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Article ; Online: Comment to 'Choosing the right score and threshold to identify low-risk patients with an upper gastrointestinal bleeding is critical'.

Ageron, Francois-Xavier / Rivieri, Sirio

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2023 Volume 30, Issue 2, Page(s) 147

MeSH term(s)	Humans ; Gastrointestinal Hemorrhage ; Risk Assessment
Language	English
Publishing date	2023-02-21
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000999
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Article ; Online: The role of tranexamic acid in trauma - a life-saving drug with proven benefit.

Roberts, Ian / Ageron, Francois-Xavier

Nature reviews. Disease primers

2022 Volume 8, Issue 1, Page(s) 34

MeSH term(s)	Antifibrinolytic Agents/pharmacology ; Antifibrinolytic Agents/therapeutic use ; Hemorrhage ; Humans ; Tranexamic Acid/therapeutic use
Chemical Substances	Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2022-05-26
Publishing country	England
Document type	Letter ; Comment
ISSN	2056-676X
ISSN (online)	2056-676X
DOI	10.1038/s41572-022-00367-5
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Article ; Online: Identifying traumatic significant haemorrhage is challenging for patient with low and intermediate risk, not when bleeding is obvious.

Darioli, Vincent / Ageron, François-Xavier

Scandinavian journal of trauma, resuscitation and emergency medicine

2023 Volume 31, Issue 1, Page(s) 32

MeSH term(s)	Humans ; Hemorrhage/diagnosis ; Hemorrhage/etiology
Language	English
Publishing date	2023-06-26
Publishing country	England
Document type	Letter
ZDB-ID	2455990-8
ISSN	1757-7241 ; 1757-7241
ISSN (online)	1757-7241
ISSN	1757-7241
DOI	10.1186/s13049-023-01096-8
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Article ; Online: Effects of tranexamic acid treatment in severely and non-severely injured trauma patients.

Ageron, Francois-Xavier / Shakur-Still, Haleema / Roberts, Ian

Transfusion

2022 Volume 62 Suppl 1, Page(s) S151–S157

Abstract: Background: Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non-severely injured trauma patients.: Study ... ...

Abstract	Background: Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non-severely injured trauma patients. Study design and methods: We did an individual patient data meta-analysis of randomized trials with over 1000 trauma patients that assessed the effects of TXA on survival. We defined the severity of injury according to characteristics at first assessment: systolic blood pressure of less than 90 mm Hg and a heart rate greater than 120 beats per minute or Glasgow Coma Scale score of less than nine or any GCS with one or more fixed dilated pupils. The primary measure was survival on the day of the injury. We examined the effect of TXA on survival in severely and non-severely injured patients and how these effects vary with the time from injury to treatment. Results: We obtained data for 32,944 patients from two randomized trials. Tranexamic acid significantly increased survival on the day of the injury (OR = 1.22, 95% CI 1.11-1.34; p < .01). The effect of tranexamic acid on survival in non-severely injured patients (OR = 1.25, 1.03-1.50) was similar to that in severely injured patients (OR = 1.22, 1.09-1.37) with no significant heterogeneity (p = .87). In severely and non-severely injured pateints, treatment within the first hour after injury was the most effective. Discussion: Early tranexamic acid treatment improves survival in both severely and non-severely injured trauma patients. Its use should not be restricted to the severely injured.
MeSH term(s)	Antifibrinolytic Agents/therapeutic use ; Glasgow Coma Scale ; Hemorrhage/drug therapy ; Humans ; Tranexamic Acid/therapeutic use ; Wounds and Injuries/drug therapy
Chemical Substances	Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2022-06-24
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16954
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Article ; Online: Étude de l’exposition médicamenteuse aux cardiotropes des sujets âgés consultant aux urgences pour chute avec malaise en Rhône-Alpes.

Hélias, Gaëlle / Garnier, Virginie / Enzinger, Lukas / Eymaron, Maeva / Ageron, Francois-Xavier / Couturier, Pascal

Geriatrie et psychologie neuropsychiatrie du vieillissement

2023 Volume 21, Issue 2, Page(s) 173–184

Abstract: Study of cardiovascular drugs usage, among elderly subjects admitted to the emergency department for syncopal falls in Rhône-Alpes region. Polypharmacy and cardiovascular medication usage are risk factors for falls in the elderly. This study included ... ...

Title translation	Study of cardiovascular drugs usage, among elderly subjects admitted to the emergency department for syncopal falls in Rhône-Alpes region.
Abstract	Study of cardiovascular drugs usage, among elderly subjects admitted to the emergency department for syncopal falls in Rhône-Alpes region. Polypharmacy and cardiovascular medication usage are risk factors for falls in the elderly. This study included subjects aged 75 and over, admitted in the emergency department for falls, based on evaluation data of professional practices carried out in the Nord Alpine region by the French Network of North-Alps Emergency Departments (Réseau Nord Alpin des Urgences, RENAU). The patients included were divided into 4 groups: "syncope", "accidental falls", "repeated falls" and "other types of fall". From the emergency room admission prescriptions, we studied the consumption of cardiovascular drugs in number and quality in the "syncope" group compared to other types of falls. The main objective in this study was to highlight higher cardiovascular drug usage among the elderly patients admitted to the emergency department for syncopal falls, in comparison with other types of falls. We included 1,476 patients among whom 262 patients came for "syncopal falls". We found superior usage of cardiovascular medication among syncopal falls compared to other type of falls (p < 0,01). However, there is no statistically significant association between inappropriate cardiovascular drug prescriptions, and the type of falls. The "standardized" fall assessment whose orthostatic hypotension investigation, is not always exhaustive in the emergency room. Orthostatic hypotension diagnostic is insufficiently sought in the emergency room. This study highlights a significantly higher usage of diuretic medication within the syncope group, in comparison to the other groups, and especially loop diuretic. Antihypertensive drugs (angiotensin-converting enzyme inhibitor, angiotensin II receptor blockers, calcium inhibitor) are also recurrent within the syncope group compared to the others. A careful supervising of these prescriptions among elderly patients seems required. These data prompt to revise prescriptions during fall related hospitalizations, and then with the primary-care physician, or with the cardiologist.
MeSH term(s)	Aged ; Humans ; Hypotension, Orthostatic/complications ; Hypotension, Orthostatic/diagnosis ; Accidental Falls ; Cardiovascular Agents/adverse effects ; Syncope/epidemiology ; Hospitalization ; Emergency Service, Hospital
Chemical Substances	Cardiovascular Agents
Language	French
Publishing date	2023-07-31
Publishing country	France
Document type	English Abstract ; Journal Article
ISSN	2115-7863
ISSN (online)	2115-7863
DOI	10.1684/pnv.2023.1107
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Article ; Online: External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland.

Rivieri, Sirio / Carron, Pierre-Nicolas / Schoepfer, Alain / Ageron, Francois-Xavier

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2022 Volume 30, Issue 1, Page(s) 32–39

Abstract: Upper gastrointestinal bleeding (UGIB) presents a high incidence in an emergency department (ED) and requires careful evaluation of the patient's risk level to ensure optimal management. The primary aim of this study was to externally validate and ... ...

Abstract	Upper gastrointestinal bleeding (UGIB) presents a high incidence in an emergency department (ED) and requires careful evaluation of the patient's risk level to ensure optimal management. The primary aim of this study was to externally validate and compare the performance of the Rockall score, Glasgow-Blatchford score (GBS), modified GBS and AIMS65 score to predict death and the need for an intervention among patients with UGIB. This was a cross-sectional observational study of patients consulting the ED of a Swiss tertiary care hospital with UGIB. Primary outcomes were the inhospital need for an intervention, including transfusion, or an endoscopic procedure or surgery or inhospital death. The secondary outcome was inhospital death. We included 1521 patients with UGIB, median age, 68 (52-81) years; 940 (62%) were men. Melena or hematemesis were the most common complaints in 1020 (73%) patients. Among 422 (28%) patients who needed an intervention or died, 76 (5%) died in the hospital. Accuracy of the scoring systems assessed by receiver operating characteristic curves showed that the Glasgow-Blatchford bleeding and modified GBSs had the highest discriminatory capacity to determine inhospital death or the need of an intervention [AUC, 0.77 (95% CI, 0.75-0.80) and 0.78 (95% CI, 0.76-0.81), respectively]. AIMS65 and the pre-endoscopic Rockall score showed a lower discrimination [AUC, 0.68 (95% CI, 0.66-0.71) and 0.65 (95% CI, 0.62-0.68), respectively]. For a GBS of 0, only one patient (0.8%) needed an endoscopic intervention. The modified Glasgow-Blatchford and Glasgow-Blatchford bleeding scores appear to be the most accurate scores to predict the need for intervention or inhospital death.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Switzerland ; Cross-Sectional Studies ; Gastrointestinal Hemorrhage/diagnosis ; Gastrointestinal Hemorrhage/therapy ; Gastrointestinal Hemorrhage/etiology ; ROC Curve ; Hospitals ; Risk Assessment/methods ; Severity of Illness Index ; Prognosis
Language	English
Publishing date	2022-11-10
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000983
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Article: Urgences hospitalières : crise COVID-19 et aspects organisationnels.

Ageron, François-Xavier / Sarasin, François / Pasquier, Mathieu / Carron, Pierre-Nicolas

Revue medicale suisse

2020 Volume 16, Issue 692, Page(s) 924–929

Abstract: Emergency departments are on the front line in the management of COVID-19 cases, from screening to the initial management of the most severe cases. The clinical presentation of COVID-19 range from non-specific symptoms to adult acute respiratory distress ...

Title translation	Emergency department : COVID-19 crisis and organizational aspects.
Abstract	Emergency departments are on the front line in the management of COVID-19 cases, from screening to the initial management of the most severe cases. The clinical presentation of COVID-19 range from non-specific symptoms to adult acute respiratory distress syndrome (ARDS). Diagnosis is based on PCR from a nasopharyngeal swab and emergency treatment rely on oxygen therapy. Patient's orientation (home, hospitalization, admission in intensive care unit) is a central aspect of emergency management. The shift from a strategy of systematic recognition of potential cases to the one of epidemic mitigation required hospital emergency medicine services to implement crisis management measures, to guarantee admission and hospitalization capacity.
MeSH term(s)	Adult ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Emergency Medical Services ; Emergency Service, Hospital/organization & administration ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; SARS-CoV-2
Keywords	covid19
Language	French
Publishing date	2020-05-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
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Zs.A 5998: Show issues

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Article ; Online: Problems With Clinical Application of Low-Dose Vasopressin for Traumatic Hemorrhagic Shock.

Gauss, Tobias / Bouzat, Pierre / Ageron, Francois-Xavier

JAMA surgery

2020 Volume 155, Issue 4, Page(s) 363

MeSH term(s)	Arginine Vasopressin ; Dietary Supplements ; Humans ; Shock, Hemorrhagic/drug therapy ; Shock, Hemorrhagic/etiology ; Vasopressins
Chemical Substances	Vasopressins (11000-17-2) ; Arginine Vasopressin (113-79-1)
Language	English
Publishing date	2020-01-15
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2019.5433
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Article ; Online: Survival is surfing on the guidelines wave.

Ageron, François-Xavier / Debaty, Guillaume

Resuscitation

2016 Volume 98, Page(s) e2–3

MeSH term(s)	Cardiopulmonary Resuscitation/standards ; Emergency Medical Services ; France ; Guideline Adherence ; Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Practice Guidelines as Topic ; Registries
Language	English
Publishing date	2016-01
Publishing country	Ireland
Document type	Letter
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2015.10.014
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Article ; Online: Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria.

Ageron, Francois-Xavier / Coats, Timothy J / Darioli, Vincent / Roberts, Ian

Scandinavian journal of trauma, resuscitation and emergency medicine

2021 Volume 29, Issue 1, Page(s) 6

Abstract: Background: Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score ( ... ...

Abstract	Background: Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death from bleeding. Methods: We conducted an external validation of the BATT score using data from the UK Trauma Audit Research Network (TARN) from 1st January 2017 to 31st December 2018. We evaluated the impact of tranexamic acid treatment thresholds in trauma patients. Results: We included 104,862 trauma patients with an injury severity score of 9 or above. Tranexamic acid was administered to 9915 (9%) patients. Of these 5185 (52%) received prehospital tranexamic acid. The BATT score had good accuracy (Brier score = 6%) and good discrimination (C-statistic 0.90; 95% CI 0.89-0.91). Calibration in the large showed no substantial difference between predicted and observed death due to bleeding (1.15% versus 1.16%, P = 0.81). Pre-hospital tranexamic acid treatment of trauma patients with a BATT score of 2 or more would avoid 210 bleeding deaths by treating 61,598 patients instead of avoiding 55 deaths by treating 9915 as currently. Conclusion: The BATT score identifies trauma patient at risk of significant haemorrhage. A score of 2 or more would be an appropriate threshold for pre-hospital tranexamic acid treatment.
MeSH term(s)	Adolescent ; Adult ; Aged ; Antifibrinolytic Agents/therapeutic use ; Emergency Medical Services ; Female ; Hemorrhage/mortality ; Hemorrhage/prevention & control ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Patient Selection ; Predictive Value of Tests ; Risk Assessment ; Tranexamic Acid/therapeutic use ; Wounds and Injuries/complications ; Wounds and Injuries/mortality ; Wounds and Injuries/therapy ; Young Adult
Chemical Substances	Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2021-01-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2455990-8
ISSN	1757-7241 ; 1757-7241
ISSN (online)	1757-7241
ISSN	1757-7241
DOI	10.1186/s13049-020-00827-5
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