The Role of Venous Blood Gas Analysis in Critical Care: A Narrative Review.

ABG analysis is the gold standard for assessing acid-base balance, oxygenation, and ventilation in critically ill patients, but it is invasive and associated with patient discomfort and potential complications. Venous blood gas (VBG) analysis offers a less invasive alternative, although its clinical utility remains debated. This review evaluates the current evidence on VBG analysis, exploring its correlation with ABG, clinical applications, and limitations.

Explorative Values of Ubiquitin Carboxy-Terminal Hydrolase L1 in Spontaneous Subarachnoid Hemorrhage: Prediction of Clinical Outcomes and Delayed Cerebral Ischemia.

Background And Objectives: Spontaneous subarachnoid hemorrhage (sSAH) is a critical neurological condition with high mortality and significant long-term sequelae. Delayed cerebral ischemia (DCI) is a significant contributor to poor clinical outcomes. Despite advances in management, early predictors of clinical outcomes and DCI remain unclear.

Psychotropic Drugs for Older Adults With Psychiatric Disorders Presenting to the Emergency Department: Prescription Patterns and Treatment Outcomes.

Objective: A high proportion of patients presenting to Emergency Departments (EDs) consists of vulnerable elderly people. Mental illnesses are frequently related to advancing age, with difficult to detect symptoms. The aim of this study was to investigate psychiatric drug use by geriatric patients in an ED for whom a psychiatric consultation was needed, according to their psychopathology and severity of outcome.

Periprosthetic femur fractures of the hip in elderly patients: early surgery reduces operative time, hospitalization, and mortality.

Introduction: Periprosthetic femur fractures around the hip represent a significant clinical challenge, particularly in patients aged 65 and older, as delayed treatment can lead to increased morbidity and mortality. Early surgical intervention is generally recommended to minimize complications and optimize functional recovery. This study aims to assess the impact of surgical timing on operative duration, hospitalization length, complication rates, and long-term survival in elderly patients with periprosthetic femur fractures.

Frailty is a prognostic marker of mortality and sepsis in patients ≥ 70 years with acute left-sided colonic diverticulitis.

Background: Acute left-sided colonic diverticulitis (ALCD) has a more complicated course in older patients. Rather than age, frailty may be crucial in ALCD prognosis in this heterogeneous population. This study aims to define the influence of the Clinical Frailty Scale (CFS) on mortality and clinical outcomes in patients aged 70 or older with ALCD.

A novel stroke mimic prediction score during in-hospital triage for suspected stroke patients: The Stroke Mimics Score (SMS).

Introduction: Early differential diagnosis between stroke mimics and cerebrovascular events is a major challenge in the Emergency Department (ED). The primary aim of this study was to identify diagnostic predictors of stroke mimics based on parameters acquired during the ED triage of patients with suspected stroke. Secondly, we aimed to develop a diagnostic score for early differential diagnosis.

FPG Score: A Rapid Admission-Based Tool for Predicting In-Hospital Mortality in Elderly Hip Fracture Patients.

Objective: Hip fractures in elderly patients are a major public health concern, associated with high morbidity and mortality. Early identification of high-risk patients is crucial to guide clinical decision-making, optimize resource allocation, and improve outcomes. However, existing risk prediction models, such as the Nottingham Hip Fracture Score (NHFS) and the Charlson Comorbidity Index (CCI), require laboratory or postoperative data, delaying risk stratification.

Frailty as a determinant of mortality, surgical timing and hospital stay in proximal femur fractures: a retrospective cohort study.

Background: Proximal femur fractures are common in elderly patients and are strongly associated with frailty, increased mortality, and functional decline. The Clinical Frailty Scale (CFS) has emerged as a key predictor of outcomes, influencing perioperative management and rehabilitation strategies. This study aims to evaluate the impact of frailty on mortality, surgical timing, and length of hospital stay (LOS) in patients with hip fractures.

Surgical timing and clinical factor predicting in-hospital mortality in older adults with hip fractures: a neuronal network analysis.

Introduction: Hip fractures in older adults are associated with a significant mortality rate, which has been reported to be around 35% within a year. Today, the incidence of these fractures is on the rise, and this trend is expected to increase even more owing to the aging of the population. Treatment timing and perioperative management of these patients are typically challenging owing to the presence of multiple comorbidities that are important risk factors for mortality after surgery.

Impact of Living Arrangements on Delirium in Older ED Patients.

: The purpose of this study is to assess how the socio-family demographic status of patients is related to the onset of delirium in a large cohort of older adults aged ≥65 years evaluated in the emergency department (ED) using a comprehensive geriatric assessment (CGA). : This is a cross-sectional, observational, retrospective study conducted in the ED of a teaching hospital. We enrolled 2770 geriatric patients admitted to the ED from January 2019 to December 2023 and evaluated them using CGA.

Evaluation of Presepsin for Early Diagnosis of Sepsis in the Emergency Department.

: to date, there are no specific markers available for diagnosing sepsis. Diagnosis is, indeed, mainly determined by clinical suspicion and the evaluation of the patient's overall condition. This evaluation involves assessing various inflammatory markers, such as C-reactive protein (CRP) and procalcitonin (PCT), along with markers of tissue hypoxia, such as serum lactate.

The Impact of Microbiota on Musculoskeletal Injuries.

Musculoskeletal injuries comprise a wide range of physical conditions impacting the coordination of bones, muscles, and joints. Estimations suggest that close to one-third of the world's population will experience a musculoskeletal or non-musculoskeletal injury at some point in their life. Musculoskeletal injuries affect athletes, office workers, industrial workers, older adults, and children every year.

The Prognostic Role of Serum Procalcitonin for Adult Patients with Acute Diarrhea in the Emergency Department.

Acute diarrhea is one of the leading causes of Emergency Department (ED) access. The search for the causative pathogen cannot be routinely performed since conventional methods, like stool cultures, are time-consuming, requiring days for growth and delaying diagnosis and the start of therapy. In this large sample retrospective study, we evaluated the prognostic role of serum procalcitonin (PCT) for adult patients with acute diarrhea in the ED.

Mental Illness Strikes at the Heart: Impact of Psychiatric Diseases on Ventricular Ejection Fraction in Patients with Acute Coronary Syndromes.

Mental illnesses can have a significant impact on individuals experiencing acute coronary syndromes (ACS). Mental illnesses are associated with an increased cardiovascular risk profile and early onset of cardiovascular disease. A critical aspect of this interplay is the effect of psychiatric conditions on left ventricular ejection fraction (LVEF), a key parameter in evaluating cardiac function and predicting long-term outcomes in ACS patients.

Prognostic Value of Procalcitonin in Febrile People Living with Human Immunodeficiency Virus (PLWH) Admitted to the Emergency Department.

: The management of HIV patients presenting with fever in the Emergency Department (ED) remains a challenging clinical scenario. Accurate risk stratification and prognostic indicators are crucial for timely intervention and improved patient outcomes. Procalcitonin (PCT) has emerged as a promising biomarker for assessing the severity and prognosis of various infectious diseases.

Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives.

About 5% of annual access to emergency departments (EDs) and up to 25-30% of hospital admissions involve patients with symptoms suggestive of acute coronary syndrome (ACS). The process of evaluating and treating these patients is highly challenging for clinicians because failing to correctly identify an ACS can result in fatal or life-threatening consequences. However, about 50-60% of these patients who are admitted to the hospital because of chest pain are found to have no ACS.

Vascular complications in hospitalized patients with inflammatory bowel disease and acute gastroenteritis and colitis: A propensity score-matched study.

Objectives: Atherosclerotic cardiovascular disease (ASCVD) and venous thromboembolism (VTE) are severe complications of inflammatory bowel disease (IBD). Risk factors for ASCVD and VTE in IBD are not entirely elucidated. This study investigated the incidence and risk factors for ASCVD and VTE in IBD compared to acute infective gastroenteritis and colitis (AGC).

Foot and Ankle Trauma: Epidemiology Before, During, and Post COVID-19 Pandemic in a Level I Trauma Center: A 5-Year Experience and Data Analysis.

: Foot and ankle injuries are one of the leading orthopedic causes of emergency department (ED) admissions. The purpose of this study was to analyze, through 5 years of data collection, differences in number and type of admissions, as well as the severity of foot and ankle trauma to the ED in the pre-pandemic period, during the COVID-19 emergency, and in the post-pandemic period. This study aims to assess epidemiological and clinical data.

Outcome of Neonatal Hydronephrosis, a New Cut-Off to Identify Patients with Spontaneous Resolution.

Background/objectives: The anteroposterior renal pelvis diameter (APRPD) is used to assess the grade of urinary tract dilatation (UTD). There is no univocal method stratifying the risk of complications related to postnatal UTD. This study aims to identify APRPD cut-offs at birth to determine outcome stratification and second-level exams.

Clinical Significance of Perinephric Fluid Collection in Patients with Renal Colic and Urolithiasis: A Retrospective Analysis.

: Perinephric fluid is commonly identified in patients with renal colic and urolithiasis, especially in cases associated with hydronephrosis. However, its clinical relevance, particularly its impact on treatment decisions and prognosis, is not well established. : This retrospective, single-center study included adult patients who presented to the emergency department (ED) with suspected renal colic between January 2021 and October 2023.

The Gut Microbiome in Sepsis: From Dysbiosis to Personalized Therapy.

Sepsis is a complex clinical syndrome characterized by an uncontrolled inflammatory response to an infection that may result in septic shock and death. Recent research has revealed a crucial link between sepsis and alterations in the gut microbiota, showing that the microbiome could serve an essential function in its pathogenesis and prognosis. In sepsis, the gut microbiota undergoes significant dysbiosis, transitioning from a beneficial commensal flora to a predominance of pathobionts.

Unraveling Pneumomediastinum in COVID-19 Patients: Insights from a High-Volume-Center Case-Control Study.

Background: Pneumomediastinum (PNM) is a severe complication in COVID-19 patients, potentially exacerbating morbidity and requiring heightened clinical attention. This study aims to identify risk factors, clinical characteristics, and outcomes associated with PNM in COVID-19 patients hospitalized for respiratory failure in our institution.

Methods: Among 4513 patients admitted in our institution and testing positive for COVID-19 infection during the peak of the COVID-19 pandemic in Italy (1 March 2020 to 31 July 2020), we conducted a single-center, retrospective case-control study focusing our analysis on those with severe disease (respiratory failure).