rahul kashyap - Academia.edu (original) (raw)

Papers by rahul kashyap

Research paper thumbnail of Knowledge of signs, treatment and need for urgent management in patients presenting with an acute ischaemic stroke or transient ischaemic attack: a prospective study

Emergency Medicine Journal, 2008

To assess stroke awareness among patients presenting to the emergency department with an acute is... more To assess stroke awareness among patients presenting to the emergency department with an acute ischaemic stroke or transient ischaemic attack (TIA). A consecutive cohort of patients presenting with a cerebrovascular event was prospectively enrolled over a 15-month period and questionnaires were administered. If the patient was unable to respond to the questions or answer the questionnaire, it was administered to the primary caregiver. Comprehension of having a cerebrovascular event, reason for delay in presentation, mode of arrival and knowledge of treatment modalities were determined. Only 42% of 400 patients thought they were having a stroke or TIA. The median time to presentation was 3.4 h. Delayed presentation was almost equal in men and women. When asked about onset, 19.4% thought that a stroke came on gradually and only 51.9% thought immediate presentation was crucial. 20.8% of patients had heard of thrombolysis. Community knowledge of ischaemic stroke needs to be enhanced so that individuals present earlier, leading to timely management.

Research paper thumbnail of Alcohol Consumption and Development of Acute Respiratory Distress Syndrome: A Population-Based Study

International Journal of Environmental Research and Public Health, 2009

This retrospective population-based study evaluated the effects of alcohol consumption on the dev... more This retrospective population-based study evaluated the effects of alcohol consumption on the development of acute respiratory distress syndrome (ARDS). Alcohol consumption was quantified based on patient and/or family provided information at the time of hospital admission. ARDS was defined according to American-European consensus conference (AECC). From 1,422 critically ill Olmsted county residents, 1,357 had information about alcohol use in their medical records, 77 (6%) of whom developed ARDS. A history of significant alcohol consumption (more than two drinks per day) was reported in 97 (7%) of patients. When adjusted for underlying ARDS risk factors (aspiration, chemotherapy, high-risk surgery, pancreatitis, sepsis, shock), smoking, cirrhosis and gender, history of significant alcohol consumption was associated with increased risk of ARDS development (odds ratio 2.9, 95% CI 1.3-6.2). This population-based study confirmed that excessive alcohol consumption is associated with higher risk of ARDS.

Research paper thumbnail of 79: Serum Magnesium as a Predictor of Stroke Severity

Annals of Emergency Medicine, 2007

Research paper thumbnail of Long-Term Survival and Quality of Life After Transfusion-Associated Pulmonary Edema in Critically III Medical Patients

Chest, 2010

A hydrostatic edema (transfusion-associated circulatory overload [TACO]) and a permeability edema... more A hydrostatic edema (transfusion-associated circulatory overload [TACO]) and a permeability edema (transfusion-related acute lung injury [TRALI]) are common pulmonary complications of blood transfusion. With advances in transfusion safety, in particular regarding the transmission of infectious agents, TRALI and TACO emerged as the most important transfusion complications. According to a US Food and Drug Administration report, TRALI was the most frequent cause of transfusion-related fatalities (65%) reported to the Food and Drug Administration during the years 2005 to 2007, with TACO (10%) and microbial contamination (12%) being the second most important reported causes of death. 1 Our previous Background: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TRALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TRALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group.

Research paper thumbnail of Blood Pressure Hemodynamics in Acute Ischemic Stroke: Association with Stroke Severity, Disability and Death

Academic Emergency Medicine, 2007

Research paper thumbnail of 45: Computerized Recruiting for Clinical Research in the Emergency Department

Annals of Emergency Medicine, 2008

Research paper thumbnail of 173: Functional Outcome Following an Acute Ischemic Stroke: Sex Differences

Annals of Emergency Medicine, 2008

Research paper thumbnail of 4: Hyperglycemia Does Not Predict Functional Outcome in Lacunar Strokes

Annals of Emergency Medicine, 2008

Research paper thumbnail of 108: Comparing the FOUR Score and Glasgow Coma Scale Performed by Diverse Evaluators

Annals of Emergency Medicine, 2007

Research paper thumbnail of 37: Lower Thoracic Fluid Impedance Measured Non-invasively by Impedance Cardiography Predicts ICU Admission and In-hospital Mortality in Emergency Department Shock Patients

Annals of Emergency Medicine, 2008

Research paper thumbnail of 332: The New FOUR Score Coma Scale as a Predictor of Functional Outcome at Hospital Discharge Following ED Presentation for Neurologic Complaint

Annals of Emergency Medicine, 2007

Research paper thumbnail of Mortality rate of vasopressor-dependent septic shock from 1997 through 2006

Research paper thumbnail of 117: Presence of Pain in Patients With Stroke or Transient Ischemic Attack Coming to the Emergency Department

Annals of Emergency Medicine, 2008

Research paper thumbnail of Role of Statins in Functional Outcome Following an Acute Ischemic Stroke

Academic Emergency Medicine, 2007

Research paper thumbnail of Accuracy of waste blood measurement in critically ill patients

Intensive Care Medicine, 2011

Research paper thumbnail of Validation of a New Coma Scale, the FOUR Score, in the Emergency Department

Neurocritical Care, 2009

Objective Full Outline of Unresponsiveness (FOUR) score has previously been validated scale in th... more Objective Full Outline of Unresponsiveness (FOUR) score has previously been validated scale in the Neurosciences Intensive Care Unit. In this study, we sought to validate the use of FOUR score in the emergency department (ED) using non-neurology staff. We also compared its performance to the Glasgow Coma Scale (GCS) and correlated it to functional outcome at hospital discharge and overall survival. Methods We prospectively rated 69 patients with initial neurologic symptoms presenting to the ED. Three types of examiners performed the FOUR score: ED physician, ED resident, and ED nurse. Patients were followed through hospital discharge; functional outcome was measured using modified Rankin Score (mRS). Results Interrater reliability for FOUR score and GCS was excellent (respectively, κw = 0.88 and 0.86). Both FOUR score and GCS predicted functional outcome, and overall survival with and without adjustment for age, sex, and alertness group. Conclusion The FOUR score can be reliably used in the ED by non-neurology staff. Both FOUR score and GCS performed equally well, but the neurologic detail incorporated in the FOUR score makes it more useful in management and triage of patients.

Research paper thumbnail of 202: Best “Better Early Stroke Treatment”: Implementation of Nursing Questionnaire Aids in Triage of Acute Ischemic Stroke Patients

Annals of Emergency Medicine, 2008

Research paper thumbnail of Ischemic Stroke in Young Adults: Etiology and Outcome

Academic Emergency Medicine, 2007

Research paper thumbnail of Acute lung injury prediction score: derivation and validation in a population based sample

European Respiratory Journal, 2010

Early recognition of patients at high risk of acute lung injury (ALI) is critical for successful ... more Early recognition of patients at high risk of acute lung injury (ALI) is critical for successful enrollment of patients in prevention strategies for this devastating syndrome.

Research paper thumbnail of 247: Is Non-invasive Impedance Cardiography Recording for Shock Patients in the Emergency Department Useful for Outcome Analysis

Annals of Emergency Medicine, 2007

Research paper thumbnail of Knowledge of signs, treatment and need for urgent management in patients presenting with an acute ischaemic stroke or transient ischaemic attack: a prospective study

Emergency Medicine Journal, 2008

To assess stroke awareness among patients presenting to the emergency department with an acute is... more To assess stroke awareness among patients presenting to the emergency department with an acute ischaemic stroke or transient ischaemic attack (TIA). A consecutive cohort of patients presenting with a cerebrovascular event was prospectively enrolled over a 15-month period and questionnaires were administered. If the patient was unable to respond to the questions or answer the questionnaire, it was administered to the primary caregiver. Comprehension of having a cerebrovascular event, reason for delay in presentation, mode of arrival and knowledge of treatment modalities were determined. Only 42% of 400 patients thought they were having a stroke or TIA. The median time to presentation was 3.4 h. Delayed presentation was almost equal in men and women. When asked about onset, 19.4% thought that a stroke came on gradually and only 51.9% thought immediate presentation was crucial. 20.8% of patients had heard of thrombolysis. Community knowledge of ischaemic stroke needs to be enhanced so that individuals present earlier, leading to timely management.

Research paper thumbnail of Alcohol Consumption and Development of Acute Respiratory Distress Syndrome: A Population-Based Study

International Journal of Environmental Research and Public Health, 2009

This retrospective population-based study evaluated the effects of alcohol consumption on the dev... more This retrospective population-based study evaluated the effects of alcohol consumption on the development of acute respiratory distress syndrome (ARDS). Alcohol consumption was quantified based on patient and/or family provided information at the time of hospital admission. ARDS was defined according to American-European consensus conference (AECC). From 1,422 critically ill Olmsted county residents, 1,357 had information about alcohol use in their medical records, 77 (6%) of whom developed ARDS. A history of significant alcohol consumption (more than two drinks per day) was reported in 97 (7%) of patients. When adjusted for underlying ARDS risk factors (aspiration, chemotherapy, high-risk surgery, pancreatitis, sepsis, shock), smoking, cirrhosis and gender, history of significant alcohol consumption was associated with increased risk of ARDS development (odds ratio 2.9, 95% CI 1.3-6.2). This population-based study confirmed that excessive alcohol consumption is associated with higher risk of ARDS.

Research paper thumbnail of 79: Serum Magnesium as a Predictor of Stroke Severity

Annals of Emergency Medicine, 2007

Research paper thumbnail of Long-Term Survival and Quality of Life After Transfusion-Associated Pulmonary Edema in Critically III Medical Patients

Chest, 2010

A hydrostatic edema (transfusion-associated circulatory overload [TACO]) and a permeability edema... more A hydrostatic edema (transfusion-associated circulatory overload [TACO]) and a permeability edema (transfusion-related acute lung injury [TRALI]) are common pulmonary complications of blood transfusion. With advances in transfusion safety, in particular regarding the transmission of infectious agents, TRALI and TACO emerged as the most important transfusion complications. According to a US Food and Drug Administration report, TRALI was the most frequent cause of transfusion-related fatalities (65%) reported to the Food and Drug Administration during the years 2005 to 2007, with TACO (10%) and microbial contamination (12%) being the second most important reported causes of death. 1 Our previous Background: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TRALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TRALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group.

Research paper thumbnail of Blood Pressure Hemodynamics in Acute Ischemic Stroke: Association with Stroke Severity, Disability and Death

Academic Emergency Medicine, 2007

Research paper thumbnail of 45: Computerized Recruiting for Clinical Research in the Emergency Department

Annals of Emergency Medicine, 2008

Research paper thumbnail of 173: Functional Outcome Following an Acute Ischemic Stroke: Sex Differences

Annals of Emergency Medicine, 2008

Research paper thumbnail of 4: Hyperglycemia Does Not Predict Functional Outcome in Lacunar Strokes

Annals of Emergency Medicine, 2008

Research paper thumbnail of 108: Comparing the FOUR Score and Glasgow Coma Scale Performed by Diverse Evaluators

Annals of Emergency Medicine, 2007

Research paper thumbnail of 37: Lower Thoracic Fluid Impedance Measured Non-invasively by Impedance Cardiography Predicts ICU Admission and In-hospital Mortality in Emergency Department Shock Patients

Annals of Emergency Medicine, 2008

Research paper thumbnail of 332: The New FOUR Score Coma Scale as a Predictor of Functional Outcome at Hospital Discharge Following ED Presentation for Neurologic Complaint

Annals of Emergency Medicine, 2007

Research paper thumbnail of Mortality rate of vasopressor-dependent septic shock from 1997 through 2006

Research paper thumbnail of 117: Presence of Pain in Patients With Stroke or Transient Ischemic Attack Coming to the Emergency Department

Annals of Emergency Medicine, 2008

Research paper thumbnail of Role of Statins in Functional Outcome Following an Acute Ischemic Stroke

Academic Emergency Medicine, 2007

Research paper thumbnail of Accuracy of waste blood measurement in critically ill patients

Intensive Care Medicine, 2011

Research paper thumbnail of Validation of a New Coma Scale, the FOUR Score, in the Emergency Department

Neurocritical Care, 2009

Objective Full Outline of Unresponsiveness (FOUR) score has previously been validated scale in th... more Objective Full Outline of Unresponsiveness (FOUR) score has previously been validated scale in the Neurosciences Intensive Care Unit. In this study, we sought to validate the use of FOUR score in the emergency department (ED) using non-neurology staff. We also compared its performance to the Glasgow Coma Scale (GCS) and correlated it to functional outcome at hospital discharge and overall survival. Methods We prospectively rated 69 patients with initial neurologic symptoms presenting to the ED. Three types of examiners performed the FOUR score: ED physician, ED resident, and ED nurse. Patients were followed through hospital discharge; functional outcome was measured using modified Rankin Score (mRS). Results Interrater reliability for FOUR score and GCS was excellent (respectively, κw = 0.88 and 0.86). Both FOUR score and GCS predicted functional outcome, and overall survival with and without adjustment for age, sex, and alertness group. Conclusion The FOUR score can be reliably used in the ED by non-neurology staff. Both FOUR score and GCS performed equally well, but the neurologic detail incorporated in the FOUR score makes it more useful in management and triage of patients.

Research paper thumbnail of 202: Best “Better Early Stroke Treatment”: Implementation of Nursing Questionnaire Aids in Triage of Acute Ischemic Stroke Patients

Annals of Emergency Medicine, 2008

Research paper thumbnail of Ischemic Stroke in Young Adults: Etiology and Outcome

Academic Emergency Medicine, 2007

Research paper thumbnail of Acute lung injury prediction score: derivation and validation in a population based sample

European Respiratory Journal, 2010

Early recognition of patients at high risk of acute lung injury (ALI) is critical for successful ... more Early recognition of patients at high risk of acute lung injury (ALI) is critical for successful enrollment of patients in prevention strategies for this devastating syndrome.

Research paper thumbnail of 247: Is Non-invasive Impedance Cardiography Recording for Shock Patients in the Emergency Department Useful for Outcome Analysis

Annals of Emergency Medicine, 2007