Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19

ABSTRACT Background: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. Objectives: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). Methods: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. Results: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom were discharged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176-3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A total of 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). Conclusion: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.

Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19.

BACKGROUND: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. OBJECTIVES: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). METHODS: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. RESULTS: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom weredischarged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176 3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A totalof 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). CONCLUSION: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.

Analysis of the citation of articles published in the European Journal of Emergency Medicine since its foundation.

OBJECTIVES: The aim of this study was to evaluate the evolution of the citation of articles from the European Journal of Emergency Medicine (EJEM) from 1994 (EJEM foundation) to 2015 and identify highly cited articles and their principal characteristics and determine a possible correlation between the citations counted in different databases. MATERIALS AND METHODS: We obtained the articles published in EJEM from 1994 to 2015 in ISI-WoS (main source) and Scopus, Google Scholar, and Medline databases (accessory sources). The citations were quantified and their annual evolution and the bibliometric indices derived (impact factor and SCImago Journal Rank) were evaluated. We identified and analyzed the highly cited EJEM articles and evaluated the possible correlation between the citations counted for these articles in the databases. RESULTS: Overall, 1705 EJEM articles were cited 9422 times in 8122 different articles. The evolution of the global citation, impact factor, and SCImago Journal Rank from 1994 to 2015 increased significantly. The h-index of EJEM was 30, and 31 articles were considered highly cited (≥30 citations), 16.1% of them being clinical trials. By subjects, 22.5% corresponded to cardiology, 19.3% to emergency department management, and 12.9% to pediatrics; by countries, 81% were from Europe, with Belgian authors publishing four (12.9%) highly cited articles, and French, Spanish, British, and Swedish authors having three (9.7%) each. Two studies in the EJEM achieved the definition of 'citation classics' (more than 100 citations). The number of citations in all the databases, except Medline, showed statistically significant correlations. CONCLUSION: Citation of EJEM articles has progressively increased and EJEM bibliometric indicators have improved; most highly cited articles are mainly by European authors.

[Analysis of Spanish research collaboration in emergency medicine: 2010-2014]. / Análisis de redes de colaboración españolas en la investigación en Medicina de Urgencias y Emergencias (2010-2014).

OBJECTIVES: To describe the structure of the Spanish emergency medicine research network or networks, researchers' roles, and patterns of collaboration between hospitals. MATERIAL AND METHODS: The search for publications was carried out in the SCOPUS database for the 5-year period of 2010 to 2014. We used network analysis software to map ties between researchers and hospitals that had established at least 5 and 10 relationships, respectively, during the period under study. We calculated indicators of degree of centrality for individual scientists and hospitals and tabulated data for the main authors and centers. RESULTS: We identified 2626 articles with 12 372 different authors at 1134 hospitals in 75 countries. The largest number of international relations were with France, the United States, and the United Kingdom. Authors had established 93 687 connections that allowed us to identify 23 collaborating groups, the largest of which was comprised of 30 individuals. We also found 12 855 connections between hospitals that identified a single subnetwork of collaboration comprised of 19 hospitals, 1 of which was in Switzerland. Measures of centrality, intermediation, and proximity led to classification of the most important members of author and hospital networks. CONCLUSION: This analysis of research networks in emergency medicine has afforded the first details describing the relationships maintained by Spanish scientists and hospitals.

OBJETIVO: Estudio descriptivo que investiga cómo se estructura la red o redes de investigación en Medicina de Urgencias y Emergencias (MUE) en España, establece el rol de cada investigador, así como describe la red de colaboración entre los hospitales españoles dentro de esta especialidad médica. METODO: Se realizó una búsqueda en la base de datos SCOPUS® para el quinquenio 2010-2014. Mediante programas específicos de análisis de redes se dibujaron las redes de investigadores y de hospitales, bajo la condición de haber establecido al menos 5 y 10 relaciones, respectivamente, durante el periodo. Para investigadores y hospitales se calcularon los indicadores de centralidad de grado, cercanía e intermediación, y se tabularon los principales autores y centros. RESULTADOS: Se identificaron 2.626 artículos de 12.372 autores diferentes y 1.134 hospitales distintos de 75 países. El mayor número de relaciones internacionales se establecieron con Francia, Estados Unidos y Reino Unido. Los autores establecieron 93.687 conexiones que permitieron identificar 23 grupos de colaboración, el mayor formado por 30 integrantes. Además, se establecieron 12.855 conexiones entre hospitales, que permitieron identificar una única subred de colaboración formada por 19 hospitales, 1 de ellos suizo. Mediante los indicadores de centralidad, intermediación y cercanía se pudo establecer una clasificación de aquellos elementos más relevantes dentro de las redes de autores y hospitales. CONCLUSIONES: El análisis de redes de la investigación en MUE ha permitido conocer por vez primera al detalle las relaciones que se establecen entre investigadores y hospitales españoles.

Puntos clave para introducir la enseñanza de la reanimación cardiopulmonar básica en las escuelas / Key factors for teaching basic cardiopulmonary resuscitation in schools

La muerte súbita es la situación de máxima urgencia médica. Muchas de estas muertes se producen en la vía pública en presencia de otras personas. Se ha comprobado repetidamente que, en esta situación, el porcentaje de fallecimientos supera el 90% y que entre los supervivientes más de la mitad presentará algún tipo de secuela neurológica. Todo ello indica que, teóricamente, se podrían recuperar muchos de estos enfermos si se inicia en maniobras de reanimación cardiopulmonar (RCP) básica por parte del primer interviniente. Sin embargo, esto sucede en menos del 25% de los paros cardiorrespiratorios (PCR) presenciados por testigos. Por ello, deben implementarse cuantas medidas conduzcan a un incremento del conocimiento de las maniobras de RCP básica a la población general. Numerosas instituciones y sociedades médicas internacionales han recomendado que la enseñanza de la RCP básica se introduzca durante la educación obligatoria, ya que la escuela constituye un ámbito ideal para iniciar a la población en el conocimiento y el aprendizaje de las técnicas básicas que forman parte de la RCP y todos los ciudadanos pasan por esta fase educativa. Reconociendo esta importancia, se ha enviado un proyecto de ley a la Cámara de Diputados para incorporar la enseñanza de técnicas de RCP al currículo escolar del nivel secundario en todas las instituciones de educación pública del país, sean de gestión estatal, privada, cooperativa o social. Existen numerosas experiencias en este sentido, que han obtenido resultados, implantación y pervivencia diversos. Este trabajo analiza la experiencia de los autores adquirida durante el desarrollo del PROCES, un programa dirigido a los estudiantes de 15 y 16 años que se lleva a cabo desde hace 10 años en la ciudad de Barcelona...