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To investigate the association between the New Early Warning Score (NEWS) and 28-day mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).
A cross-sectional derivation and validation study.
A total of 382 SFTS patients were included in retrospective and prospective studies. The primary outcome was short-term (28-day) mortality. Cox regression, receiver operating characteristic (ROC), and Kaplan–Meier analysis were utilised in the retrospective study to assess the association between NEWS and mortality. The prospective study assessed the applicability of the NEWS.
This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Among 219 SFTS patients in the retrospective study, 27 (12.3%) died within 28 days. NEWS was significantly higher in non-survivors than in survivors (4.00 [1.00, 5.00] vs. 1.00 [1.00, 2.00]). The ROC curve for MEWS predicting 28-day mortality showed an area under the curve (AUC) of 0.757 (95% confidence interval: 0.65–0.87), with a cut-off of 3.5 (sensitivity: 90.6%; specificity: 55.6%). SFTS patients were stratified into low (NEWS < 4), medium (NEWS 4–6), and high (NEWS > 6) risk groups. Kaplan–Meier analysis showed significantly lower survival rates in medium and high risk groups compared to the low risk group. The prospective study included 63 SFTS patients, of whom 11 (17.5%) died. 28-day mortality significantly increased across NEWS categories: [low risk (4/50, 8.0%), medium risk (4/8, 50.0%), high risk (3/5, 60.0%)].
NEWS was a quicker, simpler, and valuable parameter to identify SFTS patients at risk of 28-day mortality.
An elevated NEWS at admission is associated with a higher risk of poor short-term prognosis in SFTS patients. Incorporating NEWS into emergency nursing practice may aid in the early identification of SFTS patients at risk of adverse prognosis.
Emergency nurses performed the NEWS for the SFTS patients at admission.
by Ji Sun, Xuanyu Deng, Juanjuan Huang, Gefei He, Shiqiong Huang
Nirmatrelvir/Ritonavir, acting as an effective agent against COVID-19, has achieved considerable results in clinical studies in terms of drug efficacy. However, there is little research about its medication safety. Based on the FDA adverse event reporting system (FAERS) database, this study aims to mine the adverse reaction signals of the latest major recommended drug Nirmatrelvir/Ritonavir for the antiviral treatment of COVID-19, so as to provide a basis for safe and rational drug use. The reporting odds ratio (ROR) was used to explore the adverse event report data of all COVID-19 emergency use authorization (EUA) products in the FAERS database with the deadline of third quarter of 2023. In the analysis, 135427 adverse drug event (ADE) reports were found, and 35250 ADEs were reported with Nirmatrelvir/Ritonavir as the primary suspected drug, which was involved in multiple system. There was a high signal intensity of dysgeusia (ROR = 72.98), diarrhea (ROR = 3.03) and headache (ROR = 1.25), which was compatible with the adverse reactions recorded in the manual for Nirmatrelvir/Ritonavir. In addition, it was suggested that Nirmatrelvir/Ritonavir might cause pale-colored stools (ROR = 45.53), chromaturia (ROR = 3.07), yellow skin (ROR = 3.62), tongue coating (ROR = 35.55) and other new adverse reactions (not included in the instructions manual for Nirmatrelvir/Ritonavir). The ADEs of Nirmatrelvir/Ritonavir that are not in the instructions and are highly relevant in the real world are supplemented, prompting clinical attention to the ADEs of the drug, and providing a theoretical basis for the safe and effective application of the drug.
FreshRSS 