1
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Hsu JY, Komine K, Jaw FS, Hsieh CC. Reader Comment Regarding Delta shock index in the emergency department as a predictor of clinical outcomes in traumatic injury. Am J Emerg Med 2025; 92:187-188. [PMID: 40185673 DOI: 10.1016/j.ajem.2025.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2025] [Accepted: 03/22/2025] [Indexed: 04/07/2025] Open
Affiliation(s)
- Jen-Yu Hsu
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Kazuhiro Komine
- Department of Emergency and Critical care Medicine, Cheng Hsin General Hospital, Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Chien-Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan; International Bachelor Program in Electrical and Communication Engineering, Yuan Ze University, Taoyuan, Taiwan.
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2
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Hsieh CC, Jaw FS, Lu CY, Hsieh CC. Predictors for safe early discharge in ED patients with SIRS. Am J Emerg Med 2025; 89:270-271. [PMID: 39799103 DOI: 10.1016/j.ajem.2025.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 01/04/2025] [Indexed: 01/15/2025] Open
Affiliation(s)
- Chien-Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Chen-Yen Lu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, Banqiao District, New Taipei City, Taiwan.
| | - Chien-Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan.
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3
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Chung C, Hsieh CC, Jaw FS, Chen PA, Hsieh CC. Mortality risk factors in patients receiving ECPR after cardiac arrest. Am J Emerg Med 2025; 89:274-275. [PMID: 39799104 DOI: 10.1016/j.ajem.2025.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Accepted: 01/05/2025] [Indexed: 01/15/2025] Open
Affiliation(s)
- Chiang Chung
- Department of Medical Education, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chien Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Po-An Chen
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
| | - Chien Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan..
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4
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Vural S, Mulders MCF, Boekhoud L, Olgers TJ, Ter Maaten JC, Bouma HR. Clinical prediction models and future directions. Am J Emerg Med 2025; 89:272-273. [PMID: 39799101 DOI: 10.1016/j.ajem.2025.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2025] [Accepted: 01/04/2025] [Indexed: 01/15/2025] Open
Affiliation(s)
- Sevilay Vural
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Emergency Medicine, Yozgat Bozok University, Yozgat, Turkey.
| | - Merijn C F Mulders
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lisanne Boekhoud
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tycho J Olgers
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan C Ter Maaten
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hjalmar R Bouma
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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5
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Hsieh CC, Jaw FS, Chiu WC, Chang CC, Yeh CM. A high-flow nasal cannula versus noninvasive ventilation in acute exacerbations of chronic obstructive pulmonary disease. Am J Emerg Med 2025; 88:243-244. [PMID: 39638745 DOI: 10.1016/j.ajem.2024.11.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Accepted: 11/27/2024] [Indexed: 12/07/2024] Open
Affiliation(s)
- Chien-Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan; Department of Emergency Medicine, Ten Chan General Hospital, Chung-Li, Taoyuan City, Taiwan; Department of Emergency Medicine, Evergreen general Hospital, Chung-Li, Taoyuan City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Wei-Che Chiu
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Chang Chang
- Department of Emergency Medicine, Evergreen general Hospital, Chung-Li, Taoyuan City, Taiwan.
| | - Che-Ming Yeh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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6
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Hsieh CC, Jaw FS, Hsu CT, Hsieh CC, Chen HW. Predicting severe outcomes in pediatric trauma patients: Shock index pediatric age-adjusted. Am J Emerg Med 2025; 87:132-133. [PMID: 39117467 DOI: 10.1016/j.ajem.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/04/2024] [Indexed: 08/10/2024] Open
Affiliation(s)
- Chien-Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan; Department of Emergency Medicine, Ten Chan General Hospital, Chung-Li, Taoyuan City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Ching-Tang Hsu
- Department of Emergency Medicine, Ten Chan General Hospital, Chung-Li, Taoyuan City, Taiwan.
| | - Chien-Chieh Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan; Department of Emergency Medicine, Ten Chan General Hospital, Chung-Li, Taoyuan City, Taiwan.
| | - Hung-Wei Chen
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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7
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Chen TJ, Ho MP. Shock index pediatric age-adjusted for predicting severe outcomes in patients with pediatric trauma. Am J Emerg Med 2025; 87:134. [PMID: 39343623 DOI: 10.1016/j.ajem.2024.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 09/24/2024] [Indexed: 10/01/2024] Open
Affiliation(s)
- Tai-Jung Chen
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Min-Po Ho
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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8
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Chou SF, Hsieh CY, Tsai KC, Liu YH, Fan CM, Mi Le JR, Jaw FS, Chang CT, Sim SS, Wu YW, Tai TL, Chen KC, Wu YH, Hsieh CC. Impact of the COVID-19 Pandemic on Door-to-Device Time Segments and Clinical Outcomes for STEMI Patients in Northern Taiwan. ACTA CARDIOLOGICA SINICA 2025; 41:121-129. [PMID: 39776930 PMCID: PMC11701492 DOI: 10.6515/acs.202501_41(1).20241021a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 10/21/2024] [Indexed: 01/11/2025]
Abstract
Background Prompt primary percutaneous coronary intervention (pPCI) is crucial for the prognosis and reduction of myocardial damage in ST-segment elevation myocardial infarction (STEMI) patients. The Coronavirus Disease 2019 (COVID-19) pandemic had multifaceted impacts on healthcare. This study assessed the effects of the pandemic on pPCI procedures and clinical outcomes in emergency STEMI patients. Methods This retrospective, single-center study analyzed STEMI patients who underwent pPCI from February 2019 to January 2022. The COVID-19 pandemic was categorized into three periods: pre-COVID-19 (Period-I), early-pandemic (Period-II), and epidemic (Period-III). The impacts on Door-to-Device time, its segments, and clinical outcomes were analyzed using Statistical Package for the Social Sciences. Results A total of 404 STEMI patients were included, with a reduced number in Period-III. Compared to Period-I, the time intervals of Door-to-electrocardiogram (ECG), ECG-to-Cardiac Catheterization Laboratory Activation (CCLA), and CCLA-to-Cardiac Catheterization Laboratory Door in Period III were extended by 0.62 minutes (p = 0.006), 3.30 minutes (p = 0.009), and 9.65 minutes (p < 0.001), respectively. In contrast, the Angio-to-Device time was shorter in Period- II and III by 2.60 and 4.08 minutes (p < 0.001), respectively. Overall Door-to-Device time increased by 10.06 minutes (p < 0.001) in Period-III but decreased by 3.67 minutes in Period-II (p = 0.017). The odds of achieving a Door-to-Device time ≤ 90 minutes decreased by 70% in Period-III (p = 0.002). Clinical outcomes, including intensive care unit stay, hospital stay, in-hospital mortality, and 30-day readmission rate, remained stable across periods. Conclusions The COVID-19 pandemic had various effects on different segments of the Door-to-Device procedure, and they were influenced by the complex interplay between infection control measures and clinical workflow. The stability of clinical outcomes reflects the resilience and effective adaptations of the healthcare system during the pandemic.
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Affiliation(s)
| | - Chun-Yu Hsieh
- Department of Cardiovascular Surgery, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | | | - Yuan-Hung Liu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City
- Department of Electronic Engineering, Asia Eastern University of Science and Technology, New Taipei City
| | | | - Jie-Ren Mi Le
- Department of Biomedical Engineering, National Taiwan University, Taipei
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei
| | - Chung-Ta Chang
- Department of Emergency Medicine
- Graduate Institute of Medicine, Yuan Ze University
| | | | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City
- Department of Nuclear Medicine, Far Eastern Memorial Hospital
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | | | - Kuan-Chang Chen
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City
| | - Yuan-Hui Wu
- Department of Emergency Medicine
- School of Medicine, Fu-Jen Catholic University, New Taipei City
| | - Chien-Chieh Hsieh
- Department of Biomedical Engineering, National Taiwan University, Taipei
- Department of Emergency Medicine
- Graduate Institute of Medicine, Yuan Ze University
- International Bachelor Program in Electrical and Communication Engineering, Yuan Ze University, Taoyuan
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9
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Nugent K, Berdine G. Do Vital Sign Trajectories During the Initial 8 Hours of Hospitalization Help Clinicians Manage Patients With COVID-19 Infections? Chest 2024; 166:e125. [PMID: 39389695 DOI: 10.1016/j.chest.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 10/12/2024] Open
Affiliation(s)
- Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
| | - Gilbert Berdine
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
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10
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Chen PS, Hsieh CY, Jaw FS, Chen HK, Hsi KY, Chang HP. The hypoxia-age-shock index at triage is a useful and rapid tool. Am J Emerg Med 2024; 83:154-155. [PMID: 39003195 DOI: 10.1016/j.ajem.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/06/2024] [Indexed: 07/15/2024] Open
Affiliation(s)
- Pao-Shan Chen
- Department of Medical Education and Research, Cathay general hospital, Taipei City, Taiwan
| | - Chia-Yin Hsieh
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Pediartics, Taipei Tzu Chi Hospital, Buddhist Tzu ChiMedical Foundation, New Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Hsaio-Kang Chen
- Department of Emergency Medicine, Ten Chan General Hospital, Chung-Li, Taoyuan City, Taiwan.
| | - Kuo-Yang Hsi
- Department of Emergency Medicine, Show Chwan Memorial Hospital, Changhua City, Taiwan.
| | - Hung-Pin Chang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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11
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Zhang JH, Fang YT, Hsieh CY, Jaw FS, Hsieh CC. Utility of emergency department triage tools in predicting the outcomes of COVID-19 patients. Am J Emerg Med 2024; 80:209. [PMID: 38670911 DOI: 10.1016/j.ajem.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Affiliation(s)
- Jia-Hao Zhang
- Division of Chest Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yang-Ta Fang
- Department of Pediatrics, Ten Chan General Hospital, Chung-Li, Taoyuan City, Taiwan
| | - Chia-Yin Hsieh
- Department of Medical Education, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Chien-Chieh Hsieh
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan; Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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12
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Liu CY, Chou SF, Chiang PY, Sun JT, Tsai KC, Jaw FS, Chang CT, Fan CM, Wu YH, Lee PY, Hsieh CY, Chen JM, Hsieh CC. The FIB-4 scores in the emergency department to predict the outcomes of COVID-19 patients in taiwan. Heliyon 2024; 10:e25649. [PMID: 38390148 PMCID: PMC10881524 DOI: 10.1016/j.heliyon.2024.e25649] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
Objective We aimed to determine the reliability of using the Fibrosis-4 (FIB-4) index in COVID-19 patients without underlying liver illness. Method We employed multivariate logistic regression to identify variables that exhibited statistically significant influence on the ultimate outcome. Multilayer perceptron analysis was employed to develop a prediction model for the FIB-4 index concerning ICU admission and intubation rates. However, the scarcity of cases rendered the assessment of the mortality rate unfeasible. We plotted ROC curves to analyze the predictive strength of the FIB-4 index across various age groups. Result In univariate logistic regression, only the FIB-4 index and respiratory rate demonstrated statistical significance on all poor outcomes. The FIB-4 index for mortality prediction had an ROC and AUC of 0.863 (95% CI: 0.781-0.9444). It demonstrates predictive power across age groups, particularly for age ≥65 (AUC: 0.812, 95% CI: 0.6571-0.9673) and age <65 (AUC: 0.878, 95% CI: 0.8012-0.9558). Its sensitivity for intubation and ICU admission prediction is suboptimal. Conclusion FIB-4 index had promising power in prediction of mortality rate in all age groups.
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Affiliation(s)
- Chia-Yu Liu
- Department of Radiology, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - San-Fang Chou
- Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Ying Chiang
- Division of Hospital Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taiwan
| | - Jen-Tang Sun
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Kuang-Chau Tsai
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Chung-Ta Chang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
| | - Chieh-Min Fan
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yuan-Hui Wu
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Peng-Yu Lee
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chia-Ying Hsieh
- Department of Medical Education, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Jie-Ming Chen
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chien-Chieh Hsieh
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan
- Department of Emergency Medicine, Ten Chan General Hospital, Zhongli Dist, Taoyuan City, Taiwan
- International Bachelor Program in Electrical and Communication Engineering, Yuan Ze University, Taoyuan, Taiwan
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Oh S, Lee K. The new combination of oxygen saturation with age shock index predicts the outcome of COVID-19 pneumonia. SAGE Open Med 2023; 11:20503121231203683. [PMID: 37846368 PMCID: PMC10576920 DOI: 10.1177/20503121231203683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/06/2023] [Indexed: 10/18/2023] Open
Abstract
Introduction Emergency departments around the world have been struggling to deal with patients with COVID-19 and presumed COVID-19. Triaging patients who need further medical support is the key matter to emergency physicians as the delay of proper treatment may worsen the results. The aim of this study was to validate the ability of age shock index and hypoxia-age-shock index at the time of presentation to the emergency department to predict case fatality in patients with COVID-19 pneumonia. Methods We only included patients who had COVID-19-associated pneumonia who needed in-hospital treatment. The vital signs and oxygen saturation used in the study were collected, especially from the triage sector, before patients were given supplemental oxygen. Results A total of 241 patients enrolled in the study. The case fatality rate was 27%. The median age of the study samples was 78 (66-86) years with 133 male and 108 female patients. Hypoxia-age-shock index showed the best performance in analysis (odds ratio 15.1, 95% confidence interval: 5.1-44.4; adjusted odds ratio 8.6, 95% confidence interval: 2.8-26.8). Conclusion The hypoxia-age-shock index was a strong predictor for in-hospital mortality of COVID-19 pneumonia. Furthermore, when it was compared with age shock index, hypoxia-age-shock index showed better performance in predicting fatality of the disease.
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Affiliation(s)
- Sangyeop Oh
- Department of Emergency Medicine, Myongi Hospital, Gyeonggi, South Korea
| | - Kyoungmi Lee
- Department of Emergency Medicine, Myongi Hospital, Gyeonggi, South Korea
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Tai TL, Hsieh CY, Jaw FS, Tat TS, Hsieh CC. D-dimer measurement is a useful tool of acute aortic syndrome. Am J Emerg Med 2023; 75:S0735-6757(23)00548-X. [PMID: 39492023 DOI: 10.1016/j.ajem.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/09/2023] [Indexed: 11/05/2024] Open
Affiliation(s)
- Ting-Li Tai
- Department of Medical Education, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chia-Yin Hsieh
- Department of Medical Education, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taiwan
| | - Tang-Sai Tat
- Department of Emergency Medicine, Ten Chan General Hospital, Taoyuan City, Taiwan
| | - Chien-Chieh Hsieh
- Department of Biomedical Engineering, National Taiwan University, Taiwan; Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Emergency Medicine, Ten Chan General Hospital, Taoyuan City, Taiwan.
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15
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Alsagaff MY, Kurniawan RB, Purwati DD, Ul Haq AUD, Saputra PBT, Milla C, Kusumawardhani LF, Budianto CP, Susilo H, Oktaviono YH. Shock index in the emergency department as a predictor for mortality in COVID-19 patients: A systematic review and meta-analysis. Heliyon 2023; 9:e18553. [PMID: 37576209 PMCID: PMC10413000 DOI: 10.1016/j.heliyon.2023.e18553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background The shock index (SI) ratio serves as a straightforward predictor to identify patients who are either at risk of or experiencing shock. COVID-19 patients with shock face increased mortality risk and reduced chances of recovery. This review aims to determine the role of SI in the emergency department (ED) to predict COVID-19 patient outcomes. Methods The systematic search was conducted in PubMed, ProQuest, Scopus, and ScienceDirect on June 16, 2023. We included observational studies evaluating SI in ED and COVID-19 patient outcomes. Random-effect meta-analysis was done to generate odds ratios of SI as the predictor of intensive care unit (ICU) admission and mortality. The sensitivity and specificity of SI in predicting these outcomes were also pooled, and a summary receiver operating characteristics (sROC) curve was generated. Results A total of eight studies involving 4557 participants were included in the pooled analysis. High SI was found to be associated with an increased risk of ICU admission (OR 5.81 [95%CI: 1.18-28.58], p = 0.03). Regarding mortality, high SI was linked to higher rates of in-hospital (OR 7.45 [95%CI: 2.44-22.74], p = 0.0004), within 30-day (OR 7.34 [95%CI: 5.27-10.21], p < 0.00001), and overall (OR 7.52 [95%CI: 3.72-15.19], p < 0.00001) mortality. The sensitivity and specificity of SI for predicting ICU admission were 76.2% [95%CI: 54.6%-89.5%] and 64.3% [95%CI: 19.6%-93.0%], respectively. In terms of overall mortality, the sensitivity and specificity were 54.0% (95%CI: 34.3%-72.6%) and 85.9% (95%CI: 75.8%-92.3%), respectively, with only subtle changes for in-hospital and within 30-day mortality. Adjustment of SI cut-off to >0.7 yielded improved sensitivity (95%CI: 78.0% [59.7%-89.4%]) and specificity (95%CI: 76.8% [41.7%-93.9%]) in predicting overall mortality. Conclusion SI in emergency room may be a simple and useful triage instrument for predicting ICU admission and mortality in COVID-19 patients. Future well-conducted studies are still needed to corroborate the findings of this study.
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Affiliation(s)
- Mochamad Yusuf Alsagaff
- Department Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
- Department Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | | | - Dinda Dwi Purwati
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | | | - Pandit Bagus Tri Saputra
- Department Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Clonia Milla
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Louisa Fadjri Kusumawardhani
- Department Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Christian Pramudita Budianto
- Department Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Hendri Susilo
- Department Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | - Yudi Her Oktaviono
- Department Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
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16
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Hsieh CC, Jaw FS, Hsieh CY, Yu CJ. Prehospital age-shock index and outcomes among patients with COVID-19 disease. Am J Emerg Med 2023; 66:171. [PMID: 36682947 PMCID: PMC9846895 DOI: 10.1016/j.ajem.2023.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Affiliation(s)
- Chien-Chieh Hsieh
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan; Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Emergency Medicine, Ten- Chan General Hospital, Chung-Li, Taoyuan City, Taiwan
| | - Fu-Shan Jaw
- Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Chia-Yin Hsieh
- Department of Medical Education, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Ching-Juing Yu
- Department of Emergency Medicine, Ten- Chan General Hospital, Chung-Li, Taoyuan City, Taiwan.
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