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The IRYSS-COPD appropriateness study was developed in 16 hospitals belonging to the Spanish National Health Service from June 2008 to September 2010 (n = 2,877). The objectives were to apply a set of explicit criteria for the appropriateness of hospital admission created by the RAND/UCLA methodology to patients evaluated in the emergency department (ED) for exacerbations of COPD. This is a prospective cohort study. We explored the relationship between appropriateness of admission as defined by the explicit criteria and the final decision to admit or discharge. A total of 2,877 patients were included for analysis; of these, 1,747 (60.7 %) were admitted and 1,130 (39.3 %) were discharged from the ED to home. Among patients classified by the explicit criteria as appropriate for hospital admission, 81.3 % were admitted, compared with 64.81 % of those classified as uncertain and 48.65 % of those classified as inappropriate for admission. Severity of exacerbation was the most influencing variable in the decision. Application of our explicit criteria for appropriate hospital admission among a large sample of patients experiencing an exacerbation of COPD in the ED setting suggests that these criteria could be used as the basis for clinical decision-making and health-care assessment.
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http://dx.doi.org/10.1007/s11739-013-0927-9 | DOI Listing |
J Med Ethics
December 2024
Centre for Biomedical Ethics, National University of Singapore, Singapore.
BMC Med Ethics
December 2024
Center of Expertise on Gender Dysphoria (CEGD), Amsterdam UMC, Vrije Universiteit, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands.
Background: The scrutiny surrounding gender-affirming medical treatment (GAMT) for youth has increased, particularly concerning the limited evidence on long-term treatment outcomes. The Standards of Care 8 by the World Professional Association for Transgender Health addresses this by outlining research evidence suggesting "effective" outcomes of GAMT for adolescents. However, claims concerning what are considered "effective" outcomes of GAMT for adolescents remain implicit, requiring further reflection.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
December 2024
Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Background: Early identification of gestational diabetes mellitus is essential for improving maternal and neonatal outcomes. While risk factors such as advanced maternal age, elevated pre-pregnancy body mass index, multiparity, and a history of gestational diabetes have been recognized, the role of serum biomarkers remains uncertain. This study explores the predictive value of early-pregnancy laboratory findings in conjunction with maternal demographic and clinical characteristics for gestational diabetes mellitus.
View Article and Find Full Text PDFAddiction
December 2024
Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Background And Aims: Disposable e-cigarettes designed for one-time use are the most popular option among youth users in the United States (US). Product-level data (e.g.
View Article and Find Full Text PDFAm J Emerg Med
December 2024
Department of Medicine, Division of General Internal and Emergency Medicine, Aarau, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland. Electronic address:
Procalcitonin is a useful biomarker for infection. Over the past two decades, there has been much research on the clinical applications of procalcitonin, yet the majority of these studies have been conducted in the intensive care setting. Despite the extensive use of procalcitonin in emergency departments, there have been no guidelines focusing specifically on these clinical settings.
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