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The association of level of care and MTS was evaluated using Spearman's rank correlation coefficient. The ability of MTS to predict admission was assessed via receiver operating characteristic curves. A distinction was made here in the prediction of hospitalization in general and the predictability of admission to an ICU. The duration of survival was defined as survival from the time of triage until time of death.
Deceased patients in the lower MTS levels green and blue were considered separately. In Germany critical ill patients e. In a rendezvous system, specially equipped emergency ambulances or helicopters bring the doctor to the patient. Less ill patients are transported to the ED by paramedics and ambulances. Reliability is expressed in terms of inter-rater agreement.
In this study we focused on consistency of ratings between triage nurses and one expert. Inter-rater agreement for ordinal scales such as MTS is preferably measured via weighted kappa statistic and a rank correlation coefficient. Following consultation with the chairman of the local ethics committee K.
All collected clinical data evaluated in this study were fully anonymized before analysis. Therefore, according to prior agreement with the local ethics committee and the data protection officer appointed by the University Hospital, verbal or written informed consent was not obtained.
No statistical differences were found among patients in relation to gender in the studies group and among groups in terms of age. Patient disposition by MTS level is shown in Table 2. The receiver operating characteristic curves are depicted in Figure 1 and Figure 2. For hospitalization in general Figure 1 the area under the curve was 0. Length of stay increased from blue to orange, and was shortest for red. The box plots indicate the median black line , the interquartile range box , the smallest and largest values that are not considered outliers whiskers, not farther away than 1.
The red patients had the longest hospital stay altogether Figure 4. Thus, within the red category, In the other categories orange till blue, together 0.
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The day likelihood of survival among admitted patients with lower acuity levels MTS green and blue was Those classified according to MTS had a likelihood of survival more than days in the majority of yellow The area under the curve was 0. Deceased patients in the lowest urgency category showed the following distinctive characteristics: The situation for the group of green patients was similar, with 12 suffering from a liver coma and 18 from a malignant underlying disease.
The association between duration between the time of triage and time of death in category blue showed that the first patient died after 11 days.
The median of the blue group was Subgroup analysis of the day survival rate for those in a non-operative department Cardiology is depicted in Figure 7. For comparison, the day likelihood of survival in an operative subgroup is shown in Figure 8. The numbers of invasive diagnostics, intra-cardiac catheter and endoscopy used across MTS levels are indicated in Table 3.
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Categories orange and red had the highest numbers of intra-cardiac catheter and endoscopies. Patient allocation by MTS level is depicted in Figure 9. Category red and orange were mostly associated with being accompanied by an emergency physician, whereas categories blue and green were brought to the ED by an ambulance without any prehospital contact to a doctor or were walk-in patients.
Helicopter and NEF are specially equipped emergency vehicles accompanied by an emergency physician German Notarzt. Category red and orange were mostly associated with prehospital contact to a doctor. The inter-rater agreement between the MTS expert and the triage nurses is shown in Table 4. Since this study was conducted at a facility with comprehensive medical care, a high percentage of critically ill patients were treated. In particular, there were higher-than-average numbers of patients treated who had severe liver diseases.
Thus, there might have been a selection bias in low-priority MTS categories blue and green. Other potentially important factors such as age or socio-economic conditions are not part of the MTS calculation and may have an additional influence on indication for admission.
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The doctors in charge at the Emergency Department were responsible for selecting the level of care for patients ICU vs. Since the doctors were aware of patients' triage level during emergency care, it cannot be excluded that this may have influenced the choice of further care structures via the MTS-Category. Among the higher levels of urgency, this will have only had a minor influence, since the frequency of the type of injury e.
An immediate transferal to the ICU based only on the triage-level can be excluded, since all patients undergo their primary survey in the Emergency Department. In future, further, prospective blinded studies will be required to ensure the exclusion of this bias. These patients can no longer be filtered out retrospectively. Since the percentage of such patients was only around 0. The findings of our study are that the MTS classifications reasonable correlate with the different classes of admission.
Martins et al found an increased rate of hospital admissions with increased urgency in the MTS English version . The higher the MTS level the less often patients are discharged from the ED rather than transferred to another ward . Although the percentage of patients admitted per triage category of the MTS was slightly higher in our study than that reported by van der Wulp et al, our study showed the same effect.
The same high associations apply to ED length of stay, which increased across categories from blue to orange, yet was shortest for red. The authors are not aware of any comparative values from other studies using the original English version. It is logical that the red patients had the shortest duration of stay in the ED, due to their prompt transfer to emergency surgery, emergency intervention or to the ICU, as indicated.
In agreement with the guidelines, patients with suspected acute coronary syndrome are assigned to MTS-Level orange based on the indicator thoracic pain. The longest duration of stay in the emergency department in the category orange can be explained by the fact that coronary patients made up a high proportion of those classified into the orange group.
A second laboratory value has to be obtained to exclude heart attack in these patients, which automatically lengthened the duration of stay . The association by MTS category and hospital length of stay was also significant in general, with red showing the longest hospital stay. Mortality in our study showed increasing death rate with increasing level of MTS priority, as was shown in Martins et al . Compared to the other MTS levels significantly fewer patients in the lower urgency levels died: In the depiction of the day likelihood of survival for the entire sample of admitted patients, the red patients are clearly distinct from the other categories.
This observation has also been made elsewhere .
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Knorring Passau: Biographie und Vergangenheitsdeutung. Stefan Majewski Wien: Massendigitalisierung als Basis geistes- und kulturwissenschaftlicher Forschung. Historisch-biographische Informationsmittel, Erstellt und bearbeitet von Bernhard Ebneth Nationale und internationale biographische Lexika in elektronischen Medien. Institutions, Networks and Communities of National Historiography , ed. Viva i dizionari! Note per uan storia dei dizionari biografici nazionali in Europa, in: Storica, vol. Call for papers. It includes various information from other biographical dictionaries as well as different online resources such as works and portraits.
As such, it would qualify as a Pan-European project, but the focus is decidedly on German-language biographical resources and it is, therefore, listed here. Three words in the song title, translated into Swedish, have been traced from notebooks and diaries written during his adolescence years.
The initiated gesture illuminates the fragmentation of memory over time and touches a brief moment of queer history through the remains of a dismantled song, which adds an intimate and private coming-of-age narrative consisting of urgent longings and desires.
After a lecture by Karlsson Lundgren at an art institution in northern Sweden, someone in the audience initiated contact. The person, a collector, seemed to have a carefully selected collection of mainly American photo-based art with a queer approach — somewhat a surprising finding in this rural area. They initiated a dialogue and started a process of going through the art collection. The Teenage Runner unfolds a specific fragment of a collection and draws parallels between different narratives that combine hazy memories, erotic sensations, scientific texts and poetry with philosophy.
The combination of voices from the collector, the photographer, the artist, the performers and others, becomes a way of reconstructing and re-visiting the memory of a single event and examines how an artwork has been transposed into a collection.
Together they form the stage set for a performance — The Teenage Runner , which will be performed during the opening and five more times during the exhbition period. The gesture, a subtle body movement, can be understood as a carrier of identity. To feel the carpet texture on my face and arm. To come.
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Open your mouth with desire and discomfort. To be put against the wall and like it. Female leg crossing standing. Be on points. To point.