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Emergency department revisit

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https://www.readbyqxmd.com/read/29318583/geriatric-emergency-department-innovations-transitional-care-nurses-and-hospital-use
#1
Ula Hwang, Scott M Dresden, Mark S Rosenberg, Melissa M Garrido, George Loo, Jeremy Sze, Stephanie Gravenor, D Mark Courtney, Raymond Kang, Carolyn W Zhu, Carmen Vargas-Torres, Corita R Grudzen, Lynne D Richardson
OBJECTIVES: To examine the effect of an emergency department (ED)-based transitional care nurse (TCN) on hospital use. DESIGN: Prospective observational cohort. SETTING: Three U.S. (NY, IL, NJ) EDs from January 1, 2013, to June 30, 2015. PARTICIPANTS: Individuals aged 65 and older in the ED (N = 57,287). INTERVENTION: The intervention was first TCN contact. Controls never saw a TCN during the study period...
January 10, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29287880/revisits-after-pediatric-tracheotomy-airway-concerns-result-in-returns
#2
Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
OBJECTIVES: Children undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy. METHODS: Cross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010-11 were linked and examined for cases of pediatric tracheotomy (patients < 18...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29282273/association-of-socioeconomic-status-with-outcomes-in-older-adult-community-dwelling-patients-after-visiting-the-emergency-department-a-retrospective-cohort-study
#3
Joyce J H Wachelder, Isabelle van Drunen, Patricia M Stassen, Steffie H A Brouns, Suze L E Lambooij, Mieke J Aarts, Harm R Haak
OBJECTIVES: Older adults frequently visit the emergency department (ED). Socioeconomic status (SES) has an important impact on health and ED utilisation; however, the association between SES and ED utilisation in elderly remains unclear. The aim of this study was to investigate the association between SES in older adult patients visiting the ED on outcomes. DESIGN: A retrospective study. PARTICIPANTS: Older adults (≥65 years) visiting the ED, in the Netherlands...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29237710/short-term-outcomes-and-factors-associated-with-adverse-events-among-adults-discharged-from-the-emergency-department-after-treatment-for-acute-heart-failure
#4
MULTICENTER STUDY
Dana R Sax, Dustin G Mark, Renee Y Hsia, Thida C Tan, Grace H Tabada, Alan S Go
BACKGROUND: Although 80% of patients with heart failure seen in the emergency department (ED) are admitted, less is known about short-term outcomes and demand for services among discharged patients. METHODS AND RESULTS: We examined adult members of a large integrated delivery system who visited an ED for acute heart failure and were discharged from January 1, 2013, through September 30, 2014. The primary outcome was a composite of repeat ED visit, hospital admission, or death within 7 days of discharge...
December 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29226819/adherence-to-mediterranean-diet-and-all-cause-mortality-after-an-episode-of%C3%A2-acute-heart-failure-results-of-the%C3%A2-medit-ahf%C3%A2-study
#5
Òscar Miró, Ramon Estruch, Francisco J Martín-Sánchez, Víctor Gil, Javier Jacob, Pablo Herrero-Puente, Sergio Herrera Mateo, Alfons Aguirre, Juan A Andueza, Pere Llorens
OBJECTIVES: The authors sought to evaluate clinical outcomes of patients after an episode of acute heart failure (AHF) according to their adherence to the Mediterranean diet (MedDiet). BACKGROUND: It has been proved that MedDiet is a useful tool in primary prevention of cardiovascular diseases. However, it is unknown whether adherence to MedDiet is associated with better outcomes in patients who have already experienced an episode of AHF. METHODS: We designed a prospective study that included consecutive patients diagnosed with AHF in 7 Spanish emergency departments (EDs)...
November 27, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#6
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29208694/variation-in-care-and-clinical-outcomes-in-children-hospitalized-with-orbital-cellulitis
#7
Jessica L Markham, Matthew Hall, Jessica L Bettenhausen, Angela L Myers, Henry T Puls, Russell J McCulloh
OBJECTIVES: To describe variation in the care of children hospitalized with orbital cellulitis and to determine associations with length of stay (LOS), emergency department (ED) revisits, and hospital readmissions. METHODS: By using the Pediatric Health Information System, we performed a multicenter, retrospective study of children aged 2 months to 18 years with a primary International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis code for orbital cellulitis from 2007 to 2014...
December 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29202118/emergency-department-asthma-medication-delivery-program-an-initiative-to-provide-discharge-prescriptions-and-education
#8
Kayla Durkin, Tricia Montgomery, Kristen Lamberjack, Cindy C Hafer, James Naprawa, Shannon Yarosz
Background: Prescription fill rates for children being discharged from the emergency department (ED) after asthma exacerbations are low, placing the child at risk for additional ED visits or admissions for asthma. This article describes the implementation of an ED asthma prescription delivery service designed to improve pharmacy prescription capture and decrease ED revisit rates. Methods: A core group developed a service to provide asthma prescriptions and education to patients in their ED room before discharge...
July 2017: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29177620/revisiting-traumatic-cardiac-arrest-should-cpr-be-initiated
#9
Katie L Konesky, Weidun Alan Guo
OBJECTIVES: Traumatic cardiac arrest (TCA) represents a unique problem, and poses difficult challenges in the care of trauma patients. Although the literature has suggested that attempted resuscitation from TCA in trauma is futile and consumptive of medical and human resources, studies have recently demonstrated that the outcome of TCA is comparable cardiac arrest secondary to non-traumatic events. The objective of this study was to determine the incidence, predictors, and outcomes following TCA...
November 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29123857/importance-of-respiratory-rate-for-the-prediction-of-clinical-deterioration-after-emergency-department-discharge-a-single-center-case-control-study
#10
Katsunori Mochizuki, Ryosuke Shintani, Kotaro Mori, Takahisa Sato, Osamu Sakaguchi, Kanako Takeshige, Kenichi Nitta, Hiroshi Imamura
Aim: The purpose of the present study was to investigate the predictors of clinical deterioration soon after emergency department (ED) discharge. Methods: We undertook a case-control study using the ED database of the Nagano Municipal Hospital (Nagano, Japan) from January 2012 to December 2013. We selected adult patients with medical conditions who revisited the ED with deterioration within 2 days of ED discharge (deterioration group). The deterioration group was compared with a control group...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29117873/implementation-of-an-emergency-department-atrial-fibrillation-and-flutter-pathway-improves-rates-of-appropriate-anticoagulation-reduces-length-of-stay-and-thirty-day-revisit-rates-for-congestive-heart-failure
#11
David Barbic, Chris DeWitt, Devin Harris, Robert Stenstrom, Eric Grafstein, Crane Wu, Cristian Vadeanu, Brett Heilbron, Jenelle Haaf, Stanley Tung, Dan Kalla, Julian Marsden, Jim Christenson, Frank Scheuermeyer
OBJECTIVES: An evidence-based emergency department (ED) atrial fibrillation and flutter (AFF) pathway was developed to improve care. The primary objective was to measure rates of new anticoagulation (AC) on ED discharge for AFF patients who were not AC correctly upon presentation. METHODS: This is a pre-post evaluation from April to December 2013 measuring the impact of our pathway on rates of new AC and other performance measures in patients with uncomplicated AFF solely managed by emergency physicians...
November 9, 2017: CJEM
https://www.readbyqxmd.com/read/29094343/a-retrospective-nested-cohort-study-of-emergency-department-revisits-for-migraine-in-new-york-city
#12
Mia T Minen, Alexandra Boubour, Amanda Wahnich, Corita Grudzen, Benjamin W Friedman
OBJECTIVE: Migraine causes more than 1.2 million visits to US emergency departments (EDs) annually. Many of these visits are revisits among patients who had already been treated in an ED for migraine. The goal of this analysis was to determine the frequency of headache revisits among patients who present to an ED for management of migraine and sociodemographic factors associated with the revisit. METHODS: Using the New York City Department of Health and Mental Hygiene Syndromic Surveillance database, we conducted a retrospective nested cohort study...
November 2, 2017: Headache
https://www.readbyqxmd.com/read/29066022/variations-in-elderly-peoples-visits-to-the-emergency-departments-in-iceland-a-five-year-population-study
#13
Elisabet Gudmundsdottir, Helga Rosa Masdottir, Hlif Gudmundsdottir, Lovisa Agnes Jonsdottir, Ingibjörg Sigurthorsdottir, Sigrun Sunna Skuladottir, Sigrun Helga Lund, Thordis Thorsteinsdottir
INTRODUCTION: Elderly people visiting emergency departments (ED) are a non-homogenous group. Gender and other socio-demographic variations in emergency care might be present. However, gender-specific ED-data is scarce. METHODS: We retrieved retrospective data on all ED-visits, by 67years and older from 2008 to 2012, and calculated incidence of visits applying population registries. The relationship of age-categories, marital status, health and residence with outcomes were analyzed descriptively by Chi-square tests...
October 20, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29029783/follow-up-trends-after-emergency-department-discharge-for-acutely-symptomatic-hernias
#14
Lara Spence, Eric Pillado, Dennis Kim, David Plurad
BACKGROUND: Patients frequently present to the Emergency Department (ED) with symptomatic hernias. This study evaluated the outcomes of patients presenting with symptomatic hernias without indication for immediate operation who are discharged for elective repair. METHODS: A three-year retrospective analysis of patients discharged from the ED with a symptomatic hernia was performed at a university affiliated county referral center. The incidences of ED revisits, clinic follow up and repairs occurring in the elective versus emergency setting were assessed...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29018821/factors-affecting-unscheduled-return-visits-to-the-emergency-department-among-minor-head-injury-patients
#15
Kuo-Cheng Wang, Chung-Hsien Chaou, Peng-Huei Liu, Cheng-Yu Chien, Ching-Hsing Lee
STUDY OBJECTIVES: Differences between returning and non-returning minor head injury (MHI) emergency department (ED) patients, between the characteristics of the first visit and revisit, and between admitted and nonadmitted returning patients were investigated. METHODS: This was a retrospective study. All discharged ED patients with ICD-9 codes 850.0 to 850.9, 920, and 959.01 in 2013 were enrolled. Patients' demographic data, vital signs, Glasgow Coma Scale, ED diagnosis, length of stay, triage levels, ED examinations performed, and comorbidities were recorded for analysis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28986161/screening-of-the-frail-patient-in-the-emergency-department-a-systematic-review
#16
Rasmus Jørgensen, Mikkel Brabrand
BACKGROUND: Several frailty rating scales have been developed to detect and screen for the level of frailty. It is uncertain what diagnostic value screening of frailty level have in the emergency department. AIM: To assess the accuracy of the screening tools used in the emergency department to detect frailty in patients≥65years by their ability to identify the risk of adverse outcomes. METHODS: An extensive medical literature search of Embase and PubMed was conducted, to identify studies using frailty screening scales in the emergency department...
November 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28976457/revisiting-the-appendiceal-diameter-via-ultrasound-for-the-diagnosis-of-acute-appendicitis
#17
Henry P Chicaiza, Laurie Malia, Christine H Mulvey, Sharon R Smith
OBJECTIVES: This study aims to investigate the optimal outer appendiceal diameter via ultrasound for the diagnosis of acute appendicitis. METHODS: A retrospective chart review was conducted on patients (ages, 2-18 years) presenting to an urban pediatric emergency department between January 1, 2009 and December 31, 2010 with suspected acute appendicitis. Children were considered as having "suspected acute appendicitis" if they (1) presented with acute abdominal pain and had either a surgical consult or an abdominal ultrasound, or (2) presented or transferred with the stated suspicion of acute appendicitis...
October 2, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28967514/bouncing-back-elsewhere-multilevel-analysis-of-return-visits-to-the-same-or-a-different-hospital-after-initial-emergency-department-presentation
#18
Bradley D Shy, George T Loo, Tina Lowry, Eugene Y Kim, Ula Hwang, Lynne D Richardson, Jason S Shapiro
STUDY OBJECTIVE: Analyses of 72-hour emergency department (ED) return visits are frequently used for quality assurance purposes and have been proposed as a means of measuring provider performance. These analyses have traditionally examined only patients returning to the same hospital as the initial visit. We use a health information exchange network to describe differences between ED visits resulting in 72-hour revisits to the same hospital and those resulting in revisits to a different site...
September 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28926508/racial-ethnic-variation-in-emergency-department-care-for-children-with-asthma
#19
Heather G Zook, Nathaniel R Payne, Susan E Puumala, Katherine M Ziegler, Anupam B Kharbanda
OBJECTIVE: To assess the variation between racial/ethnic groups in emergency department (ED) treatment of asthma for pediatric patients. METHODS: This study was a cross-sectional analysis of pediatric (2-18 years) asthma visits among 6 EDs in the Upper Midwest between June 2011 and May 2012. We used mixed-effects logistic regression to assess the odds of receiving steroids, radiology tests, and returning to the ED within 30 days. We conducted a subanalysis of asthma visits where patients received at least 1 albuterol treatment in the ED...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28884986/corticosteroids-in-management-of-anaphylaxis-a-systematic-review-of-evidence
#20
C K Liyanage, P Galappatthy, S L Seneviratne
As anaphylaxis is a medical emergency, there are no randomized controlled clinical trials on its emergency management. Therefore, current guidelines are mostly based on data from observational studies, animal and laboratory studies. Although epinephrine is the mainstay of recommended treatment, corticosteroids are also frequently used. This review evaluates the evidence on the use of corticosteroids in emergency management of anaphylaxis from published human and animal or laboratories studies. Thirty original research papers were found with 22 human studies and eight animal or laboratory studies...
September 2017: European Annals of Allergy and Clinical Immunology
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