Emergency Departments in Contemporary Healthcare: Are They Still for Emergencies? An Analysis of over 1 Million Attendances.

Background: Over the past few decades, emergency departments (EDs) have experienced an increasing workload. However, the variation in the types of patient accesses to these departments remains poorly understood.

Objective: To evaluate the 5-year temporal trend in the volume of patients attending EDs based on the urgency of their conditions.

Relationship between fluid bolus administration and the prognostic role of serum albumin in patients with sepsis.

Background: Serum albumin plays a pivotal role in the exchange between interstitial and vascular compartments, and reduced levels of this biomarker appear to be associated with negative prognosis in septic patients. The correlation between the volume effect in sepsis therapy and the kinetics of serum albumin is unclear.

Aim: To investigate the relationship between serum albumin and fluid bolus in relation to its prognostic role in septic patients.

Improving acute care outcome in internal medicine: the role of early stabilization and intermediate care unit.

The progressive reduction of acute care beds will necessitate hospital admission in medical settings solely for acutely ill patients requiring urgent organ support. Early stabilization of the acute condition, potentially through an appropriate treatment unit, may not only improve short-term patient outcomes but also reduce the length of hospital stay. To determine if stabilization of the acute condition in an intermediate care unit (IMCU) is associated with improved patient outcomes and reduced in-hospital stay.

Exploring ChatGPT's potential in ECG interpretation and outcome prediction in emergency department.

Background: Approximately 20 % of emergency department (ED) visits involve cardiovascular symptoms. While ECGs are crucial for diagnosing serious conditions, interpretation accuracy varies among emergency physicians. Artificial intelligence (AI), such as ChatGPT, could assist in ECG interpretation by enhancing diagnostic precision.

Exploring the Variability in Triage Nursing Workload: Insights From a Multicentre Observational Study.

Aim: Although there has been a significant amount of research on nurse workloads in hospital environments, there has been a lack of comprehensive investigation of the workload of triage nurses. This study assesses the workload fluctuations of triage nurses in various emergency departments in the same region and examines how workload varies based on emergency department visit volumes and seasonal fluctuations.

Design: The study is a retrospective, multicentre, observational study from January 1, 2019, to December 31, 2023, in seven Italian emergency departments, gathering information on all patients who went through the triage process.

Challenges and peculiarities of nursing activities in intermediate care units compared with internal medicine wards: A prospective study.

Background: Intermediate Care Units (IMCs) are specialized facilities located within other departments in many Western countries. They are designed to manage patients with conditions that are not severe enough to require an intensive care unit. IMCs aim to fill the gap between regular wards and intensive care units, necessitating an adequate allocation of nursing resources.

Objective assessment of nursing workload in an intermediate care unit: A prospective observational study.

Objectives: To systematically assess the nursing workload in an Intermediate Care Unit.

Design: Single-centre prospective observational study. The nursing activities within the initial 72 h of hospitalization were recorded on a prespecified chart and standardized as activities/5 min/patient/day.

External validation of the TFC (triage frailty and comorbidity) tool: a prospective observational study.

Assessing patient frailty during triage evaluations has become increasingly relevant in Emergency Departments (ED). This study aimed to externally validating the Triage Frailty and Comorbidity (TFC) tool. This prospective study was conducted from June 1 to December 31, 2023.

Assessing triage efficiency in Italy: a comparative study using simulated cases among nurses.

Background: Emergency Departments (EDs) across Italy use different triage systems, which vary from region to region. This study aimed to assess whether nurses working in different EDs assign triage codes in a similar and standardized manner.

Methods: A multicenter observational simulation study involved the EDs of Bolzano Hospital, Merano Hospital, Pisa University Hospital, and Rovereto Hospital.

Enhancing triage accuracy: The influence of nursing education on risk prediction.

Aim: This study aimed to compare the performance in risk prediction of various outcomes between specially trained triage nurses and the Manchester Triage System (MTS).

Design: Prospective observational study.

Methods: The study was conducted from June 1st to December 31st, 2023, at the Emergency Department of Merano Hospital.

Assessing the utility of frailty scores in triage: a comparative study of validated scales.

Currently, there is conflicting evidence regarding the efficacy of frailty scales and their ability to enhance or support triage operations. This study aimed to assess the utility of three common frailty scales (CFS, PRISMA-7, ISAR) and determine their utility in the triage setting. This prospective observational monocentric study was conducted at Merano Hospital's Emergency Department (ED) from June 1st to December 31st, 2023.

Impact of the COVID-19 pandemic, its related social restriction measures and vaccination campaign on emergency department attendances for epileptic seizures: An interrupted time-series analysis.

Aim: To investigate the impact of the outbreak of the COVID-19 pandemic, its related social restriction measure (national lockdown) and vaccination campaign on emergency department (ED) accesses for epileptic seizures.

Methods: Retrospective observational analysis conducted on a consecutive cohort of patients who sought medical care at the ED of the General Hospital of Merano, Italy, from January 1, 2015, to December 31, 2021. We investigated the monthly ED attendances for epileptic seizures between the periods before and after the outbreak of the COVID-19 pandemic and the national lockdown (March 2020) using an interrupted time-series analysis with data standardized for 1000 accesses/month.

Is the National Early Warning Score able to identify nursing activity load? A prospective observational study.

Background: The National Early Warning Score scale correlates well with the intensity of the patient's acute condition. It could also correlate with the nursing activity load and prove useful in defining and redistributing nursing resources based on the acuity of patients.

Aim: To assess whether patients' National Early Warning Score at hospital admission correlates with objective nursing demands and can be used to optimize the distribution of available care resources.

Estimated plasma volume status is a simple and quick tool that could help define the severity of patients with infection on arrival at the emergency department.

Background: Infectious states are subtle and rapidly evolving conditions observed daily in the emergency department (ED), and their prognostic evaluation remains a complex clinical challenge. Recently, estimated plasma volume status (ePVS) has been suggested to have a prognostic role in conditions where volemic alteration is central to the pathophysiology. The aim of this study was to verify whether ePVS recorded at ED admission can provide prognostic indications of 30-day mortality in patients with infection.

Human intelligence versus Chat-GPT: who performs better in correctly classifying patients in triage?

Introduction: Chat-GPT is rapidly emerging as a promising and potentially revolutionary tool in medicine. One of its possible applications is the stratification of patients according to the severity of clinical conditions and prognosis during the triage evaluation in the emergency department (ED).

Methods: Using a randomly selected sample of 30 vignettes recreated from real clinical cases, we compared the concordance in risk stratification of ED patients between healthcare personnel and Chat-GPT.

Prognostic role of albumin, lactate-to-albumin ratio and C-reactive protein-to-albumin ratio in infected patients.

Introduction: The prognostic evaluation of the septic patient has recently been enriched by some predictive indices such as albumin concentration, lactate/albumin ratio (LAR) and C-reactive protein/albumin ratio (CAR). The performance of these indices has been evaluated in septic patients in intensive care, but until now their performance in infected patients in the Emergency Department (ED) has not been evaluated.

Aim: To investigate the potential prognostic role of albumin, LAR and CAR in patients with infection in the ED.

The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department.

Background: The Sequential Organ Failure Assessment (SOFA) score is currently the primary prognostic tool used in patients with infections to predict sepsis and mortality, although its predictive role remains debated. Serum albumin values have been recently found to correlate with the severity of sepsis. The purpose of this study is to evaluate the clinical usefulness of albumin dosage on SOFA score prediction in infected patients.

Real requirements of nursing activities and patient-related factors related to nursing overload in an internal medicine department.

Adequate nursing care can be decisive for the outcome of a patient admitted to an internal medicine ward. Individual prediction of nursing activity at the time of a patient's admission could improve the work process. This study aimed to assess the objectively assessed nursing requirements of patients admitted to a medical setting and to identify clinical factors that correlate with high demands.

Albumin as a prognostic marker of 30-day mortality in septic patients admitted to the emergency department.

Background: Assessing the evolutive risk of septic patients in the emergency department (ED) is very complex. Predictive tools are available, but at an early stage, none of them can detect the tissue microvascular alterations underlying the septic process. Hypoalbuminemia is present in critically ill patients in the ICU, and some early indications also suggest its early role in septic patients.

Prognostic Role of Serum Albumin in Predicting 30-Day Mortality in Patients with Infections in Emergency Department: A Prospective Study.

Background: Infections in emergency departments (EDs) are insidious clinical conditions characterised by high rates of hospitalisation and mortality in the short-to-medium term. The serum albumin, recently demonstrated as a prognostic biomarker in septic patients in intensive care units, could be an early marker of severity upon arrival of infected patients in the ED.

Aim: To confirm the possible prognostic role of the albumin concentration recorded upon arrival of patients with infection.