We investigated the hypothesis that a decline in serum zinc concentrations among critically ill patients is related to mortality, length of stay in the intensive care unit, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment (SOFA) scores. All the patients (≥18 years old) presenting to the intensive care unit from September 2009 through November 2009 were enrolled the study. Patients' demographic characteristics and Acute Physiology and Chronic Health Evaluation and SOFA scores were recorded. Blood samples were collected within 24 hours after admission and analyzed for serum zinc, copper, C-reactive protein, and albumin levels. Patients were followed up for mortality and length of stay in the intensive care unit for 28 days. A total of 36 patients, with a median age of 70.5 years (range, 18-87 years), were enrolled during the study period. Serum zinc levels were found to be inversely correlated with SOFA scores (r = -0.41, P < .01). Patients with SOFA scores of 8 or higher had significantly lower serum zinc levels compared with patients with SOFA scores lower than 8 (6.74 ± 1.63 and 9.17 ± 2.76 μmol/L, respectively; P < .01). The result of this study supports the fact that organ failure and critical illness lead to a decline in serum zinc concentrations and that administration of zinc may be beneficial for critically ill patients.

Objective: The aim of this study was to evaluate the value of the Modified Early Warning Score (MEWS) and the VitalPac Early Warning Score (VIEWS) in predicting hospitalization and in-hospital mortality in geriatric emergency department (ED) patients. Patients and methods: This prospective, single-centered observational study was carried out over 1 month at the ED of a university hospital in patients 65 years of age and older presenting to the ED. The vital parameters of the patients measured on admission to ED were recorded. The MEWS and VIEWS were calculated using the recorded physiological parameters of the patients. Hospitalization and in-hospital mortality were used as the primary outcomes. Results: A total of 671 patients included in the study. The median age of the patients was 75 (11) years, and 375 (55.9%) were men. The MEWS is effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU [1 (2) vs. 1 (1) vs. 3 (3), respectively, P<0.001]. The VIEWS is also effective for discriminating patient groups that have been discharged from ED, admitted to a ward, and admitted to ICU [2 (3) vs. 5 (5) vs. 8 (8), respectively, P<0.001]. The AUCs of the MEWS and VIEWS were 0.727 [95% confidence interval (CI) 0.689–0.765] and 0.756 (95% CI 0.720–0.792) in predicting hospitalization, respectively. The AUCs of the MEWS and VIEWS were 0.891 (95% CI 0.844–0.937) and 0.900 (95% CI 0.860–0.941) in predicting in-hospital mortality, respectively. Conclusion: The MEWS and VIEWS are powerful scoring systems that are easy-to-use for predicting the hospitalization and in-hospital mortality of geriatric ED patients.