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2022 (Engelska)Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, nr 1, artikel-id e8941Artikel i tidskrift (Refereegranskat) Published
Abstract [en]
Background: One of the most critical decisions that emergency department (ED) physicians make is the discharge versus admission of patients. We aimed to study the association of the decision in the ED to admit patients with chest pain and/or breathlessness to a ward with risk assessment using the Rapid Emergency Triage and Treatment System (RETTS), the National Early Warning Score (NEWS), and plasma levels of the biomarkers copeptin, midregional proadrenomedulin (MR-proADM), and midregional proatrial natriuretic peptide (MR-proANP). Methods: Patients presenting at the ED with chest pain and/or breathlessness with less than one week onset were enrolled. Patients were triaged according to RETTS. NEWS was calculated from the vital signs retrospectively. Results: Three hundred and thirty-four patients (167 males), mean age 63.8 +/- 16.8 years, were included. Of which, 210 (62.8%) patients complained of chest pain, 65 (19.5%) of breathlessness, and 59 (17.7%) of both. Of these, 176 (52.7%) patients were admitted to a ward, and 158 (47.3%) patients were discharged from the ED. In binary logistic models, age, gender, vital signs (O-2 saturation and heart rate), NEWS class, and copeptin were associated with admission to a ward from the ED. In receiver-operating-characteristics (ROC) analysis, copeptin had an incremental predictive value compared to NEWS alone (P = 0.002). Conclusions: Emergency physicians decisions to admit patients with chest pain and/or breathlessness from the ED to a ward are related to age, O-2 saturation, heart rate, NEWS category, and copeptin. As an independent predictive marker for admission, early analysis of copeptin might be beneficial when improving patient pathways at the ED.
Ort, förlag, år, upplaga, sidor
UPSALA MED SOC, 2022
Nyckelord
Emergency department; chest pain; breathlessness; copeptin; MR-proADM; MR-proANP
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:liu:diva-191199 (URN)10.48101/ujms.v127.8941 (DOI)000905435100001 ()36590754 (PubMedID)
Anmärkning
Funding Agencies|Region Ostergotland [RO-285131, RO351681, RO-340001, RO-430481, RO-533731, RO-534451, RO599931, RO-623391, RO-936926]
2023-01-242023-01-242024-11-19