30-day risk model.

Objectives: To build a model to predict 30-day mortality and compare it to prediction based on the Mortality in Emergency Department Sepsis (MEDS) score in patients aged 75 years or older treated for infection and systemic inflammatory response syndrome (SIRS) in the emergency department.

Material And Methods: Prospective analysis of a convenience cohort of patients aged 75 years or older treated for infection and SIRS in 13 Spanish emergency departments in 2013. We recorded demographic variables; comorbidity; risk factors for poor outcome; functional dependence at baseline; site of infection; and hemodynamic, clinical and laboratory findings on start of care.

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.

[Characteristics and epidemiological changes for patients with urinary tract infection in the emergency department].

Background: The aim of this paper is to determine both the prevalence of urinary tract infection (UTI) in the emergency department (ED) and the most relevant epidemiological changes in the last decade, as well as the profile and management of these patients.

Methods: Descriptive cross-sectional analysis at 49 Spanish ED during 12 months. All patients with infections and UTI diagnosis were included.

Short-term prognostic factors in the elderly patients seen in emergency departments due to infections.

Objectives: To analyse factors associated with short-term mortality in elderly patients seen in emergency departments (ED) for an episode of infectious disease.

Materials And Methods: A prospective, observational, multicentre, analytical study was carried out on patients aged 75years and older who were treated in the ED of one of the eight participating hospitals. An assessment was made of 26 independent variables that could influence mortality at 30days.

[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.