Search

Your search keyword '"J. Chauny"' showing total 15 results
Start Over Author "J. Chauny"
15 results on '"J. Chauny"'

1. LO86: Lack of association between four biomarkers and the presence of persistent post-concussion symptoms after a mild traumatic brain injury

Author

N. Le Sage, J. Frenette, J. Chauny, S. Berthelot, P. Archambault, J. Perry, J. Lee, E. Lang, A. McRae, X. Neveu, P. Tardif, V. Boucher, É. Mercier, and M. Émond

Subjects
medicine.medical_specialty, business.industry, Traumatic brain injury, Incidence (epidemiology), Emergency department, Rivermead post-concussion symptoms questionnaire, medicine.disease, Blood biomarkers, Post concussion symptoms, Internal medicine, Cohort, Emergency Medicine, Medicine, Biomarker (medicine), business
Abstract

Introduction: Mild Traumatic Brain Injury (mTBI) is a common problem: each year in Canada, its incidence is estimated at 500-600 cases per 100 000. Between 10 and 56% of mTBI patients develop persistent post-concussion symptoms (PPCS) that can last for more than 90 days. It is therefore important for clinicians to identify patients who are at risk of developing PPCS. We hypothesized that blood biomarkers drawn upon patient arrival to the Emergency Department (ED) could help predict PPCS. The main objective of this project was to measure the association between four biomarkers and the incidence of PPCS 90 days post mTBI. Methods: Patients were recruited in seven Canadian ED. Non-hospitalized patients, aged ≥14 years old with a documented mTBI that occurred ≤24 hrs of ED consultation, with a GCS ≥13 at arrival were included. Sociodemographic and clinical data as well as blood samples were collected in the ED. A standardized telephone questionnaire was administered at 90 days post ED visit. The following biomarkers were analyzed using enzyme-linked immunosorbent assay (ELISA): S100B protein, Neuron Specific Enolase (NSE), cleaved-Tau (c-Tau) and Glial fibrillary acidic protein (GFAP). The primary outcome measure was the presence of persistent symptoms at 90 days after mTBI, as assessed using the Rivermead Post-Concussion symptoms Questionnaire (RPQ). A ROC curve was constructed for each biomarker. Results: 1276 patients were included in the study. The median age for this cohort was 39 (IQR 23-57) years old, 61% were male and 15% suffered PPCS. The median values (IQR) for patients with PPCS compared to those without were: 43 pg/mL (26-67) versus 42 pg/mL (24-70) for S100B protein, 50 pg/mL (50-223) versus 50 pg/mL (50-199) for NSE, 2929 pg/mL (1733-4744) versus 3180 pg/mL (1835-4761) for c-Tau and 1644 pg/mL (650-3215) versus 1894 pg/mL (700-3498) for GFAP. For each of these biomarkers, Areas Under the Curve (AUC) were 0.495, 0.495, 0.51 and 0.54, respectively. Conclusion: Among mTBI patients, S100B protein, NSE, c-Tau or GFAP during the first 24 hours after trauma do not seem to be able to predict PPCS. Future research testing of other biomarkers is needed in order to determine their usefulness in predicting PPCS when combined with relevant clinical data.

Published
2020

2. LO88: S100B serum protein level for the detection of clinically significant intracranial hemorrhage in patients with mild traumatic brain injury: a prospective cohort study

Author

J. Blais-L'Écuyer, É. Mercier, P. Tardif, P. Archambault, J. Chauny, S. Berthelot, J. Frenette, J. Perry, I. Stiell, M. Émond, J. Lee, E. Lang, A. McRae, V. Boucher, and N. Le Sage

Subjects
medicine.medical_specialty, Traumatic brain injury, business.industry, Internal medicine, Emergency Medicine, medicine, Serum protein, In patient, medicine.disease, Prospective cohort study, business
Abstract

Introduction: Clinical assessment of patients with mTBI is challenging and overuse of head CT in the emergency department (ED) is a major problem. During the last decades, studies have attempted to reduce unnecessary head CTs following a mTBI by identifying new tools aiming to predict intracranial bleeding. S100B serum protein level might be helpful reducing those imaging since a higher level of S-100B protein has been associated with intracranial hemorrhage following a mTBI in previous literature. The main objective of this study was to assess whether the S100B serum protein level is associated with clinically important brain injury and could be used to reduce the number of head CT following a mTBI. Methods: This prospective multicenter cohort study was conducted in five Canadian ED. MTBI patients with a Glasgow Coma Scale (GCS) score of 13-15 in the ED and a blood sample drawn within 24-hours after the injury were included. S-100B protein was analyzed using enzyme-linked immunosorbent assay (ELISA). All types of intracranial bleedings were reviewed by a radiologist who was blinded to the biomarker results. The main outcome was the presence of clinically important brain injury. Results: A total of 476 patients were included. Mean age was 41 ± 18 years old and 150 (31.5%) were female. Twenty-four (5.0%) patients had a clinically significant intracranial hemorrhage while 37 (7.8%) had any type of intracranial bleeding. S100B median value (Q1-Q3) of was: 0.043 ug/L (0.008-0.080) for patients with clinically important brain injury versus 0.039 μg/L (0.023-0.059) for patients without clinically important brain injury. Sensitivity and specificity of the S100B protein level, if used alone to detect clinically important brain injury, were 16.7% (95% CI 4.7-37.4) and 88.5% (95% CI 85.2-91.3), respectively. Conclusion: S100B serum protein level was not associated with clinically significant intracranial hemorrhage in mTBI patients. This protein did not appear to be useful to reduce the number of CT prescribed in the ED and would have missed many clinically important brain injuries. Future research should focus on different ways to assess mTBI patient and ultimately reduce unnecessary head CT.

Published
2020

3. P030: Acute pain resolution after an emergency department visit: a 14-day trajectory analysis

Author

J. Paquet, J. Chauny, Éric Piette, R. Daoust, G. Lavigne, Judy Morris, Justine Lessard, Alexis Cournoyer, and Véronique Castonguay

Subjects
business.industry, Resolution (electron density), Emergency Medicine, Medicine, Trajectory analysis, Medical emergency, Emergency department, business, medicine.disease, Acute pain
Abstract

Introduction: The objective of the study was to evaluate the acute pain intensity evolution in ED discharged patients using Group-based trajectory modeling (GBTM). This method identified patient groups with similar profiles of change over time without assuming the existence of a particular pattern or number of groups. Methods: This was a prospective cohort study of ED patients aged ≥18 years with an acute pain condition (≤ 2 weeks) and discharged with an opioid prescription. Patients completed a 14-day diary assessing daily pain intensity level (0-10 numeric rating scale) and pain medication use. Results: Among the 372 included patients, six distinct post-ED pain intensity trajectories were identified: two started with severe levels of pain, one remained with severe pain intensity (12.6% of the sample) and the other ended with moderate pain intensity level (26.3%). Two other trajectories had severe initial pain, one decreased to mild pain (21.7%) and the other to no-pain (13.8%). Another trajectory had moderate initial pain which decreased to a mild level (15.9%) and the last one started with mild pain intensity and had no pain at the end of the 14-day (9.7%). The pain trajectory patterns were significantly associated with age, type of painful conditions, pain intensity at ED discharge, and with opioid consumption. Conclusion: Acute pain resolution following an ED visit seems to progress through six different trajectory patterns that are more informative than simple linear models and could be useful to adapt acute pain management in future research.

Published
2019

4. MP13: Association between the quantity of subcutaneous fat and the inter-device agreement of two tissue oximeters

Author

S. Cossette, A. Cournoyer, Martin Marquis, J. Paquet, Éric Notebaert, J. Chauny, Massimiliano Iseppon, R. Daoust, and A. Denault

Subjects
business.industry, Emergency Medicine, Medicine, business, Nuclear medicine, Subcutaneous fat
Abstract

Introduction: Near-infrared spectroscopy (NIRS) can be used to monitor the oxygen saturation of hemoglobin in any given superficial tissue. However, the measurements provided by different oximeters can vary a lot. Little is known about the specific patient characteristics that could affect the inter-device agreement of tissular oximeters. This study aimed to evaluate the association between the quantity of subcutaneous fat (assessed by skinfold thickness) and the inter-device agreement of two tissue oximeters, the INVOS 5100c and the Equanox 7600. Methods: In this prospective cohort study, tissue saturations and skinfold thickness were measured at four different sites on both sides of the body in healthy adult (≥18 years old) volunteers. The association between the quantity of subcutaneous fat (assessed by skinfold thickness) and the inter-device agreement (absolute difference between the oximetry values provided by the two oximeters) was first assessed with a Pearson's correlation and a scatter plot. Subsequently, a linear mixed model was used to evaluate the impact of the subcutaneous fat and other covariables (age, sex) on the inter-device agreement while adjusting for the repeated measurements across different sites for the same volunteers. Results: From January to March 2015, 53 healthy volunteers were included in this study with ages ranging between 20 and 81 years old, on which a total of 848 measures were taken. Higher skinfold measures were associated with an increase in the difference between measures provided by both oximeters (Slope = -0.59, Pearson correlation coefficient = -0.51, p < 0.001). This observed association persisted in a linear mixed model (-0.48 [95% confidence interval {CI}-0.61 to -0.36], p < 0.001). The sex of the volunteers also influenced the inter-oximeter agreement (Women:-5.77 [95%CI -8.43 to -3.11], p < 0.001), as well as the forearm sites (Left forearm: −7.16 [95%CI -9.85 to –4.47], p < 0.001; right forearm: −7.01 [95%CI -9.61 to −4.40], p < 0.001). Conclusion: The quantity of subcutaneous fat, as well as the sex of the volunteers and the measurement sites, impacted the inter-device agreement of two commonly used oximeters. Given these findings, monitoring using tissue oximetry should be interpreted with great care when there is a significant quantity of subcutaneous fat.

Published
2019

5. Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

Author

null Author et al, R. M. Bateman, M. D. Sharpe, J. E. Jagger, C. G. Ellis, J. Solé-Violán, M. López-Rodríguez, E. Herrera-Ramos, J. Ruíz-Hernández, L. Borderías, J. Horcajada, N. González-Quevedo, O. Rajas, M. Briones, F. Rodríguez de Castro, C. Rodríguez Gallego, F. Esen, G. Orhun, P. Ergin Ozcan, E. Senturk, C. Ugur Yilmaz, N. Orhan, N. Arican, M. Kaya, M. Kucukerden, M. Giris, U. Akcan, S. Bilgic Gazioglu, E. Tuzun, R. Riff, O. Naamani, A. Douvdevani, R. Takegawa, H. Yoshida, T. Hirose, N. Yamamoto, H. Hagiya, M. Ojima, Y. Akeda, O. Tasaki, K. Tomono, T. Shimazu, S. Ono, T. Kubo, S. Suda, T. Ueno, T. Ikeda, H. Ogura, H. Takahashi, J. Kang, Y. Nakamura, T. Kojima, Y. Izutani, T. Taniguchi, M. O, C. Dinter, J. Lotz, B. Eilers, C. Wissmann, R. Lott, M. M. Meili, P. S. Schuetz, H. Hawa, M. Sharshir, M. Aburageila, N. Salahuddin, V. Chantziara, S. Georgiou, A. Tsimogianni, P. Alexandropoulos, A. Vassi, F. Lagiou, M. Valta, G. Micha, E. Chinou, G. Michaloudis, A. Kodaira, H. Imaizumi, M. V. De la Torre-Prados, A. Garcia-De la Torre, A. Enguix-Armada, A. Puerto-Morlan, V. Perez-Valero, A. Garcia-Alcantara, N. Bolton, J. Dudziak, S. Bonney, A. Tridente, P. Nee, G. Nicolaes, M. Wiewel, M. Schultz, K. Wildhagen, J. Horn, R. Schrijver, T. Van der Poll, C. Reutelingsperger, S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans, E. G. Gayat, J. Struck, A. Cariou, N. Deye, B. Guidet, S. Jabert, J. Launay, M. Legrand, M. Léone, M. Resche-Rigon, E. Vicaut, A. Vieillard-Baron, A. Mebazaa, R. Arnold, M. Capan, A. Linder, P. Akesson, M. Popescu, D. Tomescu, C. L. Sprung, R. Calderon Morales, G. Munteanu, E. Orenbuch-Harroch, P. Levin, H. Kasdan, A. Reiter, T. Volker, Y. Himmel, Y. Cohen, J. Meissonnier, L. Girard, F. Rebeaud, I. Herrmann, B. Delwarde, E. Peronnet, E. Cerrato, F. Venet, A. Lepape, T. Rimmelé, G. Monneret, J. Textoris, N. Beloborodova, V. Moroz, A. Osipov, A. Bedova, Y. Sarshor, A. Pautova, A. Sergeev, E. Chernevskaya, J. Odermatt, R. Bolliger, L. Hersberger, M. Ottiger, M. Christ-Crain, B. Mueller, P. Schuetz, N. K. Sharma, A. K. Tashima, M. K. Brunialti, F. R. Machado, M. Assuncao, O. Rigato, R. Salomao, S. C. Cajander, G. Rasmussen, E. Tina, B. Söderquist, J. Källman, K. Strålin, A. L. Lange, J. S. Sundén-Cullberg, A. M. Magnuson, O. H. Hultgren, P. Van der Geest, M. Mohseni, J. Linssen, R. De Jonge, S. Duran, J. Groeneveld, R. Miller, B. K. Lopansri, L. C. McHugh, A. Seldon, J. P. Burke, J. Johnston, R. Reece-Anthony, A. Bond, A. Molokhia, C. Mcgrath, E. Nsutebu, P. Bank Pedersen, D. Pilsgaard Henriksen, S. Mikkelsen, A. Touborg Lassen, R. Tincu, C. Cobilinschi, Z. Ghiorghiu, R. Macovei, M. A. Wiewel, M. B. Harmon, L. A. Van Vught, B. P. Scicluna, A. J. Hoogendijk, A. H. Zwinderman, O. L. Cremer, M. J. Bonten, M. J. Schultz, N. P. Juffermans, W. J. Wiersinga, G. Eren, Y. Tekdos, M. Dogan, O. Acicbe, E. Kaya, O. Hergunsel, S. Alsolamy, G. Ghamdi, L. Alswaidan, S. Alharbi, F. Alenezi, Y. Arabi, J. Heaton, A. Boyce, L. Nolan, A. Dukoff-Gordon, A. Dean, T. Mann Ben Yehudah, C. Fleischmann, D. Thomas-Rueddel, C. Haas, U. Dennler, K. Reinhart, O. Suntornlohanakul, B. Khwannimit, F. Breckenridge, A. Puxty, P. Szturz, P. Folwarzcny, J. Svancara, R. Kula, P. Sevcik, L. Caneva, A. Casazza, E. Bellazzi, S. Marra, L. Pagani, M. Vetere, R. Vanzino, D. Ciprandi, R. Preda, R. Boschi, L. Carnevale, V. Lopez, M. Aguilar Arzapalo, L. Barradas, A. Escalante, J. Gongora, M. Cetina, B Adamik, D Jakubczyk, A Kübler, A. Radford, T. Lee, J. Singer, J. Boyd, D. Fineberg, M. Williams, J. Russell, E. Scarlatescu, G. Droc, S. Arama, M. Müller, M. Straat, S. S. Zeerleder, C. F. Fuchs, C. S. Scheer, S. W. Wauschkuhn, M. V. Vollmer, K. M. Meissner, S. K. Kuhn, K. H. Hahnenkamp, S. R. Rehberg, M. G. Gründling, S. Hamaguchi, E. Gómez-Sánchez, M. Heredia-Rodríguez, E. Álvarez-Fuente, M. Lorenzo-López, E. Gómez-Pesquera, M. Aragón-Camino, P. Liu-Zhu, A. Sánchez-López, A. Hernández-Lozano, M. T. Peláez-Jareño, E. Tamayo, D. O. Thomas-Rüddel, V. Adora, A. Kar, A. Chakraborty, S. Roy, A. Bandyopadhyay, M. Das, G. BenYehudah, M. Salim, N. Kumar, L. Arabi, T. Burger, P. Lephart, E. Toth-martin, C. Valencia, N. Hammami, S. Blot, J. L. Vincent, M. L. Lambert, J. Brunke, T. Riemann, I. Roschke, S. Nimitvilai, K. Jintanapramote, S. Jarupongprapa, D. Adukauskiene, D. Valanciene, G. Bose, V. Lostarakos, B. Carr, S. Khedher, A. Maaoui, A. Ezzamouri, M. Salem, J. Chen, D. R. Cranendonk, M. Day, G. Penrice, K. Roy, P. Robertson, G. Godbole, B. Jones, M. Booth, L. Donaldson, Y. Kawano, H. Ishikura, H. Al-Dorzi, M. Almutairi, B. Alhamadi, A. Crizaldo Toledo, R. Khan, B. Al Raiy, H. Talaie, J. A. Van Oers, A. Harts, E. Nieuwkoop, P. Vos, Y. Boussarsar, F. Boutouta, S. Kamoun, I. Mezghani, S. Koubaji, A. Ben Souissi, A. Riahi, M. S. Mebazaa, E. Giamarellos-Bourboulis, N. Tziolos, C. Routsi, C. Katsenos, I. Tsangaris, I. Pneumatikos, G. Vlachogiannis, V. Theodorou, A. Prekates, E. Antypa, V. Koulouras, N. Kapravelos, C. Gogos, E. Antoniadou, K. Mandragos, A. Armaganidis, A. R. Robles Caballero, B. Civantos, J. C. Figueira, J. López, A. Silva-Pinto, F. Ceia, A. Sarmento, L. Santos, G. Almekhlafi, Y. Sakr, S. Baharoon, A. Aldawood, A. Matroud, J. Alchin, S. Al Johani, H. Balkhy, S. Y. Yousif, B. O. Alotabi, A. S. Alsaawi, J. Ang, M. D. Curran, D. Enoch, V. Navapurkar, A. Morris, R. Sharvill, J. Astin, J. Patel, C. Kruger, J. O’Neal, H. Rhodes, J. Jancik, B. François, P. F. Laterre, P. Eggimann, A. Torres, M. Sánchez, P. F. Dequin, G. L. Bassi, J. Chastre, H. S. Jafri, M. Ben Romdhane, Z. Douira, M. Bousselmi, A. Vakalos, V. Avramidis, T. H. Craven, G. Wojcik, K. Kefala, J. McCoubrey, J. Reilly, R. Paterson, D. Inverarity, I. Laurenson, T. S. Walsh, S. Mongodi, B. Bouhemad, A. Orlando, A. Stella, G. Via, G. Iotti, A. Braschi, F. Mojoli, M. Haliloglu, B. Bilgili, U. Kasapoglu, I. Sayan, M. Süzer Aslan, A. Yalcin, I. Cinel, H. E. Ellis, K. Bauchmuller, D. Miller, A. Temple, C. E. Luyt, M. Singer, Y. Nassar, M. S. Ayad, A. Trifi, S. Abdellatif, F. Daly, R. Nasri, S. Ben Lakhal, F. Gul, A. Kuzovlev, A. Shabanov, S. Polovnikov, N. Kadrichu, T. Dang, K. Corkery, P. Challoner, G. Li Bassi, E. Aguilera, C. Chiurazzi, C. Travierso, A. Motos, L. Fernandez, R. Amaro, T. Senussi, F. Idone, J. Bobi, M. Rigol, C. J. Hodiamont, J. M. Janssen, C. S. Bouman, R. A. Mathôt, M. D. De Jong, R. M. Van Hest, L. Payne, G. L. Fraser, B. Tudor, M. Lahner, G. Roth, C. Krenn, P. Jault, J. Gabard, T. Leclerc, S. Jennes, Y. Que, A. Rousseau, F. Ravat, A. Eissa, S. Al-Harbi, T. Aldabbagh, S. Abdellatif., F. Paramba, N. Purayil, V. Naushad, O. Mohammad, V. Negi, P. Chandra, A. Kleinsasser, M. R. Witrz, J. F. Buchner-Doeven, A. M. Tuip-de Boer, J. C. Goslings, M. Van Hezel, A Boing, R Van Bruggen, N Juffermans, D. Markopoulou, K. Venetsanou, V. Kaldis, D. Koutete, D. Chroni, I. Alamanos, L. Koch, E. Walter, K. Maekawa, M. Hayakawa, S. Kushimoto, A. Shiraishi, H. Kato, J. Sasaki, T. Matauoka, T. Uejima, N. Morimura, A. Hagiwara, M. Takeda, O. Tarabrin, S. Shcherbakow, D. Gavrychenko, G. Mazurenko, V. Ivanova, O. Chystikov, C. Plourde, J. Lessard, J. Chauny, R. Daoust, L. Kropman, L. In het Panhuis, J. Konings, D. Huskens, E. Schurgers, M. Roest, B. De Laat, M. Lance, M. Durila, P. Lukas, M. Astraverkhava, J. Jonas, I. Budnik, B. Shenkman, H. Hayami, Y. Koide, T. Goto, R. Iqbal, Y. Alhamdi, N. Venugopal, S. Abrams, C. Downey, C. H. Toh, I. D. Welters, V. B. Bombay, J. M. Chauny, R. D. Daoust, J. L. Lessard, M. M. Marquis, J. P. Paquet, K. Siemens, D. Sangaran, B. J. Hunt, A. Durward, A. Nyman, I. A. Murdoch, S. M. Tibby, F. Ampatzidou, D. Moisidou, E. Dalampini, M. Nastou, E. Vasilarou, V. Kalaizi, H. Chatzikostenoglou, G. Drossos, S. Spadaro, A. Fogagnolo, T. Fiore, A. Schiavi, V. Fontana, F. Taccone, C. Volta, E. Chochliourou, E. Volakli, A. Violaki, E. Samkinidou, G. Evlavis, V. Panagiotidou, M. Sdougka, R. Mothukuri, C. Battle, K. Guy, J. Wijesuriya, S. Keogh, A. Docherty, R. O’Donnell, S. Brunskill, M. Trivella, C. Doree, L. Holst, M. Parker, M. Gregersen, J. Almeida, T. Walsh, S. Stanworth, S. Moravcova, J. Mansell, A. Rogers, R. A. Smith, C. Hamilton-Davies, A. Omar, M. Allam, O. Bilala, A. Kindawi, H. Ewila, A. Malamas, G. Ferreira, J. Caldas, J. Fukushima, E. A. Osawa, E. Arita, L. Camara, S. Zeferino, J. Jardim, F. Gaioto, L. Dallan, F. B. Jatene, R. Kalil Filho, F. Galas, L. A. Hajjar, C. Mitaka, T. Ohnuma, T. Murayama, F. Kunimoto, M. Nagashima, T. Takei, M. Tomita, K. Mahmoud, S. Hanoura, S. Sudarsanan, P. Sivadasan, H. Othamn, Y. Shouman, R. Singh, A. Al Khulaifi, I. Mandel, S. Mikheev, I. Suhodolo, V. Kiselev, Y. Svirko, Y. Podoksenov, S. A. Jenkins, R. Griffin, M. S. Tovar Doncel, A. Lima, C. Aldecoa, C. Ince, A. Taha, A. Shafie, M. Mostafa, N. Syed, H. Hon, F. Righetti, E. Colombaroli, G. Castellano, M. Hravnak, L. C. Chen, A. D. Dubrawski, G. C. Clermont, M. R. Pinsky, S. Gonzalez, D. Macias, J. Acosta, P. Jimenez, A. Loza, A. Lesmes, F. Lucena, C. Leon, M. Bastide, J. Richecoeur, E. Frenoy, C. Lemaire, B. Sauneuf, F. Tamion, S. Nseir, D. Du Cheyron, H. Dupont, J. Maizel, M. Shaban, R. Kolko, M. AbuRageila, A. AlHussain, P. Mercado, L. Kontar, D. Titeca, F. Brazier, A. Riviere, M. Joris, T. Soupison, B. De Cagny, M. Slama, J. Wagner, A. Körner, M. Kubik, S. Kluge, D. Reuter, B. Saugel, T. Tran, D. De Bels, A. Cudia, M. Strachinaru, P. Ghottignies, J. Devriendt, C. Pierrakos, Ó. Martínez González, R. Blancas, J. Luján, D. Ballesteros, C. Martínez Díaz, A. Núñez, C. Martín Parra, B. López Matamala, M. Alonso Fernández, M. Chana, W. Huber, M. Eckmann, F. Elkmann, A. Gruber, I. Klein, R. M. Schmid, T. Lahmer, P. W. Moller, S. Sondergaard, S. M. Jakob, J. Takala, D. Berger, D. Bastoni, H. Aya, L. Toscani, L. Pigozzi, A. Rhodes, M. Cecconi, C. Ostrowska, A. Abbas, J. Mellinghoff, C. Ryan, D. Dawson, M. Cronhjort, O. Wall, E. Nyberg, R. Zeng, C. Svensen, J. Mårtensson, E. Joelsson-Alm, N. Parenti, C. Palazzi, L. A. Amidei, F. B. Borrelli, S. C. Campanale, F. T. Tagliazucchi, G. S. Sedoni, D. L. Lucchesi, E. C. Carella, A. L Luciani, M. Mackovic, N. Maric, M. Bakula, R. M. Grounds, N. Fletcher, B. Avard, P. Zhang, M. Mezidi, J. Charbit, M. Ould-Chikh, P. Deras, C. Maury, O. Martinez, X. Capdevila, P. Hou, W. Z. Linde-Zwirble, I. D. Douglas, N. S. Shapiro, Y. Ben Aicha, B. Laribi, B. Jeribi, C. Pereira, R. Marinho, R. Antunes, A. Marinho, M. Crivits, M. Raes, J. Decruyenaere, E. Hoste, V. Bagin, V. Rudnov, A. Savitsky, M. Astafyeva, I. Korobko, V. Vein, T. Kampmeier, P. Arnemann, M. Hessler, A. Wald, K. Bockbreder, A. Morelli, H. Van Aken, S. Rehberg, C. Ertmer, S. Reddy, M. Bailey, R. Beasley, R. Bellomo, D. Mackle, A. Psirides, P. Young, H. Venkatesh, S. Ramachandran, A. Basu, H. Nair, S. Egan, J. Bates, S. Oliveira, N. R. Rangel Neto, F. Q. Reis, C. P. Lee, X. L. Lin, C. Choong, K. M. Eu, W. Y. Sim, K. S. Tee, J. Pau, J. Abisheganaden, K. Maas, H. De Geus, E. Lafuente, J. Moura, T. E. Doris, D. Monkhouse, T. Shipley, S. Kardasz, I Gonzalez, S. Stads, A. J. Groeneveld, I. Elsayed, N. Ward, A. Raithatha, A. Steuber, C. Pelletier, S. Schroeder, E. Michael, T. Slowinski, D. Kindgen-Milles, S. Ghabina, F. Turani, A. Belli, S. Busatti, G. Barettin, F. Candidi, F. Gargano, R. Barchetta, M. Falco, O. Demirkiran, M. Kosuk, S. Bozbay, V. Weber, J. Hartmann, S. Harm, I. Linsberger, T. Eichhorn, G. Valicek, G. Miestinger, C. Hoermann, S. Faenza, D. Ricci, E. Mancini, C. Gemelli, A. Cuoghi, S. Magnani, M. Atti, T. Laddomada, A. Doronzio, B. Balicco, M. C. Gruda, P. O’Sullivan, V. P. Dan, T. Guliashvili, A. Scheirer, T. D. Golobish, V. J. Capponi, P. P. Chan, K. Kogelmann, M. Drüner, D. Jarczak, A. B. Belli, S. M. Martni, V. C. Cotticelli, F. Mounajergi, S. Morimoto, I. Hussain, A. Nadeem, K. Ghorab, K. Maghrabi, S. K. Kloesel, C. Goldfuss, A. Stieglitz, A. S. Stieglitz, L. Krstevska, G. Albuszies, G. Jimmy, J. Izawa, T. Iwami, S. Uchino, M. Takinami, T. Kitamura, T. Kawamura, J. G. Powell-Tuck, S. Crichton, M. Raimundo, L. Camporota, D. Wyncoll, M. Ostermann, A. Hana, H. R. De Geus, M. Aydogdu, N. Boyaci, S. Yuksel, G. Gursel, A. B. Cayci Sivri, J. Meza-Márquez, J. Nava-López, R. Carrillo-Esper, A. Dardashti, A. Grubb, M. Wetzstein, E. Peters, H. Njimi, P. Pickkers, M. Waraich, J. Doyle, T. Samuels, L. Forni, N. Desai, R. Baumber, P. Gunning, A. Sell, S. Lin, H. Torrence, M. O’Dwyer, C. Kirwan, J. Prowle, T. Kim, M. E. O’Connor, R. W. Hewson, C. J. Kirwan, R. M. Pearse, M. Maksoud, O. Uzundere, D. Memis, M. Ýnal, A. Gultekin, N. Turan, M. A. Aydin, H. Basar, I. Sencan, A. Kapuagasi, M. Ozturk, Z. Uzundurukan, D. Gokmen, A. Ozcan, C. Kaymak, V. A. Artemenko, A. Budnyuk, R. Pugh, S. Bhandari, T. Mauri, C. Turrini, T. Langer, P. Taccone, C. A. Volta, C. Marenghi, L. Gattinoni, A. Pesenti, L. Sweeney, A. O’Sullivan, P. Kelly, E. Mukeria, R. MacLoughlin, M. Pfeffer, J. T. Thomas, G. B. Bregman, G. K. Karp, E. K. Kishinevsky, D. S. Stavi, N. A. Adi, T. Poropat, R. Knafelj, E. Llopart, M. Batlle, C. De Haro, J. Mesquida, A. Artigas, D. Pavlovic, L. Lewerentz, A. Spassov, R. Schneider, S. De Smet, S. De Raedt, E. Derom, P Depuydt, S. Oeyen, D. Benoit, A. Gobatto, B. Besen, P. Tierno, L. Melro, P. Mendes, F. Cadamuro, M. Park, L. M. Malbouisson, B. C. Civantos, J. L. Lopez, A. Robles, J. Figueira, S. Yus, A. Garcia, A. Oglinda, G. Ciobanu, C. Oglinda, L. Schirca, T. Sertinean, V. Lupu, M. Wolny, A. Pagano, F. Numis, G. Visone, L. Saldamarco, T. Russo, G. Porta, F. Paladino, C. Bell, J. Liu, J. Debacker, C. Lee, E. Tamberg, V. Campbell, S. Mehta, Ý. Kara, F. Yýldýrým, A. Zerman, Z. Güllü, N. Boyacý, B. Basarýk Aydogan, Ü. Gaygýsýz, K. Gönderen, G. Arýk, M. Turkoglu, G. Aygencel, Z. Ülger, Z. Isýkdogan, Ö. Özdedeoglu, M. Badoglu, U. Gaygýsýz, N. Kongpolprom, C. Sittipunt, A. Eden, Y. Kokhanovsky, S. Bursztein – De Myttenaere, R. Pizov, L. Neilans, N. MacIntyre, M. Radosevich, B. Wanta, T. Meyer, N. Smischney, D. Brown, D. Diedrich, A. Fuller, P. McLindon, K. Sim, M. Shoaeir, K. Noeam, A. Mahrous, R. Matsa, A. Ali, C. Dridi, F. Haddad, A. Pérez-Calatayud, A. Zepeda-Mendoza, M. Diaz-Carrillo, E. Arch-Tirado, S. Carbognin, L. Pelacani, F. Zannoni, A. Agnoli, G. Gagliardi, R. Cho, A. Adams, S. Lunos, S. Ambur, R. Shapiro, M. Prekker, M. Thijssen, L. Janssen, N. Foudraine, C. J. Voscopoulos, J. Freeman, E. George, D. Eversole, S. Muttini, R. Bigi, G. Villani, N. Patroniti, G. Williams, E George, A. Waldmann, S. Böhm, W. Windisch, S. Strassmann, C. Karagiannidis, C. K. Karagiannidis, A. W. Waldmann, S. B. Böhm, W. W. Windisch, P. Persson, S. Lundin, O. Stenqvist, C. S. Serra, A. P. Pagano, M. M. Masarone, L. R. Rinaldi, A. A. Amelia, M. F. Fascione, L. A. Adinolfi, E. R. Ruggiero, F. Asota, K. O’Rourke, S. Ranjan, P. Morgan, J. W. DeBacker, L. O’Neill, L. Munshi, L. Burry, E. Fan, S. Poo, K. Mahendran, J. Fowles, C. Gerrard, A. Vuylsteke, R. Loveridge, C. Chaddock, S. Patel, V. Kakar, C. Willars, T. Hurst, C. Park, T. Best, A. Vercueil, G. Auzinger, A. Borgman, A. G. Proudfoot, E. Grins, K. E. Emiley, J. Schuitema, S. J. Fitch, G. Marco, J. Sturgill, M. G. Dickinson, M. Strueber, A. Khaghani, P. Wilton, S. M. Jovinge, C. Sampson, S. Harris-Fox, M. E. Cove, L. H. Vu, A. Sen, W. J. Federspiel, J. A. Kellum, C. Mazo Torre, J. Riera, S. Ramirez, B. Borgatta, L. Lagunes, J. Rello, A. K. Kuzovlev, A. Goloubev, S. Nenchuk, V. Karavana, C. Glynos, A. Asimakos, K. Pappas, C. Vrettou, M. Magkou, E. Ischaki, G. Stathopoulos, S. Zakynthinos, I. Kozhevnikova, F. Dalla Corte, S. Grasso, P. Casolari, G. Caramori, T. Andrianjafiarinoa, T. Randriamandrato, T. Rajaonera, S. El-Dash, E. L. V. Costa, M. R. Tucci, F Leleu, L Kontar, G. Bacari-Risal, M. Amato, S. El Dash, null Remmington, A. Fischer, S. Squire, M. Boichat, H. Honzawa, H. Yasuda, T. Adati, S. Suzaki, M. Horibe, M. Sasaki, M. Sanui, J. Daniel, H. Miranda, K. Milinis, M. Cooper, G. R. Williams, E. McCarron, S. Simants, I. Patanwala, I. Welters, Y. Su, J. Fernández Villanueva, R. Fernández Garda, A. López Lago, E. Rodríguez Ruíz, R. Hernández Vaquero, S. Tomé Martínez de Rituerto, E. Varo Pérez, N. Lefel, F. Schaap, D. Bergmans, S. Olde Damink, M. Van de Poll, K. Tizard, C. Lister, L. Poole, D. Ringaitiene, D. Gineityte, V. Vicka, I. Norkiene, J. Sipylaite, A. O’Loughlin, V. Maraj, J. Dowling, M. B. Velasco, D. M. Dalcomune, E. B. Dias, S. L. Fernandes, T. Oshima, S. Graf, C. Heidegger, L. Genton, V. Karsegard, Y. Dupertuis, C. Pichard, N. Friedli, Z. Stanga, L. Vandersteen, B. Stessel, S. Evers, A. Van Assche, L. Jamaer, J. Dubois, H. Castro, J. Valente, P. Martins, P. Casteloes, C. Magalhaes, S. Cabral, M. Santos, B. Oliveira, A. Salgueiro, S. Duarte, S. Castro, M. Melo, S. Gray, K. Maipang, R. Bhurayanontachai, L. G. Grädel, P. Schütz, P. Langlois, W. Manzanares, M. Lemieux, G. Elke, F. Bloos, D. Heyland, I. Aramendi, N. Babo, M. Hoshino, Y. Haraguchi, S. Kajiwara, T. Mitsuhashi, T. Tsubata, M. Aida, T. Rattanapraphat, C. Kongkamol, B. Xavier, C. Koutsogiannidis, M. Moschopoulou, G. Taskin, M. Çakir, AK Güler, A. Taskin, N. Öcal, S. Özer, L. Yamanel, J. M. Wong, C. Fitton, S. Anwar, S. Stacey, M. Aggou, B. Fyntanidou, S. Patsatzakis, E. Oloktsidou, K. Lolakos, E. Papapostolou, V. Grosomanidis, S. Gaudry, V. Desailly, P. Pasquier, PB Brun, AT Tesnieres, JD Ricard, D. Dreyfuss, A. Mignon, J. C White, A. Stilwell, G. Friedlaender, M. Peters, S. Stipulante, A. Delfosse, AF Donneau, A. Ghuysen, C. Feldmann, D. Freitag, W. Dersch, M. Irqsusi, D. Eschbach, T. Steinfeldt, H. Wulf, T. Wiesmann, J. Cholkraisuwat, S. Beitland, E. Nakstad, H. Stær-Jensen, T. Drægni, G. Andersen, D. Jacobsen, C. Brunborg, B. Waldum-Grevbo, K. Sunde, K. Hoyland, D. Pandit, K. Hayakawa, K. Kotzampassi, L. Loukipoudi, E. Doumaki, M. M. Admiraal, M. Van Assen, M. J. Van Putten, M. Tjepkema-Cloostermans, A. F. Van Rootselaar, F. Ragusa, A. Marudi, S. Baroni, A. Gaspari, E. Bertellini, T. Abdullah, S. Abdel Monem, S. Alcorn, S. McNeill, S. Russell, W. Eertmans, C. Genbrugge, I. Meex, J. Dens, F. Jans, C. De Deyne, B Avard, R Burns, A. Patarchi, T. Spina, H. Tanaka, N. Otani, S. Ode, S. Ishimatsu, J. Cho, J. B. Moon, C. W. Park, T. G. Ohk, M. C. Shin, M. H. Won, S. Dakova, Z. Ramsheva, K. Ramshev, A Marudi, S Baroni, A Gaspari, E Bertellini, P. E. Ozcan, S. Sencer, C. Ulusoy, M. Fallenius, M. B. Skrifvars, M. Reinikainen, S. Bendel, R. Raj, M. Abu-Habsa, C. Hymers, A. Borowska, H. Sivadhas, S. Sahiba, S. Perkins, J. Rubio, J. A. Rubio, R. Sierra, S. English, M. Chasse, A. Turgeon, F. Lauzier, D. Griesdale, A. Garland, D. Fergusson, R. Zarychanski, A. Tinmouth, C. Van Walraven, K. Montroy, J. Ziegler, R. Dupont Chouinard, R. Carignan, A. Dhaliwal, C. Lum, J. Sinclair, G. Pagliarello, L. McIntyre, T. Groza, N. Moreau, D. Castanares-Zapatero, P. Hantson, M. Carbonara, F. Ortolano, T. Zoerle, S. Magnoni, S. Pifferi, V. Conte, N. Stocchetti, L. Carteron, T. Suys, C. Patet, H. Quintard, M. Oddo, V. Spatenkova, E. Pokorna, P. Suchomel, N. Ebert, T. Bylinski, C. Hawthorne, M. Shaw, I. Piper, J. Kinsella, A. K. Kink, I. R. Rätsep, A. Boutin, L. Moore, J. Lacroix, P. Lessard-Bonaventure, A. F. Turgeon, R. Green, M. Erdogan, M. Butler, P. Desjardins, D. A. Fergusson, B. Goncalves, B. Vidal, C. Valdez, A. C. Rodrigues, L. Miguez, G. Moralez, T. Hong, A. Kutz, P. Hausfater, D. Amin, T. Struja, S. Haubitz, A. Huber, T. Brown, J. Collinson, C. Pritchett, T. Slade, M. Le Guen, S. Hellings, R. Ramsaran, A. Alsheikhly, T. Abe, L. Kanapeckaite, R. Bahl, M. Q. Russell, K. J. Real, R. M. Lyon, N. P. Oveland, J. Penketh, M. Mcdonald, F. Kelly, M. Alfafi, W. Almutairi, B. Alotaibi, A. E Van den Berg, Y. Schriel, L. Dawson, I. A. Meynaar, D. Silva, S. Fernandes, J. Gouveia, J. Santos Silva, J. Foley, A. Kaskovagheorgescu, D. Evoy, J. Cronin, J. Ryan, M. Huck, C. Hoffmann, J. Renner, P. Laitselart, N. Donat, A. Cirodde, J. V. Schaal, Y. Masson, A. Nau, O. Howarth, K. Davenport, P. Jeanrenaud, S. Raftery, P. MacTavish, H. Devine, J. McPeake, M. Daniel, T. Quasim, S. Alrabiee, A. Alrashid, O. Gundogan, C. Bor, E. Akýn Korhan, K. Demirag, M. Uyar, F. Frame, C. Ashton, L. Bergstrom Niska, P. Dilokpattanamongkol, T. Suansanae, C. Suthisisang, S. Morakul, C. Karnjanarachata, V. Tangsujaritvijit, S. Mahmood, H. Al Thani, A. Almenyar, S. E. Morton, Y. S. Chiew, C. Pretty, J. G. Chase, G. M. Shaw, P. Kordis, V. Grover, I. Kuchyn, K. Bielka, Z. Aidoni, G. Stavrou, C. Skourtis, S. D. Lee, K. Williams, I. D. Weltes, S. Berhane, C. Arrowsmith, C. Peters, S. Robert, R. B. Panerai, T. G. Robinson, E. Borg-Seng-Shu, M. De Lima Oliveira, N. C. Mian, R. Nogueira, S. P. Zeferino, M. Jacobsen Teixeira, P. Killeen, M. McPhail, W. Bernal, J. Maggs, J. Wendon, T. Hughes, L. U. Taniguchi, E. M. Siqueira, J. M. Vieira Jr, L. C. Azevedo, A. N. Ahmad, E. Helme, S. Hadfield, J. Shak, C. Senver, R. Howard-Griffin, P. Wacharasint, P. Fuengfoo, N. Sukcharoen, R. Rangsin, D. Sbiti-Rohr, H. Na, S. Song, S. Lee, E. Jeong, K. Lee, E. Zoumpelouli, E. A Volakli, V. Chrysohoidou, K. Charisopoulou, E. Kotzapanagiotou, K. Manavidou, Z. Stathi, B. AlGhamdi, Q. Marashly, K. Zaza, M. Khurshid, Z. Ali, M. Malgapo, M. Jamil, A. Shafquat, M. Shoukri, M. Hijazi, F. A. Rocha, K. Ebecken, L. S. Rabello, M. F. Lima, R. Hatum, F. V. De Marco, A. Alves, J. E. Pinto, M. Godoy, P. E. Brasil, F. A. Bozza, J. I. Salluh, M. Soares, J. Krinsley, G. Kang, J. Perry, H. Hines, K. M. Wilkinson, C. Tordoff, B. Sloan, M. C. Bellamy, E. Moreira, F. Verga, M. Barbato, G. Burghi, M Soares, U. V. Silva, A. P. Torelly, J. M. Kahn, D. C. Angus, M. F. Knibel, R. Marshall, T. Gilpin, D. Mota, B. Loureiro, J. Dias, O. Afonso, F. Coelho, A. Martins, F. Faria, H. Al Orainni, F. AlEid, H. Tlaygeh, A. Itani, A. Hejazi, J. Messika, J. D. Ricard, S. Guillo, B. Pasquet, E. Dubief, F. Tubach, K. James, P. Temblett, L. Davies, C. Lynch, S. Pereira, S. Cavaco, J. Fernandes, I. Moreira, E. Almeida, F. Seabra Pereira, M. Malheiro, F. Cardoso, I. Aragão, T. Cardoso, M. Fister, P. Muraray Govind, N. Brahmananda Reddy, R. Pratheema, E. D. Arul, J. Devachandran, N. Chin-Yee, G. D’Egidio, K. Thavorn, K. Kyeremanteng, A. G. Murchison, K. Swalwell, J. Mandeville, D. Stott, I. Guerreiro, C. Goossens, M. B. Marques, S. Derde, S. Vander Perre, T. Dufour, S. E. Thiessen, F. Güiza, T. Janssens, G. Hermans, I. Vanhorebeek, K. De Bock, G. Van den Berghe, L. Langouche, B. Miles, S. Madden, M. Weiler, P. Marques, C. Rodrigues, M. Boeira, K. Brenner, C. Leães, A. Machado, R. Townsend, J. Andrade, R. Kishore, C. Fenlon, T. Fiks, A. Ruijter, M. Te Raa, P. Spronk, P. Docherty, J. Dickson, E. Moltchanova, C. Scarrot, T. Hall, W. C. Ngu, J. M. Jack, A. Pavli, X. Gee, E. Akin Korhan, M. Shirazy, A. Fayed, S. Gupta, A. Kaushal, S. Dewan, A. Varma, E. Ghosh, L. Yang, L. Eshelman, B. Lord, E. Carlson, R. Broderick, J. Ramos, D. Forte, F. Yang, J. Feeney, K. Wilkinson, K. Shuker, M. Faulds, D. Bryden, L. England, K Shuker, A Tridente, M Faulds, A Matheson, J. Gaynor, D Bryden, S South Yorkshire Hospitals Researc ᅟ, B. Peroni, R. Daglius-Dias, L. Miranda, C. Cohen, C. Carvalho, I. Velasco, J. M. Kelly, A. Neill, G. Rubenfeld, N. Masson, A. Min, E. Boezeman, J. Hofhuis, A. Hovingh, R. De Vries, G. Cabral-Campello, M. Van Mol, M. Nijkamp, E. Kompanje, P. Ostrowski, K. Kiss, B. Köves, V. Csernus, Z. Molnár, Y. Hoydonckx, S. Vanwing, V. Medo, R. Galvez, J. P. Miranda, C. Stone, T. Wigmore, Y. Arunan, A. Wheeler, Y. Wong, C. Poi, C. Gu, P. Molmy, N. Van Grunderbeeck, O. Nigeon, M. Lemyze, D. Thevenin, J. Mallat, M. Correa, R. T. Carvalho, A. Fernandez, C. McBride, E. Koonthalloor, C. Walsh, A. Webber, M. Ashe, K. Smith, E. A. Volakli, M. Dimitriadou, P. Mantzafleri, O. Vrani, A. Arbouti, T. Varsami, J. A. Bollen, T. C. Van Smaalen, W. C. De Jongh, M. M. Ten Hoopen, D. Ysebaert, L. W. Van Heurn, W. N. Van Mook, A. Roze des Ordons, P. Couillard, C. Doig, R. V. Van Keer, R. D. Deschepper, A. F. Francke, L. H. Huyghens, J. B. Bilsen, B. Nyamaizi, C. Dalrymple, A. Dobru, E. Marrinan, A. Ankuli, R. Struthers, R. Crawford, P. Mactavish, P. Morelli, M. Degiovanangelo, F. Lemos, V. MArtinez, J. Cabrera, A. Rutten, S. Van Ieperen, S. De Geer, M. Van Vugt, E. Der Kinderen, A. Giannini, G Miccinesi, T Marchesi, and E Prandi

Subjects
0301 basic medicine, 03 medical and health sciences, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, 030104 developmental biology, 0302 clinical medicine, business.industry, Intensive care, Emergency medicine, Medicine, Critical Care and Intensive Care Medicine, business
Published
2016

6. LO29: Création dune règle de décision clinique pour le diagnostic dun syndrome aortique aigu avec les outils dintelligence artificielle : phase initiale de définition des attributs communs aux patients sans syndrome aortique aigu chez une population à risque

Author

A. Cournoyer, R. Daoust, J. Chauny, and V. Langlois-Carbonneau

Subjects
Emergency Medicine
Abstract

Introduction: Les outils de prédiction disponibles (score clinique, ratio des neutrophiles sur lymphocytes et dosage des D-dimères) dans le diagnostic du syndrome aortique aigu (SAA) demeurent imparfaits. Dans ce contexte, avec lobjectif de développer une règle de décision clinique pour le diagnostic du SAA, la présente étude visait à définir un ensemble de variables discriminantes chez les patients souffrant ou non dun SAA en utilisant les outils dintelligence artificielle. Methods: À partir de lensemble des données cliniques disponibles chez les patients investigués pour douleur thoracique au département durgence avec une angiographie par tomodensitométrie (angioCT) visant à éliminer un SAA entre 2008 et 2014, un programme dapprentissage a été chargé de construire un arbre de décision (Clustering And Regression Tree) identifiant les patients ne souffrant pas dun SAA. La variable dintérêt était labsence de SAA et 23 attributs ont été testés. Le diagnostic de SAA était établi avec les résultats de langioCT. Des échantillons aléatoires de 70% de la population étudiée ont été testés de façon récursive (maximum de 100 itérations) pour construire larbre de décision. Six algorithmes dapprentissage (Reg Tree, LR, KNN, Naive B, Random Forest et CN2) ont été comparés et loptimisation du gain dinformation a été mesurée par les techniques de Gain Ratio et de Gini. Results: Un total de 198 patients (99 hommes et 99 femmes) dun âge moyen de 63 ans (±16) ont été inclus dans létude, parmi lesquels 26 (13%) souffraient dun SAA. Trois attributs ou regroupements dattributs ont permis de construire un arbre de décision permettant didentifier 114 patients sur 198 (57,6%) ayant une très faible probabilité de SAA (sensibilité visée de 100%). La sensibilité et spécificité de larbre de décision clinique était respectivement de 100% (intervalle de confiance [IC] 95% 86,7-100,0) et 70,4% (IC 95% 62,7-77,3). Les attributs en question étaient labsence de tout facteur de risque (e.g. syndrome de Marfan, chirurgie aortique ou valvulaire, histoire familiale), les signes vitaux (tension artérielle systolique, pouls et choc index) et les D-dimères. Le seuil de D-dimères utilisé pouvait varier entre 1114 et 1211 mcg/L selon lhémodynamie et la présence de facteur de risque. Les attributs suivants nétaient pas discriminants : le sexe, un antécédent de diabète, dhypertension artérielle ou de dyslipidémie, le tabagisme, avoir un déficit de perfusion, une différence de tension artérielle entre les deux bras ou un souffle dinsuffisance aortique et la formule sanguine. Conclusion: Les attributs les plus discriminants pour le SAA sont les facteurs à risque, lhémodynamie et les D-dimères. Une étude prospective multicentrique devrait être réalisé afin de développer une règle de décision clinique afin didentifier les patients à très bas risque de SAA à partir de ces attributs.

Published
2018

7. MP36: Short-term side effects associated with opioids for acute pain

Author

G. Lavigne, Véronique Castonguay, Éric Piette, D. Williamson, Alexis Cournoyer, Justine Lessard, J. Chauny, J. Paquet, R. Daoust, and Judy Morris

Subjects
business.industry, Anesthesia, Emergency Medicine, Medicine, business, Acute pain, Term (time)
Abstract

Introduction: Opioid side effects are common when treating chronic pain. However, the rate of opioid side effects for acute pain has rarely been examined, particularly in the post emergency department (ED) setting. The objective of this study was to evaluate the short-term incidence of opioid induced side effects (constipation, nausea/vomiting, dizziness, and drowsiness) in patients discharged from the ED with an opioid prescription. Methods: This was a prospective cohort study of patients aged ≥18 years that visited the ED for an acute pain condition (≤ 2 weeks) and were discharged with an opioid prescription. Patients completed a 14-day diary assessing daily pain medication use and side effects. Results: Mean age of the 386 patients included was 55 ± 16 years; 50% were women. During the 2-week follow-up, 80% of patients consumed at least one dose of opioids. Among the patients who used opioids, 38% (95%CI: 33-48) reported constipation, 27% (95%CI:22-32) nausea/vomiting, 30% (95%CI:25-35) dizziness, 51% (95%CI:45-57) drowsiness, and 77% (95%CI:72-82) reported any side effects. Adjusting for age, sex, and pain condition, patients who used opioids were more likely to report any side effect (OR 7.5, 95%CI:4.3-13.3) and constipation (OR 7.5, 95%CI:3.1-17.9). A significant dose response effect was observed for constipation but not for the other side effects. Nausea/vomiting (OR 2.0, 95%CI:1.1-3.6) and dizziness (OR 1.9, 95%CI:1.1-3.4) were associated with oxycodone compared to morphine. Conclusion: Similar to chronic pain, opioid side effects are highly prevalent during short-term treatment for acute pain. Physicians should be aware and inform patients about those side effects.

Published
2019

8. P029: Are acute pain trajectories after an emergency department visit associated with chronic pain at 3 months?

Author

J. Paquet, J. Chauny, Véronique Castonguay, Alexis Cournoyer, Judy Morris, G. Lavigne, R. Daoust, Justine Lessard, and Éric Piette

Subjects
medicine.medical_specialty, business.industry, Emergency medicine, Emergency Medicine, Chronic pain, Medicine, Emergency department, business, medicine.disease, Acute pain
Abstract

Introduction: Studies suggest that acute pain evolution after an emergency department (ED) visit has been associated with the development of chronic pain. Using group-based trajectory modeling (GBTM), we aimed to evaluate if ED discharged patients with similar pain intensity profiles of change over 14 days are associated with chronic pain at 3 months. Methods: This is a prospective cohort study of patients aged 18 years or older who visited the ED for an acute pain condition (≤2 weeks) and were discharged with an opioid prescription. Patients completed a 14-day diary in which they listed their daily pain intensity level (0-10 numeric rating scale). Three months post-ED visit, participants were interviewed by phone to report their pain intensity related to the initial pain. Results: A total of 305 patients were retained at 3 months (mean age ± SD: 55 ± 15 years, 49% women). Using GBTM, six distinct pain intensity trajectories were identified during the first 14 days of the acute pain period; two linear one with moderate or severe pain during the follow-up (representing almost 40% of the patients) and four cubic polynomial order trajectories, with mild or no-pain at the end of the 14 days (low final pain). Twelve percent (11.9; ±95%CI: 8.2-15.4) of the patients had chronic pain at 3 months. Controlling for age, sex and types of pain condition, patients with trajectories of moderate or severe pain and those with only severe pain were 5.1 (95%CI: 2.2-11.8) and 8.2 (95%CI: 3.4-20.0) times more likely to develop chronic pain at 3 months, respectively, compared to the low final pain group. Conclusion: Trajectories could be useful to early identification of patients at risk of chronic pain.

Published
2019

10. PSY70 - MANAGEMENT COSTS OF CHEMOTHERAPY AND ALLOGENEIC STEM-CELL TRANSPLANT OF CHILDREN AND ADOLESCENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA IN FRANCE

Author

B. Jouaneton, J. Chauny, V. Leprou, F. Di Giambattista, M. Sion, V. Herzog, and L. Grailles

Subjects
Oncology, medicine.medical_specialty, Chemotherapy, business.industry, Health Policy, Internal medicine, medicine.medical_treatment, Lymphoblastic Leukemia, Public Health, Environmental and Occupational Health, medicine, Stem cell, business
Published
2018

11. Survival and Rehospitalization After a First Hospitalization for Heart Failure: a Nationwide Population-Based Cohort Study using the French Egb Database

Author

I. Millot, B. Husson-Robert, C Thonnelier, M. Czekala, J Chauny, C. Bonnet, A. Achouba, and Y. Cottin

Subjects
medicine.medical_specialty, Population based cohort, Text mining, business.industry, Heart failure, Health Policy, Emergency medicine, medicine, Public Health, Environmental and Occupational Health, medicine.disease, business, Data science
Published
2015
Full Text
View/download PDF

12. LO28: Utilité diagnostique des D-dimères pour le diagnostic du syndrome aortique aigu: une revue systématique et méta-analyse

Author

R. Daoust, V. Langlois-Carbonneau, A. Cournoyer, and J. Chauny

Subjects
Emergency Medicine
Abstract

Introduction: Le syndrome aortique aigu (SAA) est une condition potentiellement létale et nécessitant une prise en charge immédiate et fréquemment chirurgicale. Lutilisation dun test de D-dimère a été proposé afin dexclure ce diagnostic suite à de nombreuses études récentes sur le sujet. Dans ce contexte, lobjectif de la présente revue systématique et méta-analyse était dévaluer et de synthétiser lévidence disponible quant à la valeur diagnostique dun dosage de D-dimères pour le SAA. Methods: Les bases de données Medline, Cochrane, ACP Journal Club, DARE, Health technology assessment, NHS Economic evaluation et Embase ont été fouillées en utilisant les mots clés «D-Dimers» et «Acute aortic». Les bibliographies des articles retenus ont également été consultées. Les résultats des études incluses ont été regroupés pour calculer la sensibilité, la spécificité, le rapport de vraisemblance positif (RV+) et négatif (LR-) du test de D-dimères aux seuils choisis par les auteurs. Les sensibilités et spécificités sont présentées avec leurs intervalles de confiance (IC) à 95% et les RV+ et RV- sont donnés à titre indicatif. Results: À partir des 6942 articles initialement identifiés, 34 études portant sur lutilité diagnostique des D-dimères en SAA, incluant un total de 7938 patients, ont été retenues. La prévalence globale de SAA était de 27,1%, mais variait considérablement dune étude à lautre (médiane=38,5%; intervalle interquartile=29% ; prévalence minimale=0.7% ; prévalence maximale=100%). Les seuils de positivité des tests de D-dimères variaient également selon lentreprise les fabriquant. La sensibilité dun test de D-dimères selon le seuil proposé par leur fabriquant était de 91% (IC 95% 86-96) et la spécificité 46% (IC 95% 39-54). Le RV+ était de 1,69 et le VR- était de 0,2. Conclusion: La prévalence très variable du SAA dans la population regroupée par ces études laisse présager une différence entre ces populations et celles rencontrées en médecine durgence. Un test de D-dimères a sensibilité acceptable, mais imparfaite, qui ne semble pas permettre dexclure une pathologie aussi grave que le SAA.

Published
2018

13. P085: Potential benefits of incentive spirometry following a rib fracture: a propensity-score analysis

Author

M. Emond, A. Laguë, B. Batomen Kuimi, V. Boucher, C. Guimont, J. Chauny, J. Shields, E. Bergeron, L. Vanier, M. Plourde, and N. Le Sage

Subjects
Emergency Medicine
Abstract

Introduction: Incentive spirometry (IS) is commonly used in post-operative patients for respiratory recovery. Literature suggest that it can possibly improve lung function and reduce post-operative pulmonary complication. There is no recommendation about the use of IS in the emergency department (ED). However, rib fractures, a common complaint, increase the risk of pulmonary complications. There is heterogeneous ED practice for the management of rib fractures. The objective of this study is to assess the benefits of IS to reduce potential delayed complications in ED discharged patients with confirmed rib fracture. Methods: This is a prospective observational planned sub-study in 4 canadians ED between November 2006 and May 2012. Non-admitted patients over 16 y.o. with a main complaint of minor thoracic injury and at least one suspected/confirmed rib fracture on radiographs were included. Discharge recommendations of IS use was left to attending physician. IS training was done by ED nurses. Main outcomes were pneumonia, atelectasis and hemothorax within 14 days. Analyses were made with propensity score matching. Results: 450 patients with at least one rib fracture were included. Of these, 182 (40%) received IS with a mean age of 57.0 y.o. Patients with IS seem to have worse condition. 61 (33.5%) had 3 fractures comparatively to 56 (20.9) for patient without IS. Although, the groups were similar for mean age, sex and mechanism of injury. There were in total 76 cases of delayed hemothorax (16.9%), 69 cases of atelectasis (15.3%) and five cases of pneumonia (1.1%). The use of IS was not protector for delayed hemothorax (RR= 0.80, 95% CI [0.45 1.36]) and nor for atelectasis or pneumonia (RR=0.74, 95% CI [0.45 1.36]) Conclusion: Our results suggest that unsupervised and broad incentive spirometry use does not seem to add a protective effect against the development of delayed pulmonary complications after a rib fracture. Further study should be made to assess the usefulness of IS in specific injured population in the ED.

Published
2018

14. LO027: Cervical spine injury in trauma patients 65 years and older immobilised in the prehospital setting

Author

J. Chauny, L. Lamy, and D. Ross

Subjects
Geriatrics, education.field_of_study, medicine.medical_specialty, business.industry, Population, Trauma center, Retrospective cohort study, Cervical spine injury, Lower risk, Surgery, Lesion, Internal medicine, Emergency Medicine, medicine, In patient, medicine.symptom, education, business
Abstract

Introduction: Following a protocol derived from the Canadian C-spine Rule (CCR), patients 65 years and older transported by ambulance after trauma require full spinal immobilisation. Immobilisation complicates the transport and the evaluation; potential side effects have been recognized. The aim of this study was to evaluate the effect of mechanism of trauma and age on the rate of cervical injury in a geriatric population. Methods: We conducted a retrospective observational study on patients 65 years and older transported by ambulance to a level-one trauma center from March 2008 to October 2013. The outcome was the rate of clinically important cervical spine injury (CICSI), defined as any fracture, dislocation or ligamentous injury needing treatment or specialised follow up. The rate was calculated in the geriatric population and in the subgroup of patients with minor trauma, defined as a fall from a standing height, a chair or a bed. We then looked at the rate of CICSI based on age to define a subgroup at lower risk of lesion. Results: We included 1221 patients with a mean age of 80 y.o. (SD = 8), 739 women (61%). CICSI was found in 53 patients (4.3%, 95% CI 3.2-5.4). This is similar to the rate found in patients 65 years and older in the NEXUS population (4.6%) and the CCR population (6.0%). The mechanism of injury was a minor trauma for 716 patients (59%). Of those, 24 patients (3.4%, 95% CI 2.1-4.7) had CICSI. The rate increased after 85 y.o in both the overall population (3.4% vs 6.4%) and the minor trauma subgroup (2.6% vs 4.4%). Conclusion: The subgroup of patients 65-84 y.o. with a minor trauma had the lower rate of cervical spine injury (2.6%). In a lot of prehospital systems, those patients are not systematically immobilised for transport. It will be interesting to review the files of all patients with CICSI to identify any possible case that would have been missed without the age criteria.

Published
2016

Catalog

Books, media, physical & digital resources
See catalog results