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emergency department revisits

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https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#1
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#2
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28562277/reducing-hospitalization-rates-for-children-with-anaphylaxis
#3
Karen S Farbman, Kenneth A Michelson, Mark I Neuman, Timothy E Dribin, Lynda C Schneider, Anne M Stack
BACKGROUND AND OBJECTIVES: Most children with anaphylaxis in the emergency department (ED) are hospitalized. Opportunities exist to safely reduce the hospitalization rate for children with anaphylaxis by decreasing unnecessary hospitalizations. A quality improvement (QI) intervention was conducted to improve care and reduce hospitalization rates for children with anaphylaxis. METHODS: We used the Model for Improvement and began with development and implementation in 2011 of a locally developed evidence-based guideline based on national recommendations for the management of anaphylaxis...
May 25, 2017: Pediatrics
https://www.readbyqxmd.com/read/28559030/the-effect-of-utilization-review-on-emergency-department-operations
#4
Shoma Desai, Phillip F Gruber, Erick Eiting, Seth A Seabury, Wendy J Mack, Christian Voyageur, Veronica Vasquez, Hyung T Kim, Sophie Terp
STUDY OBJECTIVE: Increasingly, hospitals are using utilization review software to reduce hospital admissions in an effort to contain costs. Such practices have the potential to increase the number of unsafe discharges, particularly in public safety-net hospitals. Utilization review software tools are not well studied with regard to their effect on emergency department (ED) operations. We study the effect of prospectively used admission decision support on ED operations. METHODS: In 2012, Los Angeles County + University of Southern California Medical Center implemented prospective use of computerized admission criteria...
May 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28557725/reduced-radiation-in-children-presenting-to-the-ed-with-suspected-ventricular-shunt-complication
#5
Ronald F Marchese, Erin S Schwartz, Gregory G Heuer, Jane Lavelle, Jimmy W Huh, Louis M Bell, Xianqun Luan, Joseph J Zorc
BACKGROUND: Ventricular shunt complications in children can be severe and life-threatening if not identified and treated in a timely manner. Evaluation for shunt obstruction is not without risk, including lifetime cumulative radiation as patients routinely receive computed tomography (CT) scans of the brain and shunt series (multiple radiographs of the skull, neck, chest, and abdomen). METHODS: A multidisciplinary team collaborated to develop a clinical pathway with the goal of standardizing the evaluation and management of patients with suspected shunt complication...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28545851/sex-specific-risk-of-emergency-department-revisits-and-early-readmission-following-myocardial-infarction
#6
Magnus Lundbäck, Danijela Gasevic, Eric Rullman, Toralph Ruge, Axel C Carlsson, Martin J Holzmann
BACKGROUND: Readmissions within 30days after hospitalization have been introduced as a measure of quality of care. There is a paucity of data regarding sex-specific risk of early readmissions after myocardial infarction (MI). OBJECTIVES: To investigate the association between sex and revisits to the emergency department (ED), and readmissions after MI. METHODS: All patients with chest pain, diagnosed with MI at the Karolinska University Hospital during 2011 and 2012 were included...
May 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28535970/upper-extremity-deep-venous-thrombosis-after-port-insertion-what-are-the-risk-factors
#7
Omidreza Tabatabaie, Gyulnara G Kasumova, Tara S Kent, Mariam F Eskander, Ayotunde B Fadayomi, Sing Chau Ng, Jonathan F Critchlow, Nicholas E Tawa, Jennifer F Tseng
BACKGROUND: Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. METHODS: The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code...
May 20, 2017: Surgery
https://www.readbyqxmd.com/read/28513890/risk-of-hospitalisation-after-early-revisit-in-the-emergency-department
#8
Giorgio Cozzi, Sergio Ghirardo, Ilaria Fiorese, Ilaria Proietti, Lorenzo Monasta, Marta Minute, Egidio Barbi, Lorenzo Calligaris
AIM: Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease. METHODS: Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children's hospital in Italy...
May 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28511472/short-term-unscheduled-revisits-to-paediatric-emergency-department-a-six-year-data
#9
Onder Kilicaslan, Feruza Turan Sönmez, Harun Gunes, Ramazan Cahit Temizkan, Kenan Kocabay, Ayhan Saritas
INTRODUCTION: Reviewing the reasons for return visits within 24 hours is a very important method of determining possible problems of emergency health care. Several causes stay behind unscheduled emergency return visits. Therefore, identifying these factors is crucial to set strategies in order to decrease the number of unnecessary visits. AIM: To define the characteristics of the patients returning to the Paediatric Emergency Department (PED) within 24 hours via determining rate, number and demographic data of patients...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28484958/markers-of-diuretic-resistance-in-emergency-department-patients-with-acute-heart-failure
#10
Andrew Doering, Cathy A Jenkins, Alan B Storrow, JoAnn Lindenfeld, Gregory J Fermann, Karen F Miller, Matthew Sperling, Sean P Collins
BACKGROUND: Loop diuretics are common therapy for emergency department (ED) patients with acute heart failure (AHF). Diuretic resistance (DR) is a term used to describe blunted natriuretic response to loop diuretics. It would be important to detect DR prior to it becoming clinically apparent, so early interventions can be initiated. However, several definitions have been proposed, and it is not clear if they identify similar patients. We compared these definitions and described the clinical characteristics of patients who fulfilled them...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28457526/delayed-diagnoses-in-children-with-constipation-multicenter-retrospective-cohort-study
#11
Stephen B Freedman, Jonathan Rodean, Matthew Hall, Elizabeth R Alpern, Paul L Aronson, Harold K Simon, Samir S Shah, Jennifer R Marin, Eyal Cohen, Rustin B Morse, Yiannis Katsogridakis, Jay G Berry, Mark I Neuman
OBJECTIVE: The use of abdominal radiographs contributes to increased healthcare costs, radiation exposure, and potentially to misdiagnoses. We evaluated the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation. STUDY DESIGN: Retrospective cohort study of children aged <18 years diagnosed with constipation at one of 23 EDs from 2004 to 2015. The primary exposure was abdominal radiograph performance...
April 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28442924/a-framework-for-measuring-self-management-effectiveness-and-health-care-use-among-pediatric-asthma-patients-and-families
#12
REVIEW
Pavani Rangachari
Asthma is associated with substantial health care expenditures, including an estimated US$56 billion per year in direct costs. A recurring theme in the asthma management literature is that costly asthma symptoms, including hospitalizations and multiple emergency department (ED)/outpatient visits, can often be prevented through patient/family adherence to the national (National Institutes of Health Expert Panel Report-3) guidelines for effective self-management of asthma, specifically 1) medication adherence and 2) environmental trigger avoidance, as outlined in the patient's personalized Asthma-Action Plan...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#13
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28425577/postoperative-hemorrhage-and-hospital-revisit-after-transoral-robotic-surgery
#14
Joseph Zenga, Jasmina Suko, Dorina Kallogjeri, Patrik Pipkorn, Brian Nussenbaum, Ryan S Jackson
OBJECTIVES/HYPOTHESIS: To investigate the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). STUDY DESIGN: Retrospective review of the State Inpatient Database (SID), the State Ambulatory Surgery Database (SASD), and the State Emergency Department Database (SEDD) from the Healthcare Cost and Utilization Project. METHODS: Patients were identified from the SID, SASD, and SEDD for the states of Florida, New York, and California from 2005 to 2013 who had an International Classification of Diseases, Ninth Edition code for a surgical procedure on the upper aerodigestive tract associated with a code for robotic-assisted surgery...
April 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28416082/final-diagnosis-of-patients-with-clinically-suspected-vestibular-neuritis-showing-normal-caloric-response
#15
Sung Hwan Ahn, Jung Eun Shin, Chang-Hee Kim
Vestibular neuritis is one of the most common peripheral causes of acute vestibular syndrome, of which the diagnosis is generally based on a comprehensive interpretation of clinical and laboratory findings following reasonable exclusion of other disorders. This study aimed to investigate the final diagnosis of patients admitted to hospital under the clinical impression of vestibular neuritis who showed no unilateral caloric paresis. Forty-five patients who visited the emergency department with isolated acute spontaneous vertigo were included...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28363627/evaluation-of-a-nurse-initiated-acute-gastroenteritis-pathway-in-the-pediatric-emergency-department
#16
Rebecca A Carson, Shawna S Mudd, P Jamil Madati
Acute gastroenteritis (AGE) is a common illness treated in the emergency department. Delays in initiating rehydration for children with mild or moderate dehydration from AGE can lead to prolonged ED visits and increased resource utilization that do not provide prognostic value or support family-centered care. The purpose of this quality improvement project was to promote early oral rehydration therapy (ORT) for persons with AGE in an attempt to reduce unnecessary resource utilization and length of stay (LOS)...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28350720/pulmonary-embolism-mimicking-infectious-pleuritis
#17
Kenichi Tetsuhara, Satoshi Tsuji, Satoko Uematsu, Koichi Kamei
The diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significant medical history was referred to the ED with pleuritic and chest pain with low-grade fever 4 days before admission.Echography showed a small amount of left pleural effusion. A 12-lead electrocardiogram was normal...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28262332/report-from-the-world-health-organization-s-third-product-development-for-vaccines-advisory-committee-pdvac-meeting-geneva-8-10th-june-2016
#18
Birgitte K Giersing, Johan Vekemans, Samantha Nava, David C Kaslow, Vasee Moorthy
The third meeting of WHO's Product Development for Vaccines Advisory Committee (PDVAC) was held in June 2016, with a remit to revisit the pathogen areas for which significant progress has occurred since recommendations from the 2015 meeting, as well as to consider new advances in the development of vaccines against other pathogens. Since the previous meeting, significant progress has been made with regulatory approvals of the first malaria and dengue vaccines, and the first phase III trials of a respiratory syncytial virus (RSV) vaccine candidate has started in the elderly and pregnant women...
March 2, 2017: Vaccine
https://www.readbyqxmd.com/read/28248796/how-to-predict-oral-rehydration-failure-in-children-with-gastroenteritis
#19
Dorien Geurts, Ewout W Steyerberg, Henriëtte Moll, Rianne Oostenbrink
OBJECTIVES: Oral rehydration is the standard in most current guidelines for young children with acute gastroenteritis (AGE). Failure of oral rehydration can complicate the disease course, leading to morbidity due to severe dehydration. We aimed to identify prognostic factors of oral rehydration failure in children with AGE. METHODS: Design A prospective, observational study.Setting Emergency department (ED), Erasmus Medical Centre, Rotterdam, The Netherlands, 2010- 2012...
February 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28238501/is-tachycardia-at-discharge-from-the-pediatric-emergency-department-a-cause-for-concern-a%C3%A2-nonconcurrent-cohort-study
#20
Paria M Wilson, Todd A Florin, Guixia Huang, Matthew Fenchel, Matthew R Mittiga
STUDY OBJECTIVE: We evaluate the association between discharge tachycardia and (1) emergency department (ED) and urgent care revisit and (2) receipt of clinically important intervention at the revisit. METHODS: The study included a nonconcurrent cohort of children aged 0 to younger than 19 years, discharged from 2 pediatric EDs and 4 pediatric urgent care centers in 2013. The primary exposure was discharge tachycardia (last recorded pulse rate ≥99th percentile for age)...
February 23, 2017: Annals of Emergency Medicine
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