Comparative study of scoring systems in ICU and emergency department in predicting mortality of critically ill

Background: Scoring systems can be used to define critically ill patients, estimate their prognosis, help in clinical decision making, and guide the allocation of resources and to estimate the quality of care.  It remains unclear whether the additional data needed to compute ICU scores improves mortality prediction for critically ill patients compared to the simpler ED scores.Methods: We have done a prospective observational study of consecutively admitted 400 critically ill patients to ICU directly from Emergency Department in Dr PSIMS and RF over a period of 2 years. Clinical and laboratory data conforming to the modified early warning score (MEWS), rapid emergency medicine score (REMS), acute physiology and chronic health evaluation (APACHE II), and simplified acute physiology score (SAPS II) were recorded for all patients. A comparison was made between ED scoring systems MEWS, REMS and ICU scoring systems APACHE II, SAPSII. The outcome was recorded in two categories: survived and non-survived with a primary end point of 30-day mortality. Discrimination was evaluated using receiver operating characteristic (ROC) curves.Results: The ICU scores outperformed the ED scores with more area under curve values. The predicted mortality percentage of ICU based scoring systems is high compared to emergency scores (predicted mortality % of SAPS II-63%, APACHE II-33.3%, MEWS-18.5%, REMS-14.8%).Conclusions: ICU scores showed more predictive accuracy than ED scores in prognosticating the outcomes in critically ill patients. This difference is seemed more due to complexity of ICU scores

Role of WO3 on DC conductivity and some optical properties of TeO2 based glasses

DC electrical conductivity and optical absorption studies have been employed to understand the influence of WO3 content on the electrical and optical properties of the TeO2-GeO2-WO3 glass system. Field emission scanning electron microscope (FESEM), Energy dispersive X-ray spectrometry (EDS) measurements have been used to confirm the glassy nature and the elemental analysis of the glass composition, respectively. DC electrical conductivity of the glasses was studied in the temperature range 423-613 K. From Arrhenius plot, the activation energies (E-act) of all the glasses have been calculated and conduction mechanism has been discussed in terms of structural changes occurred with the addition of WO3 content. The optical properties such as optical band gap (E-opt), Urbach energy (Delta E), molar refraction (R-M), metallization criterion (M), electronic polarizability of the oxide ion (alpha(o2-)) and refractive index (n) have been determined from optical absorption data and were found to be composition dependent. (c) 2012 Elsevier Ltd. All rights reserved