Comparing Safety and Accuracy of Standardised Versus Subjective Triage Code Assignment by Nurses: A Multicenter Observational Simulated Study.

Background: Standardised triage systems have been in place for decades with minor modifications, while nurses' skills and knowledge have significantly advanced.

Aim: To determine whether nurses' clinical expertise outperforms triage systems in simulated clinical cases.

Design: A multicenter simulated observational study.

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.

Progression to refractory status epilepticus: A machine learning analysis by means of classification and regression tree analysis.

Background And Objectives: to identify predictors of progression to refractory status epilepticus (RSE) using a machine learning technique.

Methods: Consecutive patients aged ≥ 14 years with SE registered in a 9-years period at Modena Academic Hospital were included in the analysis. We evaluated the risk of progression to RSE using logistic regression and a machine learning analysis by means of classification and regression tree analysis (CART) to develop a predictive model of progression to RSE.

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.

Development and validation of a nomogram for assessing comorbidity and frailty in triage: a multicentre observational study.

Assessing patient frailty in the Emergency Department (ED) is crucial; however, triage frailty and comorbidity assessment scores developed in recent years are unsatisfactory. The underlying causes of this phenomenon could reside in the nature of the tools used, which were not designed specifically for the emergency context and, thus, are difficult to adapt to the emergency environment. The objective of this study was to create and internally validate a nomogram for identifying different levels of patient frailty during triage.

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.

The role of lactate-to-albumin ratio to predict 30-day risk of death in patients with sepsis in the emergency department: a decision tree analysis.

Background: Accurately estimating the prognosis of septic patients on arrival in the emergency department (ED) is clinically challenging. The lactate-to-albumin ratio (LAR) has recently been proposed to improve the predictive performance of septic patients admitted to the ICU.

Objectives: This study aims to assess whether the LAR could be used as an early prognostic marker of 30-day mortality in patients with sepsis in the ED.

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.

Comparison of the status epilepticus severity score and the epidemiology-based mortality score in predicting 30-day mortality and status epilepticus cessation.

Objective: To evaluate the role of the Status Epilepticus Severity Score (STESS) and the Epidemiology-based Mortality score (EMSE) in predicting 30-day mortality and SE (Status epilepticus) cessation, and their prognostic performance in subgroups of patients with specific characteristics.

Methods: We reviewed consecutive episodes of SE occurring in patients aged ≥14 years at Baggiovara Civil Hospital (Modena, Italy) from 2013 to 2021. We evaluated the predictive accuracy of EMSE and STESS for 30-day mortality and SE cessation through stepwise regression binary logistic models adjusted for possible univariate clinical confounders.

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.

Daily triage audit can improve nurses' triage stratification: A pre-post study.

Aims: The objective was to evaluate whether the error rate in the application of the triage system decreased after the introduction of daily auditing, and it was also evaluated if the agreement rate between physician and nurse on triage priority levels increased after the introduction of daily auditing and if the error-related variables in the pre-intervention period changed in the post-intervention period.

Design: A quasi-experimental study was performed with a pre-post design, between June 2019 and June 2021 in one emergency department.

Methods: The accuracy and error rate of triage in the pre- and post-intervention period were compared.

Predicting the progression to super-refractory status epilepticus: A machine-learning study.

Aim: Super-refractory status epilepticus (SRSE) is a status epilepticus (SE) that continues or recurs ≥24 h after the onset of anesthesia. We aimed to identify the predictors of progression to SRSE and the risk of 30-day mortality in patients with SRSE by using a machine learning technique.

Methods: We reviewed consecutive SE episodes in patients aged ≥14 years at Baggiovara Civil Hospital (Modena, Italy) from 2013 to 2021.

Development and Validation of a Nomogram Based on the Epidemiology-Based Mortality Score in Status Epilepticus (EMSE) Parameters to Predict 30-day Mortality in Status Epilepticus.

Background: To develop a nomogram using the parameters of the Epidemiology-Based Mortality Score in Status Epilepticus (EMSE) and to evaluate its accuracy compared with the EMSE alone in the prediction of 30-day mortality in patients with status epilepticus (SE).

Methods: We included a cohort of patients with SE aged ≥ 21 years admitted from 2013 to 2021. Regression coefficients from the multivariable logistic regression model were used to generate a nomogram predicting the risk of 30-day mortality.

Out-of-hospital versus in-hospital status epilepticus: The role of etiology and comorbidities.

Background And Purpose: Our objectives were to identify differences in clinical characteristics between patients with out-of-hospital and in-hospital status epilepticus (SE) onset, and to evaluate the influence of SE onset setting on 30-day mortality and SE cessation.

Methods: We included consecutive patients with SE admitted from 2013-2021 at Modena Academic Hospital. A propensity score was obtained with clinical variables unevenly distributed between the two groups.