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10.3390/ijerph13040357 http://scihub22266oqcxt.onion/10.3390/ijerph13040357 C4847019!4847019 !27023577     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27023577 .jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       Int+J+Environ+Res+Public+Health 2016 ; 13 (4 ): 357 Nephropedia Template TP {{tp|p=27023577 |t=2016. Using the Reverse Shock Index at the Injury Scene and in the Emergency Department to Identify High-Risk Patients: A Cross-Sectional Retrospective Study |pdf=|usr=}}{{27023577 }} gab.com Text Using the Reverse Shock Index at the Injury Scene and in the Emergency Department to Identify High-Risk Patients: A Cross-Sectional Retrospective Study JO: Int J Environ Res Public Health http://www.kidney.de/pget.php?&tw=1&pmid=27023577 #FOAvip BACKGROUND: The ratio of systolic blood pressure (SBP) to heart rate (HR), called the reverse shock index (RSI), is used to evaluate the hemodynamic stability of trauma patients. A SBP lower than the HR (RSI < 1) indicates the probability of hemodynamic shock. The objective of this study was to evaluate whether the RSI as evaluated by emergency medical services (EMS) personnel at the injury scene (EMS RSI) and the physician in the emergency department (ED RSI) could be used as an additional variable to identify patients who are at high risk of more severe injury. METHODS: Data obtained from all 16,548 patients added to the trauma registry system at a Level I trauma center between January 2009 and December 2013 were retrospectively reviewed. Only patients transferred by EMS were included in this study. A total of 3715 trauma patients were enrolled and subsequently divided into four groups: group I patients had an EMS RSI ?1 and an ED RSI ?1 (n = 3485); group II an EMS RSI ? 1 and an ED RSI < 1 (n = 85); group III an EMS RSI < 1 and an ED RSI ? 1 (n = 98); and group IV an EMS RSI < 1 and a ED RSI < 1 (n = 47). A Pearson's ?² test, Fisher's exact test, or independent Student's t-test was conducted to compare trauma patients in groups II, III, and IV with those in group I. RESULTS: Group II and IV patients had a higher injury severity score, a higher incidence of commonly associated injuries, and underwent more procedures (including intubation, chest tube insertion, and blood transfusion in the ED) than patients in group I. Group II and IV patients were also more likely to receive a severe injury to the thoracoabdominal area. These patients also had worse outcomes regarding the length of stay in hospital and intensive care unit (ICU), the proportion of patients admitted to ICU, and in-hospital mortality. Group II patients had a higher adjusted odds ratio for mortality (5.8-times greater) than group I patients. CONCLUSIONS: Using an RSI < 1 as a threshold to evaluate the hemodynamic condition of the patients at the injury scene and upon arrival to the ED provides valid information regarding deteriorating outcomes for certain subgroups of patients in the ED setting. Particular attention and additional resources should be provided to patients with an EMS RSI ? 1 that deteriorates to an RSI < 1 upon arrival to the ED since a higher odds of mortality was found in these patients. Twit Text FOAVip Using the Reverse Shock Index at the Injury Scene and in the Emergency Department to Identify High-Risk Patients: A Cross-Sectional Retrospective Study ????Int J Environ Res Public Health http://www.kidney.de/pget.php?&tw=1&pmid=27023577 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27023577 #FOAvip English Wikipedia <ref>{{Cite pmid|27023577 }}</ref> Using the Reverse Shock Index at the Injury Scene and in the Emergency Department to Identify High-Risk Patients: A Cross-Sectional Retrospective Study #MMPMID27023577 Lai WH ; Rau CS ; Hsu SY ; Wu SC ; Kuo PJ ; Hsieh HY ; Chen YC ; Hsieh CH Int J Environ Res Public Health 2016[Mar]; 13 (4 ): 357 PMID27023577 show ga BACKGROUND: The ratio of systolic blood pressure (SBP) to heart rate (HR), called the reverse shock index (RSI), is used to evaluate the hemodynamic stability of trauma patients. A SBP lower than the HR (RSI < 1) indicates the probability of hemodynamic shock. The objective of this study was to evaluate whether the RSI as evaluated by emergency medical services (EMS) personnel at the injury scene (EMS RSI) and the physician in the emergency department (ED RSI) could be used as an additional variable to identify patients who are at high risk of more severe injury. METHODS: Data obtained from all 16,548 patients added to the trauma registry system at a Level I trauma center between January 2009 and December 2013 were retrospectively reviewed. Only patients transferred by EMS were included in this study. A total of 3715 trauma patients were enrolled and subsequently divided into four groups: group I patients had an EMS RSI ?1 and an ED RSI ?1 (n = 3485); group II an EMS RSI ? 1 and an ED RSI < 1 (n = 85); group III an EMS RSI < 1 and an ED RSI ? 1 (n = 98); and group IV an EMS RSI < 1 and a ED RSI < 1 (n = 47). A Pearson's ?² test, Fisher's exact test, or independent Student's t-test was conducted to compare trauma patients in groups II, III, and IV with those in group I. RESULTS: Group II and IV patients had a higher injury severity score, a higher incidence of commonly associated injuries, and underwent more procedures (including intubation, chest tube insertion, and blood transfusion in the ED) than patients in group I. Group II and IV patients were also more likely to receive a severe injury to the thoracoabdominal area. These patients also had worse outcomes regarding the length of stay in hospital and intensive care unit (ICU), the proportion of patients admitted to ICU, and in-hospital mortality. Group II patients had a higher adjusted odds ratio for mortality (5.8-times greater) than group I patients. CONCLUSIONS: Using an RSI < 1 as a threshold to evaluate the hemodynamic condition of the patients at the injury scene and upon arrival to the ED provides valid information regarding deteriorating outcomes for certain subgroups of patients in the ED setting. Particular attention and additional resources should be provided to patients with an EMS RSI ? 1 that deteriorates to an RSI < 1 upon arrival to the ED since a higher odds of mortality was found in these patients. |*Injury Severity Score [MESH] |*Registries [MESH] |Adult [MESH] |Blood Pressure [MESH] |Cross-Sectional Studies [MESH] |Emergency Medical Services/methods/statistics & numerical data [MESH] |Emergency Service, Hospital/statistics & numerical data [MESH] |Female [MESH] |Heart Rate [MESH] |Hospital Mortality [MESH] |Humans [MESH] |Length of Stay [MESH] |Male [MESH] |Middle Aged [MESH] |Odds Ratio [MESH] |Retrospective Studies [MESH] |Risk Assessment/methods [MESH] |Shock/*diagnosis/etiology [MESH] |Wounds and Injuries/*complications [MESH]Using the Reverse Shock Index at the Injury Scene and in the Emergency(epmc).pdf DeepDyve Pubget Overpricing