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Death after emergency visit

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https://www.readbyqxmd.com/read/27912982/should-recommendations-about-starting-inhaled-corticosteroid-treatment-for-mild-asthma-be-based-on-symptom-frequency-a-post-hoc-efficacy-analysis-of-the-start-study
#1
Helen K Reddel, William W Busse, Søren Pedersen, Wan C Tan, Yu-Zhi Chen, Carin Jorup, Dan Lythgoe, Paul M O'Byrne
BACKGROUND: Low-dose inhaled corticosteroids (ICS) are highly effective for reducing asthma exacerbations and mortality. Conventionally, ICS treatment is recommended for patients with symptoms on more than 2 days per week, but this criterion has scant evidence. We aimed to assess the validity of the previous symptom-based cutoff for starting ICS by establishing whether there was a differential response to budesonide versus placebo for severe asthma exacerbations, lung function, and asthma symptom control across subgroups identified by baseline asthma symptom frequency...
November 29, 2016: Lancet
https://www.readbyqxmd.com/read/27880003/association-of-multimorbidity-with-mortality-and-healthcare-utilization-in-chronic-kidney-disease
#2
C Barrett Bowling, Laura Plantinga, Lawrence S Phillips, William McClellan, Katharina Echt, Neale Chumbler, Gerald McGwin, Ann Vandenberg, Richard M Allman, Theodore M Johnson
OBJECTIVES: Chronic kidney disease (CKD) almost universally occurs in individuals with other medical problems. However, few studies have described CKD-related multimorbidity using a framework that identifies chronic conditions as concordant (having overlap in treatment goals) versus discordant (having opposing treatment recommendations) and unrelated (having no overlap, but contributing to complexity via different resource requirements). DESIGN: Retrospective cohort...
November 23, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27873299/using-the-manchester-triage-system-for-refusing-nonurgent-patients-in-the-emergency-department-a-30-day-outcome-study
#3
Roger Daglius Dias, Izabel Cristina Rios, Carlos Luis Benites Canhada, Maria Dolores Galinanes Otero Fernandes, Leila Suemi Harima Letaif, Eloisa Bonfá, Maria Beatriz Moliterno Perondi
OBJECTIVE: To evaluate the long-term outcomes and satisfaction of nonurgent patients who seek care in the emergency department (ED) and are diverted to primary health services (PHS). METHODS: Data were collected from 264 nonurgent patients diverted from the ED of a tertiary public university hospital in São Paulo, Brazil. The nonurgent patient definition was performed by Manchester triage system version II (MTS-II) associated to medical interview in the triage service...
September 2016: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/27814387/volume-matters-improved-outcomes-for-patients-presenting-to-high-volume-emergency-departments-with-atrial-flutter-and-fibrillation
#4
Rhonda J Rosychuk, Michelle M Graham, Brian R Holroyd, Brian H Rowe
OBJECTIVES: Clinical familiarity plays a role in health outcomes; the relationship between emergency department (ED) volume and outcomes for atrial fibrillation and flutter (AFF) are not clear. We compared ED presentation outcomes for AFF between high (HV) and low volume (LV) EDs in Alberta, Canada. METHODS: 45,372 AFF presentations for patients aged ≥ 35 years from all 104 EDs in Alberta during 1999 to 2011 using administrative health databases formed a retrospective cohort...
2016: PloS One
https://www.readbyqxmd.com/read/27802953/prognostic-importance-of-sleep-quality-in-patients-with-heart-failure
#5
Kyoung Suk Lee, Terry A Lennie, Seongkum Heo, Eun Kyeung Song, Debra K Moser
BACKGROUND: Poor sleep quality is common and is associated with poor quality of life and health status in patients with heart failure. However, few investigators have focused on the impact of impaired sleep quality on survival in heart failure. OBJECTIVE: To examine whether self-reported sleep quality is associated with prognosis in patients with heart failure. METHODS: The study sample consisted of 204 patients with heart failure. Sleep quality was measured with the Pittsburgh Sleep Quality Index...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27777926/effects-of-the-west-africa-ebola-virus-disease-on-health-care-utilization-a-systematic-review
#6
Kim J Brolin Ribacke, Dell D Saulnier, Anneli Eriksson, Johan von Schreeb
Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries, and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reviews. A total of 3354 articles were identified for screening, and while 117 articles were read in full, 22 studies were included in the final review...
2016: Frontiers in Public Health
https://www.readbyqxmd.com/read/27764078/notes-from-the-field-pediatric-emergency-department-visits-for-buprenorphine-naloxone-ingestion-united-states-2008-2015
#7
Daniel S Budnitz, Maribeth C Lovegrove, Mathew R P Sapiano, Justin Mathew, Scott R Kegler, Andrew I Geller, Christian Hampp
Expanding access to office-based medication-assisted treatment with buprenorphine/naloxone for opioid dependence is a key part of the national strategy to address the opioid abuse epidemic (1). However, as buprenorphine/naloxone prescribing increased, emergency department (ED) visits and hospitalizations for unsupervised ingestions by young children began to increase, with buprenorphine/naloxone ingestions becoming the most common cause of hospitalization for medication ingestions by young children during 2010-2011 (2)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27752603/preventable-trauma-death-rate-in-daegu-south-korea
#8
Sungbae Moon, Suk Hee Lee, Hyun Wook Ryoo, Jong Kun Kim, Jae Yun Ahn, Sung Jin Kim, Jae Cheon Jeon, Kyung Woo Lee, Ae Jin Sung, Yun Jeong Kim, Dae Ro Lee, Byung Soo Do, Sin Ryul Park, Jin-Seok Lee
OBJECTIVE: This study investigated the preventable death rate in Daegu, South Korea, and assessed affecting factors and preventable factors in order to improve the treatment of regional trauma patients. METHODS: All traumatic deaths between January 2012 and December 2012 in 5 hospitals in Daegu were analyzed by panel review, which were classified into preventable and non-preventable deaths. We determined the factors affecting trauma deaths and the preventable factors during trauma care...
December 2015: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27751901/30-day-readmissions-after-an-acute-kidney-injury-hospitalization
#9
Samuel A Silver, Ziv Harel, Eric McArthur, Danielle M Nash, Rey Acedillo, Abhijat Kitchlu, Amit X Garg, Glenn M Chertow, Chaim M Bell, Ron Wald
BACKGROUND: The risk of hospital readmission in acute kidney injury survivors is not well understood. We estimated the proportion of acute kidney injury patients who were rehospitalized within 30 days and identified characteristics associated with hospital readmission. METHODS: We conducted a population-based study of patients who survived a hospitalization complicated by acute kidney injury from 2003-2013 in Ontario, Canada. The primary outcome was 30-day hospital readmission...
October 14, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27671917/emergency-department-screening-for-suicide-and-mental-health-risk
#10
REVIEW
Kalina Babeva, Jennifer L Hughes, Joan Asarnow
Suicide is the second leading cause of death among youth ages 10-24. An estimated 1.5 million US adolescents receive their primary health care in the emergency department (ED); this is particularly true for low-income and minority youths who often lack a regular source of care. ED visits can provide a window of opportunity to screen and identify youths with suicide and mental health risk, triage youths based on need, and facilitate effective follow-up care. Recently developed brief therapeutic assessment approaches have demonstrated success in improving rates of follow-up care after discharge from the ED...
November 2016: Current Psychiatry Reports
https://www.readbyqxmd.com/read/27658873/effects-of-a-multicomponent-intervention-to-streamline-initiation-of-antiretroviral-therapy-in-africa-a-stepped-wedge-cluster-randomised-trial
#11
Gideon Amanyire, Fred C Semitala, Jennifer Namusobya, Richard Katuramu, Leatitia Kampiire, Jeanna Wallenta, Edwin Charlebois, Carol Camlin, James Kahn, Wei Chang, David Glidden, Moses Kamya, Diane Havlir, Elvin Geng
BACKGROUND: In Africa, up to 30% of HIV-infected patients who are clinically eligible for antiretroviral therapy (ART) do not start timely treatment. We assessed the effects of an intervention targeting prevalent health systems barriers to ART initiation on timing and completeness of treatment initiation. METHODS: In this stepped-wedge, non-blinded, cluster-randomised controlled trial, 20 clinics in southwestern Uganda were randomly assigned in groups of five clinics every 6 months to the intervention by a computerised random number generator...
August 27, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27642451/epidemiological-aspects-of-suicide-attempts-among-moroccan-children
#12
Nour Mekaoui, Lamiae Karboubi, Fatima Zahra Ouadghiri, Badr Sououd Benjelloun Dakhama
Suicidal behavior among children has significantly increased in Morocco. We conducted a study on the epidemiological aspect to propose a treatment strategy. Descriptive retrospective study over a period of 3 years (April 2012-April 2015) involving children who visited pediatric medical emergencies of the Children Hospital of Rabat after an autolysis attempt. We observed epidemiological parameters, history, social and family context, the means used, the presumed cause, clinical manifestation, and the management...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27629892/non-urgent-emergency-callers-characteristics-and-prognosis
#13
K K Lehm, M S Andersen, I S Riddervold
OBJECTIVE: In Denmark, calls to the Danish emergency number 1-1-2 concerning medical emergencies are received by an emergency medical communication center (EMCC). At the EMCC, health care professionals (nurses, paramedics, and physicians) decide the necessary response, depending on the level of emergency as indicated by the Danish Index for Emergency Care. The index states 37 main criteria (symptoms) and five levels of emergency, descending from A (life threatening) to E (not serious)...
September 14, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27625724/association-of-age-systolic-blood-pressure-and-heart-rate-with-adult-morbidity-and-mortality-after-urgent-care-visits
#14
James Hart, Michael Woodruff, Elizabeth Joy, Joseph Dalto, Gregory Snow, Rajendu Srivastava, Brad Isaacson, Todd Allen
INTRODUCTION: Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. METHODS: We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008-2013...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27618853/early-follow-up-after-a-heart-failure-exacerbation-the-importance-of-continuity
#15
Finlay A McAlister, Erik Youngson, Padma Kaul, Justin A Ezekowitz
BACKGROUND: Although early follow-up for heart failure (HF) is recommended, the time window and which physicians should do the follow-up are unclear. We explored whether (1) follow-up within 14 days and (2) physician continuity influence outcomes within 30 days of a HF exacerbation. METHODS AND RESULTS: Retrospective cohort of all adults in Alberta, Canada, with a first discharge from a hospital or an emergency department where HF was the most responsible diagnosis between April 2002 and November 2013, analyzed using Cox proportional hazards models with time-varying covariates...
September 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27614302/the-effect-of-antiemetics-and-antihistamines-on-the-qtc-interval-in-emergent-dialysis-patients-with-baseline-qtc-prolongation
#16
Scott Burdette, Lynn P Roppolo, Walter Green, Nashid Shinthia, Peter Ye, Linda S Hynan
BACKGROUND: Unfunded patients with end-stage renal disease (ESRD) who do not have routinely scheduled hemodialysis often receive medications known to prolong the QTc interval for their uremic symptoms even though they may have pre-existing QTc prolongation. OBJECTIVES: The purpose of this study was to determine the effects of these medications on the QTc interval in these patients. METHODS: Unfunded patients with ESRD presenting to the emergency department (ED) for emergent hemodialysis (HD) with QTc prolongation on their initial electrocardiogram (ECG) were recruited...
August 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27609207/partial-and-no-recovery-from-delirium-after-hospital-discharge-predict-increased-adverse-events
#17
Martin G Cole, Jane McCusker, Robert Bailey, Michael Bonnycastle, Shek Fung, Antonio Ciampi, Eric Belzile
BACKGROUND: the implications of partial and no recovery from delirium after hospital discharge are not clear. We sought to explore whether partial and no recovery from delirium among recently discharged patients predicted increased adverse events (emergency room visits, hospitalisations, death) during the subsequent 3 months. METHOD: prospective study of recovery from delirium in older hospital inpatients. The Confusion Assessment Method was used to diagnose delirium in hospital and determine recovery status after discharge (T0)...
September 8, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27606039/benefits-of-early-roflumilast-treatment-after-hospital-or-emergency-department-discharge-for-a-copd-exacerbation
#18
Qing Lee, Michelle Mocarski, Shawn X Sun
BACKGROUND: Chronic lower respiratory disease, which includes chronic obstructive pulmonary disease (COPD), is the third leading cause of death in the United States. Roflumilast is an oral, once-daily, selective phosphodiesterase-4 inhibitor approved for reducing the risk for COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. OBJECTIVES: To evaluate the effects of roflumilast treatment timing on COPD exacerbation rates (primary objective) and on resource utilization and healthcare costs (secondary objective) after hospital or emergency department discharge associated with a COPD exacerbation...
May 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27590209/characteristics-and-outcomes-for-acute-heart-failure-in-elderly-patients-presenting-to-the-ed
#19
Pierre-Géraud Claret, Ian G Stiell, Justin W Yan, Catherine M Clement, Brian H Rowe, Lisa A Calder, Jeffrey J Perry
INTRODUCTION: The first aim of this study was to investigate the characteristics for elderly patients with acute heart failure presenting to the emergency department (ED). The second aim was to determine the characteristics of these elderly patients associated with serious adverse events. METHODS: The population was divided into 2 age groups, <80 and ≥80 years. The primary outcome was the occurrence of a serious adverse event, defined as either death from any cause within 30 days of the index ED visit or any of the following events within 14 days of the index ED visit: admission to a monitored unit, intubation, need for noninvasive ventilation, myocardial infarction, major procedure, or, for patients who were discharged after the initial visit, return to the ED resulting in admission to hospital...
August 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27526120/clinical-evaluation-of-mp4co-a-phase-1b-escalating-dose-safety-and-tolerability-study-in-stable-adult-patients-with-sickle-cell-disease
#20
Peter E Keipert
MP4CO, developed by Sangart Inc. (San Diego, CA), is a pegylated human hemoglobin-based carbon monoxide (CO) delivery agent and oxygen therapeutic that has shown potential to prevent and reverse red cell sickling. A double blind, comparator controlled, dose-escalation, Phase 1b study was conducted to assess the safety of MP4CO. Adult sickle cell patients with HbSS or S/β(0) Thal genotype who were not experiencing a painful crisis were randomized to receive either MP4CO or normal saline (NS) in a sequential series of six escalating dose cohorts (A-F)...
2016: Advances in Experimental Medicine and Biology
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