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Emergency department revisit

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https://www.readbyqxmd.com/read/29749948/a-population-based-cohort-study-evaluating-outcomes-and-costs-for-syncope-presentations-to-the-emergency-department
#1
Roopinder K Sandhu, Dat T Tran, Robert S Sheldon, Padma Kaul
OBJECTIVES: This study sought to examine outcomes and costs of patients with syncope admitted and discharged from the emergency department (ED). BACKGROUND: ED visits for syncope are common, yet the impact on health care utilization is relatively unknown. METHODS: A total of 51,831 consecutive patients presented to the ED with a primary diagnosis of syncope (International Classification of Diseases-9 code 780.2 and International Classification of Diseases-10 code R55) in Alberta, Canada from 2006 to 2014...
February 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29728831/time-trends-in-characteristics-clinical-course-and-outcomes-of-13-791-patients-with-acute-heart-failure
#2
Pere Llorens, Patricia Javaloyes, Francisco Javier Martín-Sánchez, Javier Jacob, Pablo Herrero-Puente, Víctor Gil, José Manuel Garrido, Eva Salvo, Marta Fuentes, Héctor Alonso, Fernando Richard, Francisco Javier Lucas, Héctor Bueno, John Parissis, Christian E Müller, Òscar Miró
OBJECTIVES: To analyse time trends in patient characteristics, clinical course, hospitalisation rate, and outcomes in acute heart failure along a 10-year period (2007-2016). METHODS: The EAHFE registry has prospectively collected 13,971 consecutive AHF patients diagnosed in 41 Spanish emergency departments (EDs) at five different time points (2007/2009/2011/2014/2016). Eighty patient-related variables and outcomes were described and statistically significant changes along time were evaluated...
May 4, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29728759/effectiveness-of-gabapentin-as-a-postoperative-analgesic-in-children-undergoing-appendectomy
#3
Katherine J Baxter, Jennifer Hafling, Jennifer Sterner, Adarsh U Patel, Helen Giannopoulos, Kurt F Heiss, Mehul V Raval
PURPOSE: Though gabapentin is increasingly used as a perioperative analgesic, data regarding effectiveness in children are limited. The purpose of this study was to evaluate gabapentin as a postoperative analgesic in children undergoing appendectomy. METHODS: A 12-month retrospective review of children undergoing appendectomy was performed at a two-hospital children's institution. Patients receiving gabapentin (GP) were matched (1:2) with patients who did not receive gabapentin (NG) based on age, sex and appendicitis severity...
May 4, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29724172/a-randomized-controlled-trial-testing-the-effectiveness-of-a-paramedic-delivered-care-transitions-intervention-to-reduce-emergency-department-revisits
#4
Ranran Mi, Matthew M Hollander, Courtney M C Jones, Eva H DuGoff, Thomas V Caprio, Jeremy T Cushman, Amy J H Kind, Michael Lohmeier, Manish N Shah
BACKGROUND: Approximately 20% of community-dwelling older adults discharged from the emergency department (ED) return to an ED within 30 days, an occurrence partially resulting from poor care transitions. Prior published interventions to improve the ED-to-home transition have either lacked feasibility or effectiveness. The Care Transitions Intervention (CTI) has been validated to decrease rehospitalization among patients transitioning from the hospital to the home but has never been tested for patients transitioning from the ED to the home...
May 3, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29698347/trends-in-imaging-findings-interventions-and-outcomes-among-children-with-isolated-head-trauma
#5
Eric R Coon, Thomas B Newman, Matt Hall, Jacob Wilkes, Susan L Bratton, Alan R Schroeder
OBJECTIVE: The aim was to analyze the impact of decreased head computed tomography (CT) imaging on detection of abnormalities and outcomes for children with isolated head trauma. METHODS: The study involves a multicenter retrospective cohort of patients younger than 19 years presenting for isolated head trauma to emergency departments in the Pediatric Health Information System database from 2003 to 2015. Patients directly admitted or transferred to another facility and those with a discharge diagnosis code for child maltreatment were excluded...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29694459/characterizing-hospitalizations-for-pediatric-concussion-and-trends-in-care
#6
Tara Rhine, Terri Byczkowski, Mekibib Altaye, Shari L Wade, Lynn Babcock
BACKGROUND: Children hospitalized for concussion may be at a higher risk for persistent symptoms, but little is known about this subset of children. OBJECTIVE: Delineate a cohort of children admitted for concussion, describe care practices received, examine factors associated with prolonged length of stay (LOS) or emergency department (ED) readmission, and investigate changes in care over time. DESIGN, SETTING: Retrospective analysis of data submitted by 40 pediatric hospitals to the Pediatric Health Information System...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29650806/timing-and-location-of-emergency-department-revisits
#7
Kenneth A Michelson, Todd W Lyons, Richard G Bachur, Michael C Monuteaux, Jonathan A Finkelstein
BACKGROUND: Emergency department (ED) revisits are used as a measure of care quality. Many EDs measure only revisits to the same facility, underestimating true rates. We sought to determine the frequency, location, and predictors of ED revisits to the same or a different ED. METHODS: We studied ED discharges for children <18 years old in Maryland and New York in the statewide ED and inpatient databases. Revisits were defined as ED visits within 7 days of an index visit...
April 12, 2018: Pediatrics
https://www.readbyqxmd.com/read/29622722/inpatient-quality-improvement-interventions-for-asthma-a-meta-analysis
#8
REVIEW
Kavita Parikh, Susan Keller, Shawn Ralston
CONTEXT: Despite the availability of evidence-based guidelines for the management of pediatric asthma, health care utilization remains high. OBJECTIVE: Systematically review the inpatient literature on asthma quality improvement (QI) and synthesize impact on subsequent health care utilization. DATA SOURCES: Medline and Cumulative Index to Nursing and Allied Health Literature (January 1, 1991-November 16, 2016) and bibliographies of retrieved articles...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29622393/heart-failure-education-in-the-emergency-department-markedly-reduces-readmissions-in-un-and-under-insured-patients
#9
Vishwaratn Asthana, Miel Sundararajan, Ruth Linda Ackah, Vivek Karun, Arunima Misra, Allison Pritchett, Pallavi Bugga, Angela Siler-Fisher, William Frank Peacock
BACKGROUND: Heart failure (HF) readmissions are a longstanding national healthcare issue for both hospitals and patients. Our purpose was to evaluate the efficacy of a structured, educational intervention targeted towards un- and under-insured emergency department (ED) HF patients. METHODS: HF patients presenting to the ED for care were enrolled between July and December 2015 as part of an open label, interventional study, using a parallel observational control group...
March 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29610252/enhancing-postdischarge-asthma-care-by-using-pharmacy-claims-and-telephone-follow-up
#10
Ronald J Teufel, Anita B Shuler, Myla D Ebeling, Kristen Morella, Annie L Andrews
BACKGROUND AND OBJECTIVES: Asthma is a common reason for hospital readmission. The majority of children are not receiving adequate preventive care after discharge. Our objective is to decrease return visits to the emergency department (ED) or hospital for asthma through a series of interventions (eg, access to real-time claims data and structured follow-up phone calls) designed to increase preventive care. METHODS: We performed a single-site quality improvement project for children 2 to 17 years old discharged with asthma from January 2010 to March 2014...
April 2, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29594372/short-term-outcomes-of-heart-failure-patients-with-reduced-and-preserved-ejection-fraction-after-acute-decompensation-according-to-the-final-destination-after-emergency-department-care
#11
Òscar Miró, V Íctor Gil, Francisco Javier Martín-Sánchez, Javier Jacob, Pablo Herrero, Aitor Alquézar, Lluís Llauger, Sira Aguiló, Gemma Martínez, José Ríos, Alberto Domínguez-Rodríguez, Veli-Pekka Harjola, Christian Müller, John Parissis, W Frank Peacock, Pere Llorens
AIMS: To compare short-term outcomes after an episode of acute heart failure (AHF) in patients with reduced and preserved ejection fractions (HFrEF, < 40%; and HFpEF, > 49%; respectively) according to their destinations after emergency department (ED) care. METHODS AND RESULTS: This secondary analysis of the EAHFE Registry (consecutive AHF patients diagnosed in 41 Spanish EDs) investigated 30-day all-cause mortality, in-hospital all-cause mortality, prolonged hospitalisation (> 7 days), and 30-day post-discharge ED revisit due to AHF, all-cause death, and combined endpoint (ED revisit/death) in 5829 patients with echocardiographically documented HFrEF and HfpEF (HFrEF/HFpEF: 1,442/4,387)...
March 28, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29575248/a-high-yield-fall-risk-and-adverse-events-screening-questions-from-the-stopping-elderly-accidents-death-and-injuries-steadi-guideline-for-older-emergency-department-fall-patients
#12
Jiraporn Sri-On, Gregory Philip Tirrell, Anucha Kamsom, Keith A Marill, Kalpana Narayan Shankar, Shan W Liu
OBJECTIVES: The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall. METHODS: We conducted a prospective study at 2 urban, teaching hospitals. We included patients aged ≥ 65 who presented to the ED for an accidental fall. Data were gathered for fall relevant co-morbidities, high-risk medications for falls and the responses to 12 questions from the STEADI guideline recommendation...
March 25, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29572185/c-reactive-protein-and-emergency-department-seven-days-revisit
#13
Tomer Ziv-Baran, Asaf Wasserman, Ronen Shteinvil, David Zeltser, Itzhak Shapira, Shani Shenhar-Tsarfaty, Ahuva Meilik, Ilana Goldiner, Ori Rogowski, Shlomo Berliner, Pinchas Halpern
BACKGROUND: Emergency department (ED) revisit might be partially preventable. C-reactive protein (CRP) is an inflammatory biomarker which is commonly used as screening tool in the ED. We sought to evaluate the association between CRP level in patients visiting emergency department and 7 days revisit after discharge. METHODS: A historical cohort study of all patients who visited the internal division of the emergency department between June 2007 and July 2017 and had a CRP test...
March 20, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29553278/patients-discharged-from-the-emergency-department-after-referral-for-hospitalist-admission
#14
Christopher A Caulfield, John Stephens, Zarina Sharalaya, Jeffrey P Laux, Carlton Moore, Daniel E Jonas, Edmund A Liles
OBJECTIVES: To describe the characteristics and outcomes of patients discharged from the emergency department (ED) by hospitalist physicians. STUDY DESIGN: Retrospective cohort study at a tertiary academic medical center. METHODS: We used consultation Current Procedural Technology codes to identify patients discharged from the ED after referral for hospitalist admission from April 2011 to April 2014. We report patient demographics and primary diagnoses...
March 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29550098/evaluating-the-emergency-department-observation-unit-for-the-management-of-hyperglycemia-in-adults
#15
Colin J Crilly, Amy J Allen, Teresa M Amato, Allison Tiberio, Rifka C Schulman, Robert A Silverman
OBJECTIVE: To determine whether hyperglycemic patients can be successfully managed in the Emergency Department Observation Unit (EDOU), as determined by the frequency of inpatient admission following their EDOU stay. METHODS: This was a retrospective chart review of patients≥18years presenting to an academic tertiary care ED between May 1, 2014 and May 31, 2016, found to have a glucose≥300mg/dL, and selected for EDOU admission. Patient demographic information, lab results including an HbA1c, disposition, and hospital revisits within 30days of discharge were recorded...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29549922/comparison-of-clinical-practice-in-the-emergency-department-female-versus-male-emergency-physicians
#16
Kuo-Chen Huang, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, I-Min Chiu, Chao-Jui Li
BACKGROUND: There are fewer female emergency physicians (EPs) than male ones. This study attempted to analyze the differences in clinical practice between female and male EPs in the emergency department (ED). MATERIALS AND METHODS: A retrospective, 1-year cohort study was conducted across 4 EDs in the largest healthcare system in Taiwan. A total of 199,757 adult patients without trauma treated by 76 EPs (9 females and 67 males) were included in the study. The clinical practice of female and male EPs was compared...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29530654/safety-of-a-brief-emergency-department-observation-protocol-for-patients-with-presumed-fentanyl-overdose
#17
Frank X Scheuermeyer, Christopher DeWitt, Jim Christenson, Brian Grunau, Andrew Kestler, Eric Grafstein, Jane Buxton, David Barbic, Stefan Milanovic, Reza Torkjari, Indy Sahota, Grant Innes
STUDY OBJECTIVE: Fentanyl overdoses are increasing and few data guide emergency department (ED) management. We evaluate the safety of an ED protocol for patients with presumed fentanyl overdose. METHODS: At an urban ED, we used administrative data and explicit chart review to identify and describe consecutive patients with uncomplicated presumed fentanyl overdose (no concurrent acute medical issues) from September to December 2016. We linked regional ED and provincial vital statistics databases to ascertain admissions, revisits, and mortality...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29525480/safety-of-reassessment-and-release-practice-for-mental-health-patients-boarded-in-the-emergency-department
#18
Sangil Lee, Karisa K Harland, Morgan Bobb Swanson, Sara Lawson, Elijah Dahlstrom, Lance Clemson, Elaine Himadi
OBJECTIVES: Among emergency department (ED) mental health and substance abuse (MHSA) patients, we sought to compare mortality and healthcare utilization by ED discharge disposition and inpatient bed request status. METHODS: A retrospective cohort study of 492 patients was conducted at a single University ED. We reviewed three groups of MHSA patients including ED patients that were admitted, ED patients with a bed request that were discharged from the ED, and ED patients with no bed request that were discharged from the ED...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29509312/using-the-hendrich-ii-inpatient-fall-risk-screen-to-predict-outpatient-falls-after-emergency-department-visits
#19
Brian W Patterson, Michael D Repplinger, Michael S Pulia, Robert J Batt, James E Svenson, Alex Trinh, Eneida A Mendonça, Maureen A Smith, Azita G Hamedani, Manish N Shah
OBJECTIVES: To evaluate the utility of routinely collected Hendrich II fall scores in predicting returns to the emergency department (ED) for falls within 6 months. DESIGN: Retrospective electronic record review. SETTING: Academic medical center ED. PARTICIPANTS: Individuals aged 65 and older seen in the ED from January 1, 2013, through September 30, 2015. MEASUREMENTS: We evaluated the utility of routinely collected Hendrich II fall risk scores in predicting ED visits for a fall within 6 months of an all-cause index ED visit...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29494993/syncope-in-a-middle-aged-female-splenic-artery-aneurysm-revisited
#20
Nour Al Jalbout, Anna Jean Moreland
Splenic artery aneurysm (SAA) is a rare potentially fatal condition with an estimated prevalence in the general population ranging between 0.2 and 10.4%. Ruptured splenic artery aneurysm poses a great diagnostic challenge to emergency physicians due to non-specific and potentially fatal presentations. Dual (arterial and venous) phase imaging is very important for identifying the source of an active intraabdominal bleed when patients are stable enough to tolerate the exam. Here, we present a case of a 54-year-old female who presented with syncope to the emergency department, diagnosed with ruptured splenic artery aneurysm...
February 26, 2018: Clinical Imaging
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