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Malnutrition:laboratory markers vs nutritional assessment

Gastroenterology Report 2016年第4期4卷 272-280,I0001页

作者： Shishira Bharadwaj shaiva ginoya Parul Tandon Tushar D.Gohel John Guirguis Hiren Vallabh Andrea Jevenn Ibrahim Hanouneh Department of Gastroenterology/Hepatology McMaster UniversityHamiltonOntarioCanada Department of Gastroenterology/Hepatology Cleveland ClinicClevelandOHUSA

Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcarerelated ***,a major dilemma exists due to lack of a unified definition for the ***,there are no standard methods for screening and diagnosing patients with malnutrition,leading to confusion and varying practices among physicians across the *** role of inflammation as a risk factor for malnutrition has also been recently ***,serum proteins such as albumin and prealbumin(PAB)have been widely used by physicians to determine patient nutritional ***,recent focus has been on an appropriate nutrition-focused physical examination(NFPE)for diagnosing *** current consensus is that laboratory markers are not reliable by themselves but could be used as a complement to a thorough physical *** studies are needed to identify serum biomarkers in order to diagnose malnutrition unaffected by inflammatory states and have the advantage of being noninvasive and relatively ***,a thorough NFPE has an unprecedented role in diagnosing malnutrition.

关键词： malnutrition physical examination serum markers

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Performance of HEART and TIMI scores in predicting major adverse cardiovascular events(MACEs)of chest pain patients in the emergency department:A prospective observational study

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Journal of Acute Disease 2021年第5期10卷 190-194页

作者： Sonal Kaushal ginoya Samira N.Parikh Department of Emergency Medicine GCS Medical CollegeHospital and Research CentreAhmedabadIndia

Objective:To compare the value of HEART and TIMI scores in predicting major adverse cardiovascular events(MACEs)of patients with chest pain in the emergency department at a tertiary care hospital in Ahmedabad,a city in western ***:A prospective study was conducted on chest pain patients from January to December *** adult patients with non-traumatic chest pain presenting to the emergency department were included,and their HEART and TIMI scores were *** patients were followed up within 4 weeks for monitoring any major adverse cardiac events or *** receiver-operating characteristics(ROC)curve was used to determine the value of HEART and TIMI scores in predicting ***,the specificity,sensitivity,positive predictive value(PPV),and negative predictive value(NPV)of the two scores were assessed and ***:A total of 350 patients were evaluated[mean age(55.03±16.6)years,56.6%of males].HEART score had the highest predictive value of MACEs with an area under the curve(AUC)of 0.98,followed by the TIMI score with an AUC of *** score had the highest specificity of 98.0%(95%CI:96.4%-99.6%),the sensitivity of 75.0%(95%CI:70.7%-79.3%),and PPV of 97.0%(95%CI:94.1%-99.9%)and NPV of 82.5%(95%CI:74.6%-90.4%)for low-risk *** score had a specificity of 95.0%(95%CI:92.4%-97.6%),sensitivity of 75.0%(95%CI:69.4%-80.6%),PPV of 92.3%(95%CI:88.1%-96.5%)and NPV of 82.3%(95%CI:73.8%-90.8%)for low-risk ***:HEART score is an easier and more practical triage instrument to identify chest pain patients with low-risk for MACEs compared to TIMI *** with high HEART scores have a higher risk of MACEs and require early therapeutic intervention and aggressive management.

关键词： Chest pain Emergency Major adverse cardiovascular events MACEs HEART TIMI

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