Read by QxMD icon Read

Preventable emergency visits

Kelly Gao, Gene Pellerin, Laurence Kaminsky
OBJECTIVES: To develop a predictive model that hospitals or healthcare systems can use to identify patients at high risk of revisiting the emergency department (ED) within 30 days and thus reduce unnecessary ED use through proactive interventions. STUDY DESIGN: A retrospective analysis of fiscal years (FYs) 2013 and 2014 data from 4 Veterans Affairs hospitals in upstate New York. METHODS: This study developed a predictive model based on administrative data, a publicly available patient classification system, and logistic regression...
November 1, 2018: American Journal of Managed Care
Kyoung Wan Kim, Soong-Nang Jang
PURPOSE: Healthcare-associated infections increase disease prevalence and mortality and are the main reason for the hospitalization of the elderly. However, the management of underlying infections in patients hospitalized in long-term care hospitals (LTCHs) is insufficient, and the transfer of these poorly managed patients to the emergency room (ER) of an acute-care hospital can lead to rapid spread of infection. This study investigated the risk factors associated with an ER visit due to infections that developed in LTCHs...
November 15, 2018: Asian Nursing Research
Pisuttikan Rangkakulnuwat, Krongkarn Sutham, Mongkol Lao-Araya
BACKGROUND: The study of anaphylaxis in different geographic areas raises the awareness to improve prevention and medical care. OBJECTIVE: To investigate the incidence, causes, characteristics, and management of anaphylaxis in Chiang Mai, Thailand METHODS: We performed a retrospective review, based on ICD-10 electronic medical records of patients who attended the Out-Patient and Emergency Departments at Chiang Mai University Hospital from January 2007 to December 2016...
October 15, 2018: Asian Pacific Journal of Allergy and Immunology
Gerene M Denning, Charles A Jennissen
All-terrain vehicles (ATVs) remain a significant source of death and injury among youth. The purpose of this review is to provide an overview of the scope of the problem, the risk factors involved, crash-related outcomes and costs, and injury prevention strategies. There are currently more than 100 pediatric ATV-related fatalities each year and over 30,000 emergency department visits, with a potential annual cost for deaths and injuries approaching $1 billion. Major risk factors include lack of training, operating adult-size ATVs, riding as or carrying passengers, riding on the road, and not wearing a helmet...
2018: Research in Sports Medicine
Jeff S Healey, Jorge Wong
Atrial fibrillation (AF) is the cause of substantial direct patient morbidity and a frequent cause of emergency room visits. Even when asymptomatic, AF remains a major cause of stroke, particularly among the elderly. As the risk of both AF and stroke increase with age, the importance of AF-related stroke is growing as a result of demographic shifts in many countries. Oral anticoagulation is highly effective at preventing stroke due to AF; however, AF remains undetected in a large number of individuals. The last decade has witnessed the development of many new technologies to detect AF...
November 9, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Fang Yuan Luo, Susan Crawford, Olivier Drouin, Rati Chadha
BACKGROUND: Hypertensive disorders of pregnancy are major causes of maternal mortality and morbidity, and postpartum hypertensive complications have significant implications on maternal health and public health care system. Antepartum community care programs for hypertension are in place at major centres of Canada, however such a program for postpartum are usually lacking, and could be a cost-effective solution to reduce postpartum hypertensive complications. OBJECTIVES: To assess the proportion of women who present to the emergency department (ED) or outpatient clinics for postpartum hypertensive (PPHTN) complications up to 6 weeks postpartum, among pregnancies complicated by antenatal hypertensive disorders in Calgary, Canada...
November 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Arjun Mohan, Gregory D Kearney, Andrew C Miller
Asthma is a chronic respiratory disease affecting 235 million people worldwide,1 burdening both patients, their families, and society in terms of lost work and school, lessened quality-of-life, avoidable emergency department (ED) visits, hospitalizations, and deaths. Data from the Centers for Disease Control and Prevention report that asthma affects roughly 8% of the U.S. population (approximately 26 million people), accounting for 2 million ED visits, 480,000 hospitalizations, and 3,400 deaths annually with an economic burden of about $82 billion...
November 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Alison J Dittmer, Domingo Molina, Cale A Jacobs, Janet Walker, Ryan D Muchow
INTRODUCTION: Following closed reduction and initial casting of pediatric forearm fractures, loss of reduction (LOR) occurs in ∼5% to 75% of fractures. Sugar-tong splinting has been shown to maintain acceptable reduction in pediatric distal radius fractures while potentially avoiding issues associated with circumferential casting. We hypothesized that the sugar-tong splint would be an acceptable method for initial immobilization to prevent LOR in distal, mid-shaft, and proximal pediatric forearm fractures...
November 6, 2018: Journal of Pediatric Orthopedics
Kerry K Hall, Helen L Petsky, Anne B Chang, KerryAnn F O'Grady
BACKGROUND: Chronic respiratory conditions are major causes of mortality and morbidity. Children with chronic health conditions have increased morbidity associated with their physical, emotional, and general well-being. Acute respiratory exacerbations (AREs) are common in children with chronic respiratory disease, often requiring admission to hospital. Reducing the frequency of AREs and recurrent hospitalisations is therefore an important goal in the individual and public health management of chronic respiratory illnesses in children...
November 2, 2018: Cochrane Database of Systematic Reviews
Pooja Hindocha, Nisha Janardhanan Nair, Jennifer L Pigoga, Katherine Barry, Meghan McCarthy, Valerie Almeida-Monroe, Anne S De Groot
Poor management of chronic diseases, such as hypertension and diabetes, particularly among the uninsured, places medical and financial burdens on the healthcare system. Clínica Esperanza/Hope Clinic initiated a chronic disease management program for uninsured residents of Rhode Island (RI) called Bridging the [Health Equity] Gap (BTG), which offers continuity of care, quarterly goal-setting appointments, and healthy lifestyle interventions. Outcomes for 549 participants from the initial evaluation period are presented here...
November 1, 2018: Rhode Island Medical Journal
Benjamin J Miller
A seizure is a symptom of brain dysfunction, resulting in 1.6 million emergency department visits each year. The evaluation of new seizures in the emergency department is a process looking for triggers of seizures such as toxins, mass lesions, or metabolic derangements. Maintaining a broad differential diagnosis is essential to prevent premature closure of the diagnostic evaluation. Timing of neurologic imaging and electroencephalogram depends on the clinical situation. In this case, a young woman presents with a "new-onset" seizure with subsequent elevation of white blood cells and serum lactate levels...
October 2018: Advanced Emergency Nursing Journal
Safiya Richardson, Philip Solomon, Alexander O'Connell, Sundas Khan, Jonathan Gong, Alex Makhnevich, Guang Qiu, Meng Zhang, Thomas McGinn
BACKGROUND: Use of computed tomography pulmonary angiography (CTPA) in the assessment of pulmonary embolism (PE) has markedly increased over the past two decades. While this technology has improved the accuracy of radiological testing for PE, CTPA also carries the risk of substantial iatrogenic harm. Each CTPA carries a 14% risk of contrast-induced nephropathy and a lifetime malignancy risk that can be as high as 2.76%. The appropriate use of CTPA can be estimated by monitoring the CTPA yield, the percentage of tests positive for PE...
October 25, 2018: JMIR Medical Informatics
Greta A Bushnell, Bradley N Gaynes, Scott N Compton, Stacie B Dusetzina, M Alan Brookhart, Til Stürmer
BACKGROUND: Anxiety disorders are one of the most common mental illnesses in children and associated with high healthcare utilization. We aimed to estimate 2-year cumulative incidence of mental health-related hospitalizations, treated self-harm, and emergency room (ER) visits in children newly diagnosed with anxiety disorders and, for context, in children without anxiety disorders. METHODS: We identified commercially insured treatment naïve children (3-17 years) with a new office-based anxiety disorder diagnosis (ICD-9-CM) from 2005-2014 in the MarketScan claims database...
October 24, 2018: Depression and Anxiety
Jill Howie-Esquivel, Kathleen Dracup, Mary A Whooley, Charles McCulloch, Chengshi Jin, Debra K Moser, Robyn A Clark, Michele M Pelter, Martha Biddle, Linda G Park
AIMS: Heart failure (HF) patients are taught to identify a rapid 5 lb body-weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5 lb weight gain in 1 week and signs and symptoms of HF increased risk for unplanned physician or emergency department (ED) visits or hospital admission in rural HF patients. METHODS AND RESULTS: This was a secondary analysis of a randomized trial. Patients tracked body weight and HF symptoms using diaries...
October 24, 2018: ESC Heart Failure
Lilliam Ambroggio, Helena Herman, Emily Fain, Guixia Huang, Todd A Florin
BACKGROUND: Children discharged from the emergency department (ED) with community-acquired pneumonia (CAP) revisit for several reasons, including disease progression or treatment failure. Understanding factors associated with revisits may assist clinicians in preventing subsequent visits. METHODS: Children aged 3 months to 18 years with an International Classification of Diseases, Ninth Revision diagnosis of CAP between December 1, 2009 and April 31, 2013 were eligible...
November 2018: Hospital Pediatrics
Zuzana Špacírová, David Epstein, Leticia García-Mochón, Virginia A Aparicio, Milkana Borges-Cosic, M Puerto López Del Amo, José J Martín-Martín
OBJECTIVE: Adequate physical activity levels and a healthy lifestyle may prevent all kinds of non-communicable diseases, promote well-being and reduce health-care costs among perimenopausal women. This study assessed an exercise programme for perimenopausal women. METHOD: A total of 150 women (aged 45-64 years) not engaged in regular physical activity were randomly assigned to either a 16 week exercise intervention or to the control group. The study was conducted from the perspective of the National Health System...
October 16, 2018: Gaceta Sanitaria
Fahd A Ahmad, Donna B Jeffe, Christopher R Carpenter, Lauren S Chernick, Kristin S Stukus, Michael Turco, Feliciano B Yu, Thomas C Bailey
STUDY OBJECTIVE: Nearly 20 million adolescents receive emergency department (ED) care each year, many of whom have untreated reproductive health issues. ED visits represent an opportunity to provide appropriate care, however ED physician reproductive healthcare practices and capabilities in the United States have not been described. We sought to characterize pediatric ED director's individual practice and ED system resources for providing adolescent reproductive healthcare. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: We invited pediatric ED division and/or medical directors nationally to participate in an anonymous, online survey...
October 16, 2018: Journal of Pediatric and Adolescent Gynecology
Maria Liljeroos, Anna Strömberg
AIM: According to clinical guidelines, it is recommended that patients with heart failure (HF) receive structured multidisciplinary care at nurse-led HF clinics in order to optimise treatment and avoid preventable readmissions. Today, there are HF clinics with specialist-trained nurses at almost all Swedish hospitals, but HF clinics remain scarce in primary care (PC). The aim of this study was two-fold: firstly, to evaluate the effects of systematically implementing nurse-led HF clinics in PC settings with regard to hospital healthcare utilisation and evidence-based HF treatment, and secondly to explore patients' experiences of HF clinics in PC...
October 19, 2018: European Journal of Heart Failure
Zoe F Cairncross, Jeremy Herring, Trevor van Ingen, Brendan T Smith, Pamela Leece, Brian Schwartz, Karin Hohenadel
BACKGROUND: Negative health outcomes associated with the use of both prescribed and nonprescribed opioids are increasingly prevalent. We examined long-term trends in opioid-related harms in Ontario across a set of 6 indicators and the relation between harms and neighbourhood income in 2016. METHODS: We examined rates of neonatal abstinence syndrome, opioid poisoning (fatal and nonfatal) and nonpoisoning opioid-related events from 2003 to 2016 in Ontario using population-based health administrative databases...
October 2018: CMAJ Open
Jeffrey R Brubacher, Yuda Shih, Jian Ting Weng, Rahul Verma, David Evans, Eric Grafstein
OBJECTIVES: Injury prevention should be informed by timely surveillance data. Unfortunately, most injury surveillance only captures patients with severe injuries and is not available in real time, hampering prevention efforts. We aimed to develop and pilot a simple injury surveillance strategy that can be integrated into routine emergency department (ED) workflow to collect more robust mechanism of injury information at time of visit for all injured ED patients with minimal impact on workflow...
October 18, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"