References of "D'Orio, Vincenzo"
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See detailAdvanced triage to redirect non-urgent emergency department visits to alternative care centers: the PERSEE algorithm
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; PETIT, Meredith ULiege et al

in Acta Clinica Belgica (2021)

Objectives: Primary care treatable visits in the Emergency Department (ED) are part of the different factors leading to the overcrowding. Their triage and diversion to alternative care centers could ... [more ▼]

Objectives: Primary care treatable visits in the Emergency Department (ED) are part of the different factors leading to the overcrowding. Their triage and diversion to alternative care centers could potentially help manage the increasing inflow provided the establishment of an advanced triage to ensure patients’ safety. We aim to suggest a new triage tool, PERSEE, and prove its feasibility, safety and performance. Methods: All self-referrals presented to the ED were triaged with the PERSEE algorithm: first, patients were classified with a five-level ED acuity scale and then evaluated by algorithms to determine their appropriate category (ED or Primary Care). Patients were eligible for a redirection if they were triaged by the acuity scale as level 3 or lower, considered as ambulatory patients and finally categorized as primary care patients. We defined appropriate redirections as patients requiring less than three emergency resources, no emergency-specific treatment and no hospitalization. Results: During the study, 1999 patients were admitted to the ED. Among those, 1333 patients were self-referred (66.9%) of whom 1167 patients were triaged as level 3 or below (58.6%) and 775 patients triaged as ambulatory (39.0%). Among the 775 patients, 200 patients were categorized as primary care treatable (10.0%) and thereby, as potentially eligible for a redirection. We noticed an error rate of 7%, sensitivity of 24.06% and specificity of 97.6%. The redirection rate reached 15% of the self-referrals. Conclusion: These results indicate that PERSEE triage could lead to a safe redirection and could be an efficient tool to reduce ED crowding provided several adjustments. [less ▲]

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See detailUsing simulation to assess patient's self-triage for unscheduled urgent care : the ODISSEE Platform
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; François, Sophie et al

Conference (2021, April 14)

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See detailUsing simulation to assess patient's self-triage for unscheduled urgent care : the ODISSEE platform
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; François, Sophie et al

in Advances in Simulation (2021), 6(Supplement 2),

Development of new technologies in the healthcare system is a current and exciting concern for many physicians. Management of unscheduled primary and emergency care is one of the many areas in which ... [more ▼]

Development of new technologies in the healthcare system is a current and exciting concern for many physicians. Management of unscheduled primary and emergency care is one of the many areas in which technological innovations are starting to emerge. We developed a French-language self-triage platform, called ODISSEE (Outil Décisionnel et Informatif des Structures de Soins Efficientes Exis- tantes), based on previously validated protocols for the triage of out- of-hours primary care calls. We aim to demonstrate its validity and safety as regards patients level of care needs using simulated triage.Development of new technologies in the healthcare system is a current and exciting concern for many physicians. Management of unscheduled primary and emergency care is one of the many areas in which technological innovations are starting to emerge. We developed a French-language self-triage platform, called ODISSEE (Outil Décisionnel et Informatif des Structures de Soins Efficientes Exis- tantes), based on previously validated protocols for the triage of out- of-hours primary care calls. We aim to demonstrate its validity and safety as regards patients level of care needs using simulated triage. [less ▲]

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See detailDevelopment and validation of a predictive model to determine the level of care in patients confirmed with COVID-19
Diep, Anh Nguyet ULiege; GILBERT, Allison ULiege; Saegerman, Claude ULiege et al

in Infectious Diseases (2021)

Background The COVID-19 pandemic has imposed significant challenges on hospital capacity. While mitigating unnecessary crowding in hospitals is favorable to reduce viral transmission, it is more important ... [more ▼]

Background The COVID-19 pandemic has imposed significant challenges on hospital capacity. While mitigating unnecessary crowding in hospitals is favorable to reduce viral transmission, it is more important to prevent readmissions with impaired clinical status due to initially inappropriate level of care. A validated predictive tool to assist clinical decisions for patient triage and facilitate remote stratification is of critical importance. Methods We conducted a retrospective study in patients with confirmed COVID-19 stratified into two levels of care, namely ambulatory care and hospitalization. Data on socio-demographics, clinical symptoms, and comorbidities was collected during the first (N=571) and second waves (N=174) of the pandemic in Belgium (March 2 to December 6, 2020). Univariate and multivariate logistic regressions were performed to build and validate the prediction model. Results Significant predictors of hospitalization were old age (OR=1.08, 95%CI:1.06-1.10), male gender (OR=4.41, 95%CI: 2.58-7.52), dyspnea (OR 6.11, 95%CI: 3.58-10.45), dry cough (OR 2.89, 95%CI: 1.54-5.41), wet cough (OR 4.62, 95%CI: 1.93-11.06), hypertension (OR 2.20, 95%CI: 1.17-4.16) and renal failure (OR 5.39, 95%CI: 1.00-29.00). Rhinorrhea (OR 0.43, 95%CI: 0.24-0.79) and headache (OR 0.36, 95%CI: 0.20-0.65) were negatively associated with hospitalization. A receiver operating characteristic (ROC) curve was constructed and the area under the ROC-curve was 0.931 (95% CI: 0.910-0.953) for the prediction model (first wave) and 0.895 (95% CI: 0.833-0.957) for the validated data set (second wave). Conclusion With a good discriminating power, the prediction model might identify patients who require ambulatory care or hospitalization, and support clinical decisions by Emergency Department staff and general practitioners. [less ▲]

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See detailClinical decision support tool for diagnosis of COVID-19 in hospitals
Saegerman, Claude ULiege; GILBERT, Allison ULiege; Donneau, Anne-Françoise ULiege et al

in PLoS ONE (2021), 16(3 March),

Background The coronavirus infectious disease 19 (COVID-19) pandemic has resulted in significant morbidities, severe acute respiratory failures and subsequently emergency departments’ (EDs) overcrowding ... [more ▼]

Background The coronavirus infectious disease 19 (COVID-19) pandemic has resulted in significant morbidities, severe acute respiratory failures and subsequently emergency departments’ (EDs) overcrowding in a context of insufficient laboratory testing capacities. The development of decision support tools for real-time clinical diagnosis of COVID-19 is of prime importance to assist patients’ triage and allocate resources for patients at risk. Methods and principal findings From March 2 to June 15, 2020, clinical patterns of COVID-19 suspected patients at admission to the EDs of Liège University Hospital, consisting in the recording of eleven symptoms (i.e. dyspnoea, chest pain, rhinorrhoea, sore throat, dry cough, wet cough, diarrhoea, headache, myalgia, fever and anosmia) plus age and gender, were investigated during the first COVID-19 pandemic wave. Indeed, 573 SARS-CoV-2 cases confirmed by qRT-PCR before mid-June 2020, and 1579 suspected cases that were subsequently determined to be qRT-PCR negative for the detection of SARS-CoV-2 were enrolled in this study. Using multivariate binary logistic regression, two most relevant symptoms of COVID-19 were identified in addition of the age of the patient, i.e. fever (odds ratio [OR] = 3.66; 95% CI: 2.97–4.50), dry cough (OR = 1.71; 95% CI: 1.39–2.12), and patients older than 56.5 y (OR = 2.07; 95% CI: 1.67–2.58). Two additional symptoms (chest pain and sore throat) appeared significantly less associated to the confirmed COVID-19 cases with the same OR = 0.73 (95% CI: 0.56–0.94). An overall pondered (by OR) score (OPS) was calculated using all significant predictors. A receiver operating characteristic (ROC) curve was generated and the area under the ROC curve was 0.71 (95% CI: 0.68–0.73) rendering the use of the OPS to discriminate COVID-19 confirmed and unconfirmed patients. The main predictors were confirmed using both sensitivity analysis and classification tree analysis. Interestingly, a significant negative correlation was observed between the OPS and the cycle threshold (Ct values) of the qRT-PCR. Conclusion and main significance The proposed approach allows for the use of an interactive and adaptive clinical decision support tool. Using the clinical algorithm developed, a web-based user-interface was created to help nurses and clinicians from EDs with the triage of patients during the second COVID-19 wave. Copyright: © 2021 Saegerman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. [less ▲]

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See detailGestion des admission aux urgences durant la pandémie de COVID-19 au sein du CHU de Liège : Apport d'un centre de tri avancé
GILBERT, Allison ULiege; PIAZZA, Justine ULiege; SZECEL, Julien ULiege et al

in Revue Médicale de Liège (2020), 75(Supplement), 11-17

résumé : La pandémie de COVID-19 a débuté au mois de mars 2020 sur le territoire belge. Elle a contraint nos institu- tions hospitalières à une série de réorganisations singulières soutenues par ... [more ▼]

résumé : La pandémie de COVID-19 a débuté au mois de mars 2020 sur le territoire belge. Elle a contraint nos institu- tions hospitalières à une série de réorganisations singulières soutenues par l’activation du Plan d’Urgence Hospitalier. Cet article a pour objet de décrire l’expérience du Centre Hospitalier Universitaire de Liège (CHU de Liège) durant la pandémie de COVID-19 et de relater l’efficience de la mise en place d’un centre de tri avancé en amont des services d’urgences pour la gestion des admissions hospitalières. Méthodes : dès le 2 Mars 2020, le CHU de Liège a mis en place une infrastructure d’accueil des patients suspects d’infection par le SARS-CoV-2. D’abord initiée au sein de l’institution hospitalière, la nécessité d’une infrastructure indépendante s’est rapidement révélée indispensable et a, dès lors, vu le jour dès la fin du mois de mars, sur les deux sites hospitaliers universitaires. Du 2 mars au 3 mai 2020, l’ensemble des données relatives aux visites au sein des centres de tri avancé ont été collectées (nombre d’ad- missions, motif des visites, examens complémentaires et évolutions cliniques). Résultats : sur la période de l’étude, 3.094 patients ont transité par les centres de tri du CHU de Liège. Cette fréquentation était constituée d’un volume global de 3.431 contacts dont 337 représentaient des réad- missions. La sensibilité et la spécificité des centres de tri en regard de la nécessité d’une hospitalisation étaient, respectivement, de 87,9 % et 93,4 %. Conclusion : notre expérience suggère une efficience optimale des centres de tri avancé, en amont des structures hospitalières tradi- tionnelles, pour orienter de manière appropriée le flux des patients suspects d’infection par le SARS-CoV-2. [less ▲]

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See detailCOVID-19 pneumonia and acute pulmonary embolism: a case report
SZECEL, Julien ULiege; GILBERT, Allison ULiege; GHUYSEN, Alexandre ULiege et al

in International Journal of Medical Reviews and Case Reports (2020)

Since December 2019, a novel coronavirus (SARS-Cov2) disease emerged in China with the evidence of multiple cases of severe pneumonia. Since then, various clinical findings and complications related to ... [more ▼]

Since December 2019, a novel coronavirus (SARS-Cov2) disease emerged in China with the evidence of multiple cases of severe pneumonia. Since then, various clinical findings and complications related to that infection have been described. Recently, studies reported various cases of thrombotic events complicating SARS-Cov2 infections. Particularly, the incidence of pulmonary embolism appears to be higher in patients with the novel coronavirus disease. In the presence of clinical and/or biological evocative findings, pulmonary embolism has to be excluded. Recent arguments tend to prone thromboprophylaxis early in specific populations. [less ▲]

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See detailLe cas clinique du mois. Complication hémorragique d’une forme sévère de maladie de moyamoya
ANGELOZZI, Valeria ULiege; GERMAY, Caroline ULiege; GILBERT, Allison ULiege et al

in Revue Médicale de Liège (2020), 75(2), 75-77

La maladie de moyamoya est une vasculopathie cérébrale souvent méconnue. Sa découverte est majoritairement brutale dans les suites de la survenue d’un accident vasculaire ischémique ou, dans certains cas ... [more ▼]

La maladie de moyamoya est une vasculopathie cérébrale souvent méconnue. Sa découverte est majoritairement brutale dans les suites de la survenue d’un accident vasculaire ischémique ou, dans certains cas, hémorragique. L’artériographie est l’examen de choix pour confirmer le diagnostic. Différentes approches thérapeutiques ont été proposées, qu’elles soient médicamenteuses, endoscopiques ou chirurgicales. Nous présentons le cas d’une jeune patiente chez qui un diagnostic de maladie de moyamoya a été posé dans le décours d’une hémorragie cérébrale avec altération rapide de l’état de conscience. [less ▲]

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See detailSALOMON, un modèle coopératif entre la première et la seconde ligne de soins pour les appels d'urgence nocturnes
BRASSEUR, Edmond ULiege; GILBERT, Allison ULiege; Servotte, Jean-Christophe ULiege et al

in Revue Médicale de Liège (2020), 75(2), 83-88

L’objectif de notre étude est d’apporter une réponse originale à la problématique de la permanence médicale de première ligne liée au vieillissement médical et à la charge de travail croissante. Nous ... [more ▼]

L’objectif de notre étude est d’apporter une réponse originale à la problématique de la permanence médicale de première ligne liée au vieillissement médical et à la charge de travail croissante. Nous proposons, à cet effet, la mise en place d’une interface de régulation des appels en période critique (nuit profonde) au moyen d’un outil algorithmique original dénommé SALOMON («Sys- tème Algorithmique Liégeois d’Orientation pour la Méde- cine Omnipraticienne Nocturne»). En fonction du degré de gravité supputé, la plateforme propose l’orientation opti- male du patient parmi quatre options possibles : renvoi de la demande vers le centre d’appel unifié 112 et prise en charge par les moyens de l’Aide Médicale Urgente (AMU), orientation du malade vers un service d’urgence spécialisé (SUS) de son choix pour une Mise Au Point Hospitalière (MAPH), mise en Contact avec le Médecin Généraliste de garde (CMG) ou enfin prise en charge par une Visite Diffé- rée (VD) via le médecin de famille. Après une description de l’outil, nous présentons l’étude de faisabilité qui a porté sur une période de 12 mois. Cette étude préliminaire était destinée à vérifier la robustesse de SALOMON avant de prévoir, le cas échéant, sa diffusion au sein d’une zone plus vaste. Les résultats préliminaires suggèrent une grande fiabilité de SALOMON. Nous avons également observé que son utilisation était associée à un réel état de satis- faction de l’ensemble des acteurs impliqués, qu’ils aient été infirmiers dispatcheurs ou médecins généralistes. Sous réserve d’une étude à plus grande échelle, les bénéfices actuellement notés en matière d’épargne de ressources humaines durant la garde de première ligne ont rapidement entraîné la fusion de deux zones de garde. [less ▲]

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See detailImmersion in an emergency department triage center during the Covid-19 outbreak: first report of the Liège University hospital experience
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; PETIT, Meredith ULiege et al

in Acta Clinica Belgica (2020)

Objectives: Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective ... [more ▼]

Objectives: Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective solution proposed in disaster medicine, also works well to manage Emergency Department (ED) flow. The aim of this study was to describe the role of an ED Triage Center for patients with suspected novel coronavirus disease (Covid-19) and character- ize the patient flow. Methods: In March 2020, we established a Covid-19 triage center close to the Liège University EDs. From March 2 to March 23, we planned to analyze the specific flow of patients admitted to this triage zone and their characteristics in terms of inner specificities, work-up and manage- ment. During this period, all patients presented to the ED with symptoms suggestive of Covid- 19 were included in the study. Results: A total amount of 1071 patients presented to the triage center during the study period. 41.50% of the patients presented with flu-like symptoms. In 82.00% of the cases, no risk factor of virus transmission was found. The SARS-Cov2 positive patients represented 29.26% of the screened patients. 83.00% of patients were discharged home while 17.00% were admitted to the hospital. Conclusion: Our experience suggests that triage centers for the assessment and management of Covid-19 suspected patients is an essential key strategy to prevent the spread of the disease among non-symptomatic patients who present to the EDs for care. This allows for a disease- centered work-up and safer diversion of Covid-19 patients to specific hospital units. [less ▲]

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See detailNouvelle approche de régulation de la demande de soins non planifiés: l'application interactive d'auto-triage ODISSEE
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; GHUYSEN, Alexandre ULiege et al

in Revue Médicale de Liège (2020)

La régulation de la demande de soins non planifiés fait partie des approches envisagées pour obtenir une meilleure répartition de la demande de soins parmi les différents intervenants de la santé. En ... [more ▼]

La régulation de la demande de soins non planifiés fait partie des approches envisagées pour obtenir une meilleure répartition de la demande de soins parmi les différents intervenants de la santé. En effet, tant la première ligne de soins que les services d’urgence font face à des flux de patients conséquents, saturant fréquemment les ressources qu’ils possèdent pour y répondre. L’apparition de nouvelles technologies et l’entrée dans la pratique courante de la diffusion de l’information médicale se sont révélées être des précurseurs de nouvelles stratégies adaptatives, mais également de nouveaux défis quotidiens. La création d’une application interactive permettant l’auto-triage du patient vers la ligne de soins la plus appropriée fait intervenir ces différents concepts. Nous avons donc développé une plateforme interactive, l’application ODISSEE (Outil Décisionnel et Informatif des Structures de Soins Efficientes Existantes), permettant au patient d’autoévaluer la gravité de son problème et de bénéficier d’un conseil avisé sur le niveau de soins à envisager. Les protocoles utilisés sont directement issus d’un outil créé précédemment dans notre institution et ayant fait ses preuves durant 5 années d’utilisation, l’outil SALOMON (Système Algorithmique Liégeois d’Orientation pour la Médecine Omnipraticienne Nocturne). La création d’un système interactif d’auto-triage du patient le guidant vers le niveau de soins le plus approprié pourrait être une méthode prometteuse pour la régulation de la demande de soins non planifiés. [less ▲]

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See detailEmergency Department Crowding: why do patients walk-in?
BRASSEUR, Edmond ULiege; GILBERT, Allison ULiege; Servotte, Jean-Christophe ULiege et al

in Acta Clinica Belgica (2019)

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See detailErythema ab igne and its association with cannabinoid hyperemesis syndrome : a case report
Sime Sidieu, Delphine; GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege et al

in International Journal of Medical Reviews and Case Reports (2019)

The erythema ab igne is an uncommon skin disorder related to repeated heat exposure such as open fires or heating pads. Cannabinoid hyperemesis syndrome is an entity including several symptoms such as ... [more ▼]

The erythema ab igne is an uncommon skin disorder related to repeated heat exposure such as open fires or heating pads. Cannabinoid hyperemesis syndrome is an entity including several symptoms such as nausea, vomiting or frequent abdominal pain following marijuana use. Most of those symptoms can be relieved by hot showering or baths. Recently in the literature, erythema ab igne has been associated with cannabinoid hyperemesis syndrome because cannabis users tend to resort to heating pads to relieve persistent abdominal pain. We report the case of a patient with recurrent vomiting and abdominal pain attributed to cannabinoid hyperemesis syndrome, whose physical examination revealed an erythema ab igne. [less ▲]

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See detailParsonage-Turner Syndrome as a rare extra hepatic complication of hepatitis E infection
Ngah Njabom, Claude Bérenger ULiege; GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege et al

in European Journal of Case Reports in Internal Medicine (2019)

Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered ... [more ▼]

Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered, among other factors, by some viral infections, although its pathophysiology remains unclear. Moreover, it has rarely been related to hepatitis E virus infection. We report the case of a 33-year-old man who was diagnosed with Parsonage-Turner syndrome following acute hepatitis E infection. [less ▲]

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See detailImpact of a prehospital discrimination between trauma patients with or without early acute coagulopathy of trauma and the need for damage control resuscitation: rationale and design of a multicenter randomized phase II trial.
TONGLET, Martin ULiege; D'ORIO, Vincenzo ULiege; MOENS, Didier ULiege et al

in Acta Chirurgica Belgica (2019)

BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be ... [more ▼]

BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be evaluated. The primary objective of this study is to evaluate the impact on mortality of a prehospital discrimination between trauma patients with or without a potential need for damage control resuscitation. METHODS: The trial will be designed as randomized phase II clinical trial with comparison of the experimental protocol against the standard of care. The TICCS will be calculated on the site of injury for the patients of the intervention group and treatment will be guided by the TICCS value. Seven days mortality, 30 days mortality, global use of blood products and global hospital length-of-stay will be compared. DISCUSSION: Many data suggest that a very early flagging of trauma patients in need for DCR would be beneficial but this need to be proved. Do we improve our quality of care by an earlier diagnosis? Does a prehospital discrimination between trauma patients with or without a potential need for DCR has a positive impact? [less ▲]

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