35 research outputs found
Multicentre cross-sectional observational registry to monitor the safety of early discharge after rule-out of acute myocardial infarction by copeptin and troponin: the Pro-Core registry
Objectives: There is sparse information on the safety of early primary discharge from the emergency department (ED) after rule-out of myocardial infarction in suspected acute coronary syndrome (ACS). This prospective registry aimed to confirm randomised study results in patients at low-to-intermediate risk, with a broader spectrum of symptoms, across different institutional standards and with a range of local troponin assays including high-sensitivity cTn (hs-cTn), cardiac troponin (cTn) and point-of-care troponin (POC Tn). Design Prospective, multicentre European registry. Setting 18 emergency departments in nine European countries (Germany, Austria, Switzerland, France, Spain, UK, Turkey, Lithuania and Hungary) Participants: The final study cohort consisted of 2294 patients (57.2% males, median age 57 years) with suspected ACS. Interventions: Using the new dual markers strategy, 1477 patients were eligible for direct discharge, which was realised in 974 (42.5%) of patients. Main outcome measures: The primary endpoint was allcause mortality at 30 days. Results: Compared with conventional workup after dual marker measurement, the median length of ED stay was 60 min shorter (228 min, 95% CI: 219 to 239 min vs 288 min, 95% CI: 279 to 300 min) in the primary dual marker strategy (DMS) discharge group. All-cause mortality was 0.1% (95% CI: 0% to 0.6%) in the primary DMS discharge group versus 1.1% (95% CI: 0.6% to 1.8%) in the conventional workup group after dual marker measurement. Conventional workup instead of discharge despite negative DMS biomarkers was observed in 503 patients (21.9%) and associated with higher prevalence of ACS (17.1% vs 0.9%, p<0.001), cardiac diagnoses (55.2% vs 23.5%, p<0.001) and risk factors (p<0.01), but with a similar all-cause mortality of 0.2% (95% CI: 0% to 1.1%) versus primary DMS discharge (p=0.64). Conclusions Copeptin on top of cardiac troponin supports safe discharge in patients with chest pain or other symptoms suggestive of ACS under routine conditions with the use of a broad spectrum of local standard POC, conventional and high-sensitivity troponin assays. Trial registration number NCT02490969
Prise en charge d'une suspicion de pneumopathie communautaire ou d'une exacerbation de BPCO dans le service des urgences du CHU de Dijon
Résumé françaisDIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF
Pertinence des hospitalisations via le Service RĂ©gional d'Accueil des Urgences du Centre Hospitalier Universitaire de Dijon chez les patients de 75 ans et moins
Résumé françaisDIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF
Vague de chaleur d'août 2003 (revue des admissions au service d'accueil d'urgence du CHU de Dijon an août 2003)
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Etats septiques graves (Ă©tude de 99 cas au service d'accueil des urgences de Dijon)
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocSudocFranceF
Comment améliorer la prise en charge des entorses de cheville au service régional d'accueil des urgences de Dijon? (étude rétrospective sur 242 cas)
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Plaintes, réclamations et remerciements adressés au service d'accueil des urgences du centre hospitalier universitaire de Dijon pendant l'année deux mille quatre
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Prise en charge des douleurs thoraciques au service d'accueil des urgences de Dijon (étude rétrospective sur deux mois)
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Evaluation sur 3 années de l'activité du service d'accueil des urgences du CHU de Dijon (incidence de la création d'une structure des urgences à la clinique de Chenôve)
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Les intoxications au paracétamol (étude rétrospective menée sur un an dans le service des Urgences Adultes du CHU de Dijon)
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocSudocFranceF