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Death after emergency visit

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: Clin Exp Emerg Med
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 (AKI) survivors is not well understood. We estimated the proportion of AKI 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 AKI from 2003-2013 in Ontario, Canada. The primary outcome was 30-day hospital readmission. We used a propensity score model to match patients with and without AKI, and a Cox proportional hazards model with death as a competing risk to identify predictors of 30-day readmission...
October 14, 2016: American Journal of Medicine
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
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
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
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
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
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
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
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
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
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
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
Julio Núñez, Pau Llàcer, Vicente Bertomeu-González, Maria José Bosch, Pilar Merlos, Sergio García-Blas, Vicente Montagud, Vicent Bodí, Vicente Bertomeu-Martínez, Valle Pedrosa, Andrea Mendizábal, Alberto Cordero, Jorge Gallego, Patricia Palau, Gema Miñana, Enrique Santas, Salvador Morell, Angel Llàcer, Francisco J Chorro, Juan Sanchis, Lorenzo Fácila
OBJECTIVES: The study sought to evaluate the prognostic effect of carbohydrate antigen 125 (CA125)-guided therapy (CA125 strategy) versus standard of care (SOC) after a hospitalization for acute heart failure (AHF). BACKGROUND: CA125 has emerged as a surrogate of fluid overload and inflammatory status in AHF. After an episode of AHF admission, elevated values of this marker at baseline as well as its longitudinal profile relate to adverse outcomes, making it a potential tool for treatment guiding...
August 1, 2016: JACC. Heart Failure
Onesmus Maina Muchemi, Agnes Wangechi Gichogo, Jane Githuku Mungai, Zeinab Gura Roka
INTRODUCTION: WHO classifies Kenya as having a high maternal mortality. Regional data on maternal mortality trends is only available in selected areas. This study reviewed health facility maternal mortality trends, causes and distribution in Central Region of Kenya, 2008-2012. METHODS: We reviewed health records from July 2008 to June 2012. A maternal death was defined according to ICD-10 criterion. The variables reviewed included socio-demographic, obstetric characteristics, reasons for admission, causes of death and contributing factors...
2016: Pan African Medical Journal
Yüksel Çavuşoğlu, Mehdi Zoghi, Mehmet Eren, Evin Bozçalı, Güliz Kozdağ, Tunay Şentürk, Güray Alicik, Korhan Soylu, İbrahim Sarı, Rida Berilgen, Ahmet Temizhan, Erkan Gencer, Ahmet Lütfü Orhan, Veli Polat, Aysel Aydın Kaderli, Meryem Aktoz, Halit Zengin, Mehmet Aksoy, Mehmet Timur Selçuk, Oktay Ergene, Özlem Soran
OBJECTIVE: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. METHODS: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC...
July 26, 2016: Anatolian Journal of Cardiology
Thomas McGraw
PURPOSE: To evaluate the safety and tolerability of aqueous solution concentrate (ASC) of polyethylene glycol (PEG) 3350 in patients with functional constipation. PATIENTS AND METHODS: The patients who met Rome III diagnostic criteria for functional constipation were randomized in this multicenter, randomized, placebo-controlled, single-blind study to receive once daily dose of PEG 3350 (17 g) ASC or placebo solution for 14 days. The study comprised a screening period (visit 1), endoscopy procedure (visits 2 and 3), and followup telephone calls 30 days post-treatment...
2016: Clinical and Experimental Gastroenterology
Lene Ryom, Jens D Lundgren, Mike Ross, Ole Kirk, Matthew Law, Philippe Morlat, Eric Fontas, Colette Smit, Christoph A Fux, Camilla I Hatleberg, Stéphane de Wit, Caroline A Sabin, Amanda Mocroft
BACKGROUND: While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)-positive individuals. METHODS: Individuals with ≥2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death...
October 15, 2016: Journal of Infectious Diseases
David S Strosberg, Todd Corbey, Jon C Henry, Jean E Starr
BACKGROUND: This study examined the outcomes of patients holding or continuing clopidogrel during the preoperative period. METHODS: We reviewed all patients taking clopidogrel who underwent one of 72 different Current Procedural Terminology code procedures, representing major emergency and elective general thoracic and vascular operations from 2009-2012 at a single institution. Demographics, comorbidities, aspirin use, details of coronary stents, and perioperative events were collected...
October 2016: Surgery
M Katherine Henry, Joanne N Wood, Kristina B Metzger, Konny H Kim, Chris Feudtner, Mark R Zonfrillo
OBJECTIVES: To describe the disposition of young children diagnosed with physical abuse in the emergency department (ED) setting and identify factors associated with the decision to discharge young abused children. STUDY DESIGN: We performed a retrospective cross-sectional study of children less than 2 years of age diagnosed with physical abuse in the 2006-2012 Nationwide Emergency Department Sample. National estimates were calculated accounting for the complex survey design...
October 2016: Journal of Pediatrics
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