Comparison of Early Warning Scores in Determining the Prognosis of COVID-19 Patients.

OBJECTIVE:  To compare the effectiveness of early warning score systems in predicting 30-day poor outcomes in Coronavirus Disease (COVID-19) patients admitted to the emergency department. STUDY DESIGN: Descriptive study. Place and and Duration of the Study: Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkiye, from March 2020 to March 2021. METHODOLOGY: The patients who presented to the emergency department, diagnosed with COVID-19 and tested positive for polymerase chain reaction were analysed. The study included the calculation of the rapid emergency medicine score, risk stratification in the emergency department in acutely ill older patients score, 4C mortality score, and modified early warning score for the patients. These scores were then compared in terms of their ability to predict adverse outcomes, defined as intensive care admission and/or mortality. RESULTS: During the study period, 10,281 COVID-19 patients were admitted to the emergency department. Out of them, 1,826 patients were included in the study. There were 159 (8.7%) cases with poor outcomes. The risk stratification in the emergency department in acutely ill older patients Score was the most successful in poor prognosis. CONCLUSION: Based on the findings of this study, the risk stratification in the emergency department in acutely ill older patients score demonstrated greater efficacy compared to other early warning scores in identifying patients diagnosed with COVID-19 who had an early indication of a poor prognosis. KEY WORDS: Early warning score, 4C mortality score, REMS, Rise-up score, MEWS, Emergency department, COVID-19.

Ischemia-modified albumin in the diagnosis of pulmonary embolism: an experimental study.

STUDY OBJECTIVE: We designed this experimental study to determine the value of ischemia-modified albumin in the diagnosis of pulmonary embolism. METHODS: Twenty-four mature female New Zealand rabbits were divided into 4 groups, each consisting of 6 animals. These were classified into group 1 ,the control group; group 2, the deep venous thrombosis group; group 3, the deep venous thrombosis with pulmonary embolism group; and group 4, the pulmonary embolism-alone group. Deep venous thrombosis was produced by ligation of the iliac vein. To establish pulmonary embolism, 2 clots were administered from the iliac vein. Blood samples were taken from all the groups at hours 0, 1, 3, and 6 for ischemia-modified albumin measurement. RESULTS: Pulmonary embolism was established in all the rabbits in groups 3 and 4, and this was confirmed by tomographic and histologic findings. Measurement of mean ischemia-modified albumin levels for all rabbits at hours 0, 1, 3, and 6 revealed that mean ischemia-modified albumin levels in groups 3 and 4 were statistically significantly higher than those in groups 1 and 2. There was no difference between the mean ischemia-modified albumin levels in groups 1 and 2 nor between groups 3 and 4. The alteration in ischemia-modified albumin levels over time was statistically significant. CONCLUSIONS: The results of our experimental study demonstrate that ischemia-modified albumin levels may be useful in the diagnosis of pulmonary embolism.