Displaying publications 1 - 20 of 43 in total

Abstract:
Sort:
  1. Peta D, Day A, Lugari WS, Gorman V, Ahayalimudin N, Pajo VMT
    J Emerg Nurs, 2023 Nov;49(6):814-825.
    PMID: 37925222 DOI: 10.1016/j.jen.2023.08.004
    Triage is a process by which patients are assessed, classified, and sorted based on their presenting complaint and clinical urgency, providing assurance for timely access to emergency care. The goal is to get the right person to the right place, in the right amount of time, for the right reason, and within the context of resource availability. In many countries, a standardized triage system, underpinned through the use of guidelines, is used to provide clinicians with support and guidance. Triage is a globally adopted principle, and although triage guidelines are used in many countries, no single system has been internationally adopted. This paper discusses the importance of how triage process standardization improves patient care, resource management, and benchmarking at local, national, and international levels by applying 5 internationally recognized triage systems to fictional case studies. Evaluation of similarities and differences in severity scores, with a gap analysis, occurs.
    Matched MeSH terms: Triage*
  2. Awwad K, Ng YG, Lee K, Lim PY, Rawajbeh B
    Int Emerg Nurs, 2021 05;56:100994.
    PMID: 33798982 DOI: 10.1016/j.ienj.2021.100994
    BACKGROUND: In the trauma triage procedure, nurses with good knowledge and skills can start initial treatment immediately pending doctors availability, and before a final diagnosis is made. The Advanced Trauma Life Support/ Advanced Trauma Care for Nurses is one of the most important trauma education programmes to enhance the knowledge and skills of emergency nurses. This systematic review of the literature attempts to investigate the implications of introducing an Advanced Trauma Life Support/Advanced Trauma Care for Nurses' knowledge and skills related to trauma triage.

    METHODS: A systematic review was carried out using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The included sites and databases are Web of Science, Scopus, PubMed, ScienceDirect, Cochrane Library, and Bielefeld Academic Search Engine (BASE) from 1994 to 2019. The quality of the selected studies was evaluated using a standard quality rating tool (SQRT). The quality of the criteria for inclusion and exclusion was independently reviewed by three researchers.

    RESULTS: This study evaluated 5266 records in the identification stage. In the included stage, only four studies were included in this review. In the standard quality assessment, none of the included studies were evaluated as being a strong study, none used an experimental design at three points in time (pre, post and follow-up), and all showed a moderate to high risk of bias. There is a lack of knowledge and skills related to trauma triage among emergency nurses in the included studies.

    CONCLUSION: A lack of knowledge and skills concerning trauma triage among emergency nurses could potentially have an adverse effect on the outcomes of the patients in trauma cases.

    Matched MeSH terms: Triage*
  3. Salman OH, Rasid MF, Saripan MI, Subramaniam SK
    J Med Syst, 2014 Sep;38(9):103.
    PMID: 25047520 DOI: 10.1007/s10916-014-0103-4
    The healthcare industry is streamlining processes to offer more timely and effective services to all patients. Computerized software algorithm and smart devices can streamline the relation between users and doctors by providing more services inside the healthcare telemonitoring systems. This paper proposes a multi-sources framework to support advanced healthcare applications. The proposed framework named Multi Sources Healthcare Architecture (MSHA) considers multi-sources: sensors (ECG, SpO2 and Blood Pressure) and text-based inputs from wireless and pervasive devices of Wireless Body Area Network. The proposed framework is used to improve the healthcare scalability efficiency by enhancing the remote triaging and remote prioritization processes for the patients. The proposed framework is also used to provide intelligent services over telemonitoring healthcare services systems by using data fusion method and prioritization technique. As telemonitoring system consists of three tiers (Sensors/ sources, Base station and Server), the simulation of the MSHA algorithm in the base station is demonstrated in this paper. The achievement of a high level of accuracy in the prioritization and triaging patients remotely, is set to be our main goal. Meanwhile, the role of multi sources data fusion in the telemonitoring healthcare services systems has been demonstrated. In addition to that, we discuss how the proposed framework can be applied in a healthcare telemonitoring scenario. Simulation results, for different symptoms relate to different emergency levels of heart chronic diseases, demonstrate the superiority of our algorithm compared with conventional algorithms in terms of classify and prioritize the patients remotely.
    Matched MeSH terms: Triage/organization & administration*
  4. Ong LK, Sivaneswaran L, Mohd Najib A, Devindran M, Say BL, Rohan MJ
    Med J Malaysia, 2020 07;75(4):400-402.
    PMID: 32724002
    In Malaysia, COVID-19 pandemic recorded considerable number of cases. Many hospitals have been converted into COVID-19 centres to manage these cases. The Penang General Hospital was designated as a hybrid hospital to manage both COVID-19 and non-COVID-19 cases. Consequently, services across specialties, including urology have been affected. Triage of referrals was necessary to ensure optimum patient care, thus we designed a triage system to address this situation. A record screening system of patients was also implemented to limit outpatient appointments. We share this early experience in managing urology patients during this pandemic.
    Matched MeSH terms: Triage*
  5. Mohammed KI, Zaidan AA, Zaidan BB, Albahri OS, Albahri AS, Alsalem MA, et al.
    Comput Methods Programs Biomed, 2020 Mar;185:105151.
    PMID: 31710981 DOI: 10.1016/j.cmpb.2019.105151
    CONTEXT: Telemedicine has been increasingly used in healthcare to provide services to patients remotely. However, prioritising patients with multiple chronic diseases (MCDs) in telemedicine environment is challenging because it includes decision-making (DM) with regard to the emergency degree of each chronic disease for every patient.

    OBJECTIVE: This paper proposes a novel technique for reorganisation of opinion order to interval levels (TROOIL) to prioritise the patients with MCDs in real-time remote health-monitoring system.

    METHODS: The proposed TROOIL technique comprises six steps for prioritisation of patients with MCDs: (1) conversion of actual data into intervals; (2) rule generation; (3) rule ordering; (4) expert rule validation; (5) data reorganisation; and (6) criteria weighting and ranking alternatives within each rule. The secondary dataset of 500 patients from the most relevant study in a remote prioritisation area was adopted. The dataset contains three diseases, namely, chronic heart disease, high blood pressure (BP) and low BP.

    RESULTS: The proposed TROOIL is an effective technique for prioritising patients with MCDs. In the objective validation, remarkable differences were recognised among the groups' scores, indicating identical ranking results. In the evaluation of issues within all scenarios, the proposed framework has an advantage of 22.95% over the benchmark framework.

    DISCUSSION: Patients with the most severe MCD were treated first on the basis of their highest priority levels. The treatment for patients with less severe cases was delayed more than that for other patients.

    CONCLUSIONS: The proposed TROOIL technique can deal with multiple DM problems in prioritisation of patients with MCDs.

    Matched MeSH terms: Triage/methods*
  6. Azeez D, Gan KB, Mohd Ali MA, Ismail MS
    Technol Health Care, 2015;23(4):419-28.
    PMID: 25791174 DOI: 10.3233/THC-150907
    BACKGROUND: Triage of patients in the emergency department is a complex task based on several uncertainties and ambiguous information. Triage must be implemented within two to five minutes to avoid potential fatality and increased waiting time.
    OBJECTIVE: An intelligent triage system has been proposed for use in a triage environment to reduce human error.
    METHODS: This system was developed based on the objective primary triage scale (OPTS) that is currently used in the Universiti Kebangsaan Malaysia Medical Center. Both primary and secondary triage models are required to develop this system. The primary triage model has been reported previously; this work focused on secondary triage modelling using an ensemble random forest technique. The randomized resampling method was proposed to balance the data unbalance prior to model development.
    RESULTS: The results showed that the 300% resampling gave a low out-of-bag error of 0.02 compared to 0.37 without pre-processing. This model has a sensitivity and specificity of 0.98 and 0.89, respectively, for the unseen data.
    CONCLUSION: With this combination, the random forest reduces the variance, and the randomized resembling reduces the bias, leading to the reduced out-of-bag error.
    KEYWORDS: Decision support system; emergency department; random forest; randomized resampling
    Matched MeSH terms: Triage
  7. Nik Azlan, N.M., Ismail, M.S.
    Medicine & Health, 2013;8(1):0-0.
    MyJurnal
    Emergency Department Overcrowding (EDOC) has been a longstanding problem. It is defined as a situation where the demand for emergency services exceeds the ability of an Emergency Department (ED) to provide quality care within appropriate time frames. Hospital beds closure or access block to ward admission is one of the most important cause of Emergency s e.g. disaster. A surge response entails even greater responses including implementing Department overcrowding. This could be compounded further in events of a patient surge eg affirmative measurement in order to mitigate the issue in tackling the situation. The steps in managing EDOC were: 1. Recognizing EDOC, 2. Initiating action, 3. Maintaining patient flow, 4. Setting clinical goals and 5. Deploying a Surge Team for Advance Triage or Fast Tract.
    Matched MeSH terms: Triage
  8. Haldeman S, Johnson CD, Chou R, Nordin M, Côté P, Hurwitz EL, et al.
    Eur Spine J, 2018 09;27(Suppl 6):901-914.
    PMID: 30151811 DOI: 10.1007/s00586-018-5721-y
    PURPOSE: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally.

    METHODS: The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. An iterative consensus process was used.

    RESULTS: After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (e.g., non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes. The care pathway can be used to guide the management of patients with any spine-related concern (e.g., back and neck pain, deformity, spinal injury, neurological conditions, pathology, spinal diseases). The pathway is simple and can be incorporated into educational tools, decision-making trees, and electronic medical records.

    CONCLUSION: A care pathway for the management of individuals presenting with spine-related concerns includes evidence-based recommendations to guide health care providers in the management of common spinal disorders. The proposed pathway is person-centered and evidence-based. The acceptability and utility of this care pathway will need to be evaluated in various communities, especially in low- and middle-income countries, with different cultural background and resources. These slides can be retrieved under Electronic Supplementary Material.

    Matched MeSH terms: Triage
  9. Khaw SK, Teo SC, Bujang MA
    Med J Malaysia, 2020 07;75(4):379-384.
    PMID: 32723998
    INTRODUCTION: A proper prioritisation system of emergency cases allows appropriate timing of surgery and efficient allocation of resources and staff expertise. The aim of this study was to determine the impact of colour coding classification on Time-to- theatre (TTT) of patients in comparison with the normal practice.

    METHOD: Categorisation was a surgical judgment call after thorough clinical assessment. There were 4 levels of urgency with their respective TTT; Red (2 hours), Yellow (8 hours), Green (24 hours), Blue (72 hours). Caesarean cases were excluded in colour coding due to pre - existing classification. The data for mean TTT was collected 4 weeks before the implementation (Stage 1), and another 4 weeks after implementation (Stage II). As there was a violation in the assumption for parametric test, Mann Whitney U test was used to compare the means between these two groups. Using logarithmic (Ln) transformation for TTT, Analysis of Covariance (ANCOVA) was conducted for multivariate analysis to adjust the effect of various departments. The mean TTT for each colour coding classification was also calculated.

    RESULTS: The mean TTT was reduced from 13 hours 48 min to 10 hours, although more cases were completed in Stage II (428 vs 481 cases). Based on Mann-Whitney U test, the difference in TTT for Stage I (Median=6.0, /IQR=18.9) and Stage II (Median=4.2, IQR=11.5) was significantly different (p=0.023). The result remained significant (p=0.039) even after controlled for various department in the analysis. The mean/median TTT after colour coding was Red- 2h 24min/1h, Yellow- 8h 26min/3h 45 min, Green- 15h 8min/8h 15min, and Blue- 13h 46min/13h 5min.

    CONCLUSION: Colour coding classification in emergency Operation (OT) was effective in reducing TTT of patients for non-caesarean section cases.

    Matched MeSH terms: Triage/classification*; Triage/organization & administration*
  10. Hussain A, Via G, Melniker L, Goffi A, Tavazzi G, Neri L, et al.
    Crit Care, 2020 12 24;24(1):702.
    PMID: 33357240 DOI: 10.1186/s13054-020-03369-5
    COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.
    Matched MeSH terms: Triage/methods; Triage/standards
  11. Chia YC
    J Hypertens, 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e16-e17.
    PMID: 27753834
    Conference abstract SY04-4: Many cardiovascular disease (CVD) risk prediction tools have been developed in an attempt to identify those at highest risk in order for them to benefit from interventional treatment. The first CVD risk tool that was developed was the coronary heart disease risk tool by the Framingham Heart Study in 1998 (1). However the Framingham Risk Score could overestimate (or underestimate) risk in populations other than the US population. Hence several other risk engines have also been developed, primarily for a better fit in the communities in which the tools are to be used (2, 3). Having said that the Framingham Heart Study risk tool has been validated in several populations (4, 5) and found to work reasonably well after some recalibration.Most risk prediction tools predict short term risk ie over a period of 10 years but since more recently risk tools now attempt to predict life-time risk or at least risk over the next 30 years. (6-8). The practical use of these risk prediction tools is that it is able to separate those at high risk (ie > 20% risk of a CVD event fatal or non-fatal event in the next 10 years) from those with the lowest risk (< 10% risk over 10 years). It then helps practitioners to triage them to either receive preventive therapy (high risk group) or none at all (low risk group) respectively. However in those with medium risk ie between 10-20%, the decision to offer treatment or not is less clear. In such a situation, other CVD risk factors for example family history of premature coronary heart disease, other biomarkers like elevated hs-CRP, presence of chronic kidney disease or albuminuria can be employed to further stratify risk.It is known that risk prediction tools are very much age dependent and in a younger individual with mildly raised CVD risk factors, his global CVD risk may be grossly under-estimated. Here additional CVD risk factors beyond those traditionally used in risk engines should be sought in order to recalibrate that individual's seemingly low risk and earlier intervention introduced if indeed he is of higher risk than what has been predicted by the conventional risk tools. Here too the use of life-time risk is probably of more importance than the traditional 10 year risk tool, again in order to identify those seemingly at "low" risk 10 year risk to receive treatment if the life-time risk is greater compared to an individual of the same age with optimal parameters. Furthermore while it is known that those with highest risk benefit the most from intervention, it is the population at large with the low or lower risk which contributes most to total CV morbidity and mortality in a country or community.Hence while short term risk prediction to identify those at highest risk is useful particularly in the presence of limited resources, attention should also be paid to those with short term low risk if the aim is to reduce CVD morbidity and mortality in any substantial way.
    Matched MeSH terms: Triage
  12. Pfaar O, Klimek L, Jutel M, Akdis CA, Bousquet J, Breiteneder H, et al.
    Allergy, 2021 03;76(3):648-676.
    PMID: 32531110 DOI: 10.1111/all.14453
    BACKGROUND: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.

    METHOD: The scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet.

    RESULTS: Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.

    CONCLUSIONS: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic.

    Matched MeSH terms: Triage
  13. Ghazali SA, Abdullah KL, Moy FM, Ahmad R, Hussin EOD
    Int Emerg Nurs, 2020 07;51:100889.
    PMID: 32622225 DOI: 10.1016/j.ienj.2020.100889
    INTRODUCTION: Patients who visit emergency departments need to undergo a precise assessment to determine their priority and accurate triage category to ensure they receive the right treatment.

    AIM: To identify the effect of triage training on the skills and accuracy of triage decisions for adult trauma patients.

    METHOD: A randomized controlled trial design was conducted in ten emergency department of public hospitals. A total of 143 registered nurses and medical officer assistants who performed triage roles were recruited for the control group (n = 74) and the intervention group (n = 69). The skill and accuracy of triage decisions were measured two weeks and four weeks after the intervention group were exposed to the intervention.

    RESULTS: There was a significant effect on the skill of triage decision-making between the control and the intervention group p 

    Matched MeSH terms: Triage
  14. Albahri OS, Zaidan AA, Zaidan BB, Hashim M, Albahri AS, Alsalem MA
    J Med Syst, 2018 Jul 25;42(9):164.
    PMID: 30043085 DOI: 10.1007/s10916-018-1006-6
    Promoting patient care is a priority for all healthcare providers with the overall purpose of realising a high degree of patient satisfaction. A medical centre server is a remote computer that enables hospitals and physicians to analyse data in real time and offer appropriate services to patients. The server can also manage, organise and support professionals in telemedicine. Therefore, a remote medical centre server plays a crucial role in sustainably delivering quality healthcare services in telemedicine. This article presents a comprehensive review of the provision of healthcare services in telemedicine applications, especially in the medical centre server. Moreover, it highlights the open issues and challenges related to providing healthcare services in the medical centre server within telemedicine. Methodological aspects to control and manage the process of healthcare service provision and three distinct and successive phases are presented. The first phase presents the identification process to propose a decision matrix (DM) on the basis of a crossover of 'multi-healthcare services' and 'hospital list' within intelligent data and service management centre (Tier 4). The second phase discusses the development of a DM for hospital selection on the basis of integrated VIKOR-Analytic Hierarchy Process (AHP) methods. Finally, the last phase examines the validation process for the proposed framework.
    Matched MeSH terms: Triage
  15. Ambigapathy S, Rajahram GS, Shamsudin UK, Khoo EM, Cheah WK, Peariasamy KM, et al.
    Malays Fam Physician, 2020;15(1):2-5.
    PMID: 32284798
    The COVID-19 outbreak continues to evolve with the number of cases increasing in Malaysia, placing a significant burden on general practitioners (GPs) to assess and manage suspected cases. GPs must be well equipped with knowledge to set up their clinics, use Personal Protective Equipment (PPE) appropriately, adopt standard protocols on triaging and referrals, as well as educate patients about PPE. The correct use of PPE will help GPs balance between personal safety and appropriate levels of public concern.
    Matched MeSH terms: Triage
  16. Chien YC, Ko YC, Chiang WC, Sun JT, Shin SD, Tanaka H, et al.
    Am J Emerg Med, 2024 Mar;77:147-153.
    PMID: 38150984 DOI: 10.1016/j.ajem.2023.12.011
    BACKGROUND: Major trauma is a leading cause of unexpected death globally, with increasing age-adjusted death rates for unintentional injuries. Field triage schemes (FTSs) assist emergency medical technicians in identifying appropriate medical care facilities for patients. While full FTSs may improve sensitivity, step-by-step field triage is time-consuming. A simplified FTS (sFTS) that uses only physiological and anatomical criteria may offer a more rapid decision-making process. However, evidence for this approach is limited, and its performance in identifying all age groups requiring trauma center resources in Asia remains unclear.

    METHODS: We conducted a multinational retrospective cohort study involving adult trauma patients admitted to emergency departments in the included countries from 2016 to 2020. Prehospital and hospital data were reviewed from the Pan-Asia Trauma Outcomes Study database. Patients aged ≥18 years transported by emergency medical services were included. Patients lacking data regarding age, sex, physiological criteria, or injury severity scores were excluded. We examined the performance of sFTS in all age groups and fine-tuned physiological criteria to improve sFTS performance in identifying high-risk trauma patients in different age groups.

    RESULTS: The sensitivity and specificity of the physiological and anatomical criteria for identifying major trauma (injury severity score ≥ 16) were 80.6% and 58.8%, respectively. The modified sFTS showed increased sensitivity and decreased specificity, with more pronounced changes in the young age group. Adding the shock index further increased sensitivity in both age groups.

    CONCLUSIONS: sFTS using only physiological and anatomical criteria is suboptimal for Asian adult patients with trauma of all age groups. Adjusting the physiological criteria and adding a shock index as a triage tool can improve the sensitivity of severely injured patients, particularly in young age groups. A swift field triage process can maintain acceptable sensitivity and specificity in severely injured patients.

    Matched MeSH terms: Triage
  17. Lim BJV, Wahab SFA, Kueh YC
    Malays J Med Sci, 2020 Mar;27(2):90-100.
    PMID: 32788845 DOI: 10.21315/mjms2020.27.2.10
    Background: The study aimed to examine the reliability and validity of the existing three-tier triaging system and a new five-level emergency triaging system, emergency severity index (ESI), in the Emergency Department (ED) of Hospital Universiti Sains Malaysia (HUSM).

    Methods: This study was conducted in HUSM's ED over two study periods. In the first three months, 300 patients were triaged under the three-tier triaging system, and, in the subsequent three months, 280 patients were triaged under the ESI. The patients were triaged by junior paramedics and the triage records were retained and later re-triaged by senior paramedics. The inter-rater reliability was evaluated using Cohen's Kappa statistics. The acuity ratings of the junior paramedics were compared with those of the expert panel to determine the sensitivity and specificity of each acuity level for both the ESI and the three-tier triaging system. The over-triage rate, under-triage rate, amount of resources used, admission rate and discharge rate were also determined.

    Results: The inter-rater agreement for the three-tier triaging system was 0.81 while that of the ESI was 0.75. The ESI had a higher average sensitivity of 74.3% and a specificity of 94.4% while the three-tier system's average sensitivity was 68.5% and its specificity 87.0%. The average under-triage and over-triage rates for the ESI were 10.7% and 6.2%, respectively, which were lower than the three-tier system's average under-triage rate of 13.1% and over-triage rate of 17.1%. The urgency levels of both the ESI and the three-tier system were associated with increased admission rates and resources used in the ED.

    Conclusion: The ESI's inter-rater reliability was comparable to the three-tier triaging system and it demonstrated better validity than the existing three-tier system.

    Matched MeSH terms: Triage
  18. Maheswaran M, Adnan WA, Ahmad R, Ab Rahman NH, Naing NN, Abdullah J
    PMID: 18613557
    Non-traumatic Altered States of Consciousness (ASC) are a non-specific consequence of various etiologies, and are normally monitored by Glasgow Coma Scale (GCS). The GCS gives varriable results among untrained emergency medicine personel in developing countries where English is not the first language. An In House Scoring System (IHSS) scale was made by the first author for the purpose of triaging so as to quickly asses patients when seen by medical personel. This IHSS scale was compared to the GCS to determine it's specificity and sensitivity in the accident and emergency department (ED) of Hospital University Sains Malaysia (HUSM). All patients with non-traumatic ASC were selected by purposive sampling according to pre-determined criteria. Patients were evaluated by the two systems, IHSS and GCS, by emergency physicians who were on call. Patient demographics, clinical features, investigations, treatment given and outcomes were collected and followed for a period of 14 days. A total of 221 patients with non-traumatic ASC were studied, 54.3% were males. The mean age of the patients was 56 years old. The mean overall GCS score on presentation to the ED was 10.3. The mean duration of ASC was 11.6 hours. One hundred thirty patients (58.8%) experienced ASC secondary to general or focal cerebral disorders. The mortality rate was 40.3% 2 weeks after the ED visit. Fifty-four point three percent of the patients were awake and considered to have good outcomes while 45.7% of the patients had poor outcomes (comatose or dead) 2 weeks after the ED visit. The mean overall GCS score, verbal and motor subscores as well as the IHSS had significantly decreased (worsened) after treatment in the ED. A poor IHSS scale, hypertension, current smoking, abnormal pupillary reflexes and acidosis were associated with a worse 2-week outcome. The mean age and WBC count was lower and the mean overall GCS score and eye, verbal and motor subscores were higher as well as those having a lower IHSS scale for the good outcome category. Multivariate analysis revealed that smokers and hypertensives were at higher risk for a poor outcome. Higher eye scores on the GCS were associated fewer poor outcomes. There was significant agreement between the IHSS scale and GCS scores in the assessment of non-traumatic ASC. The sensitivity and specificity of the IHSS score versus GCS were 71.9% and 100.0%, respectively.
    Matched MeSH terms: Triage/methods*
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links