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Death after emergency visit

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https://www.readbyqxmd.com/read/28344421/impact-of-physician-coordinated-intensive-follow-up-on-long-term-medical-costs-in-patients-with-unstable-angina-undergoing-percutaneous-coronary-intervention
#1
Jing-Jing Jia, Ping-Shuan Dong, Lai-Jing Du, Zhi-Guo Li, Li-Hong Lai, Xu-Ming Yang, Shao-Xin Wang, Xi-Shan Yang, Zhi-Juan Li, Xi-Yan Shang, Xi-Mei Fan
BACKGROUND: To investigate the impact of professional physician-coordinated intensive follow-up on long-term expenditures after percutaneous coronary intervention (PCI) in unstable angina (UA) patients. METHODS: In this study, there were 669 UA patients who underwent successful PCI and followed up for 3 years, then divided into the intensive follow-up group (N = 337), and the usual follow-up group (N = 332). Patients were provided with detailed discharge information and individualized follow-up schedules...
March 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28341087/the-impact-of-a-pediatric-emergency-department-facility-verification-system-on-pediatric-mortality-rates-in-arizona
#2
Amber Rice, Jennifer Dudek, Toni Gross, Tomi St Mars, Dale Woolridge
BACKGROUND: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. OBJECTIVE: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336445/mortality-associated-characteristics-of-traumatic-brain-injury-patients-at-the-university-teaching-hospital-of-kigali-rwanda
#3
Elizabeth Krebs, Charles J Gerardo, Lawrence P Park, Joao Ricardo Nickenig Vissoci, Jean Claude Byiringiro, Fidele Byiringiro, Stephen Rulisa, Nathan Thielman, Catherine Staton
OBJECTIVE: Traumatic Brain Injury (TBI) is a leading cause of death and disability. TBI patients in low and middle- income countries have worse outcomes than those in high-income countries. We aimed to evaluate important clinical indicators associated with mortality for TBI patients at the University Teaching Hospital of Kigali (UTHK) Kigali, Rwanda. METHODS: Prospective consecutive sampling of TBI patients presenting to UTHK Accident and Emergency Department were screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, or visible head trauma...
March 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28266943/traumatic-brain-injury-in-the-netherlands-trends-in-emergency-department-visits-hospitalization-and-mortality-between-1998-and-2012
#4
Crispijn L Van den Brand, Lennard B Karger, Susanne T M Nijman, Myriam G M Hunink, Peter Patka, Korné Jellema
BACKGROUND: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. The effects of epidemiological changes such as ageing of the population and increased traffic safety on the incidence of TBI are unknown. OBJECTIVE: The objective of this study was to evaluate trends in TBI-related emergency department (ED) visits, hospitalization and mortality in the Netherlands between 1998 and 2012. DESIGN: This was a retrospective observational, longitudinal study...
March 6, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#5
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#6
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28183322/impact-of-a-pharmacist-led-medication-review-on-hospital-readmission-in-a-pediatric-and-elderly-population-study-protocol-for-a-randomized-open-label-controlled-trial
#7
Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28156486/referral-patterns-among-patients-with-metastatic-breast-cancer-in-an-integrated-palliative-care-program
#8
Jeffrey Belkora, Melanie Catherine Majure, Amy Jo Chien, Michelle E Melisko, Hope S Rugo, Michael W Rabow
163 Background: ASCO recommends palliative care (PC) concurrently with oncologic treatment for patients with metastatic disease and there is emerging data about the benefits of early PC. However, little is known about referral patterns to specialty PC among patients who die of metastatic breast cancer. METHODS: After years of offering a stand-alone outpatient PC consult service in our comprehensive cancer center, we established an integrated PC program in breast oncology (the "Advanced Breast Cancer (ABC) Program") with a care coordinator, PC physician, and co-location with oncology...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148486/early-death-after-discharge-from-emergency-departments-analysis-of-national-us-insurance-claims-data
#9
Ziad Obermeyer, Brent Cohn, Michael Wilson, Anupam B Jena, David M Cutler
OBJECTIVE:  To measure incidence of early death after discharge from emergency departments, and explore potential sources of variation in risk by measurable aspects of hospitals and patients. DESIGN:  Retrospective cohort study. SETTING:  Claims data from the US Medicare program, covering visits to an emergency department, 2007-12. PARTICIPANTS:  Nationally representative 20% sample of Medicare fee for service beneficiaries...
February 1, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28111065/changes-in-provider-prescribing-patterns-after-implementation-of-an-emergency-department-prescription-opioid-policy
#10
Scott R Osborn, Julianna Yu, Barbara Williams, Maria Vasilyadis, C Craig Blackmore
BACKGROUND: Prescription opioid-associated abuse and overdose is a significant cause of morbidity and mortality in the United States. Opioid prescriptions generated from emergency departments (EDs) nationwide have increased dramatically over the past 20 years, and opioid-related overdose deaths have become an epidemic, according to the Centers for Disease Control and Prevention. OBJECTIVE: Our aim was to determine the effectiveness of implementing a prescription policy for opioids on overall opioid prescribing patterns in a hospital ED...
April 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28073040/the-application-of-the-interpersonal-psychological-theory-of-suicide-to-a-sample-of-swiss-patients-attending-a-psychiatric-emergency-department-for-a-non-lethal-suicidal-event
#11
Marc Baertschi, Alessandra Costanza, Hélène Richard-Lepouriel, Maurizio Pompili, François Sarasin, Kerstin Weber, Alessandra Canuto
BACKGROUND: Visits to emergency departments (EDs) for suicidal ideation or a suicide attempt have increased in the past decades. Yet comprehensive models of suicide are scarce, potentially enhancing misunderstandings from health professionals. This study aimed to investigate the applicability of the interpersonal-psychological theory of suicide (IPTS) in a population visiting EDs for suicide-related issues. METHODS: Three major hypotheses formulated by the IPTS were tested in a sample of 167 individuals visiting EDs for suicidal ideation or a suicide attempt...
January 3, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28056201/predictors-of-and-trends-in-high-intensity-end-of-life-care-among-children-with-cancer-a-population-based-study-using-health-services-data
#12
Alisha Kassam, Rinku Sutradhar, Kimberley Widger, Adam Rapoport, Jason D Pole, Katherine Nelson, Joanne Wolfe, Craig C Earle, Sumit Gupta
Purpose Children with cancer often receive high-intensity (HI) medical care at the end-of-life (EOL). Previous studies have been limited to single centers or lacked detailed clinical data. We determined predictors of and trends in HI-EOL care by linking population-based clinical and health-services databases. Methods A retrospective decedent cohort of patients with childhood cancer who died between 2000 and 2012 in Ontario, Canada, was assembled using a provincial cancer registry and linked to population-based health-care data...
January 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28041612/evaluation-of-a-routine-follow-up-visit-after-an-internal-fixation-of-proximal-femoral-fracture
#13
Joonas Mm Kuorikoski, Tim P Söderlund
BACKGROUND AND PURPOSE: Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. PATIENTS AND METHODS: A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013...
February 2017: Injury
https://www.readbyqxmd.com/read/28035037/evaluation-of-a-care-transition-program-with-pharmacist-provided-home-based-medication-review-for-elderly-singaporeans-at-high-risk-of-readmissions
#14
McVin Hua Heng Cheen, Chong Ping Goon, Wan Chee Ong, Paik Shia Lim, Choon Nam Wan, Mei Yan Leong, Giat Yeng Khee
OBJECTIVE: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. DESIGN: Retrospective cohort study. SETTING: Patient's home. PARTICIPANTS: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included...
December 29, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28025766/safety-of-cardioversion-in-atrial-fibrillation-lasting-less-than-48%C3%A2-h-without-post-procedural-anticoagulation-in-patients-at-low-cardioembolic-risk
#15
Andrea Tampieri, Valentina Cipriano, Fabrizio Mucci, Anna Maria Rusconi, Tiziano Lenzi, Patrizia Cenni
Currently, there is no unified consensus on short-term anticoagulation after cardioversion of atrial fibrillation lasting less than 48 h in low-cardioembolic-risk patients. The aim of this study is to evaluate the rate of transient ischemic attacks, stroke and death in this subset of patients after cardioversion without post-procedural anticoagulation. In a prospective observational study, patients with recent-onset AF undergoing cardioversion attempts in the Emergency Department were evaluated over the past 3 years...
December 26, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28005123/addressing-the-opioid-epidemic-with-multimodal-pain-management
#16
Michael A Kelly
The opioid epidemic has become a national public health and safety problem affecting both adults and adolescents. There is little doubt that this epidemic is rooted in the need for pain control after surgery and that orthopedic surgeons have in part contributed to opioid overprescription. Indeed, opioid abuse, misuse, and diversion are associated with increased hospitalizations, emergency department visits, and associated health care costs. In addition, postoperative exposure to opioids correlates with long-term use and abuse...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27989992/adverse-outcomes-in-older-adults-attending-emergency-departments-a-systematic-review-and-meta-analysis-of-the-identification-of-seniors-at-risk-isar-screening-tool
#17
Rose Galvin, Yannick Gilleit, Emma Wallace, Gráinne Cousins, Manon Bolmer, Timothy Rainer, Susan M Smith, Tom Fahey
BACKGROUND: older adults are frequent users of emergency services and demonstrate high rates of adverse outcomes following emergency care. OBJECTIVE: to perform a systematic review and meta-analysis of the Identification of Seniors At Risk (ISAR) screening tool, to determine its predictive value in identifying adults ≥65 years at risk of functional decline, unplanned emergency department (ED) readmission, emergency hospitalisation or death within 180 days after index ED visit/hospitalisation...
December 17, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27932362/predicting-functional-decline-in-older-emergency-patients-the-safe-elderly-emergency-discharge-seed-project
#18
Judy A Lowthian, Lahn D Straney, Caroline A Brand, Anna Barker, P de Villiers Smit, Harvey Newnham, Peter Hunter, Cathie Smith, Peter A Cameron
OBJECTIVE: to profile the trajectory of, and risk factors for, functional decline in older patients in the 30 days following Emergency Department (ED) discharge. METHODS: prospective cohort study of community-dwelling patients aged ≥65 years, discharged home from a metropolitan Melbourne ED, 31 July 2012 to 30 November 2013. The primary outcome was functional decline, comprising either increased dependency in personal activities of daily living (ADL) or in skills required for living independently instrumental ADL (IADL), deterioration in cognitive function, nursing home admission or death...
December 7, 2016: Age and Ageing
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
#19
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...
January 14, 2017: Lancet
https://www.readbyqxmd.com/read/27880003/association-of-multimorbidity-with-mortality-and-healthcare-utilization-in-chronic-kidney-disease
#20
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
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