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https://www.readbyqxmd.com/read/28638496/effect-of-early-follow-up-after-hospital-discharge-on-outcomes-in-patients-with-heart-failure-or-chronic-obstructive-pulmonary-disease-a-systematic-review
#1
(no author information available yet)
BACKGROUND: Transitions in care can increase patients' vulnerability to adverse events. In particular, patients admitted for heart failure or chronic obstructive pulmonary disorder (COPD) have high rates of readmission and return emergency department visits. Heart failure patients have the highest 30-day readmission rates in Canada, and COPD patients comprise the highest volume of readmissions. Combined, these two conditions account for the largest number of emergency department returns...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28633905/short-and-long-term-mortality-of-patients-presenting-with-bleeding-events-to-the-emergency-department
#2
Alberto Conti, Noemi Renzi, Daniele Molesti, Simone Bianchi, Irene Bogazzi, Giada Bongini, Giuseppe Pepe, Fabiana Frosini, Alessio Bertini, Massimo Santini
BACKGROUND: Death of patients presenting with bleeding events to the Emergency Department still represent a major problem. We sought to analyze clinical characteristics associated with worse outcomes including short- and long-term death, beyond antithombotic treatment strategy. METHODS: Patients presenting with any bleeding events during 2016-2017years were enrolled. Clinical parameters, site of bleeding, major bleeding, ongoing anti-thrombotic treatment strategy and death were collected...
June 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28550958/interprofessional-collaboration-to-improve-sepsis-care-and-survival-within-a-tertiary-care-emergency-department
#3
Elizabeth R Tedesco, Kimberly Whiteman, Melanie Heuston, Brenda Swanson-Biearman, Kimberly Stephens
PROBLEM: Sepsis is a leading cause of death in the United States; however, health care providers struggle with timely recognition, diagnosis, and treatment of patients. Both the Centers for Medicare and Medicaid Services and the National Quality Forum have identified this diagnosis as a priority. Presently, many patients with sepsis are identified late, resulting in significant morbidity and death. METHODS: In this project, a collaborative, interprofessional approach was created for screening and early identification of ED patients with possible sepsis...
May 25, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28499787/motocross-associated-head-and-spine-injuries-in-adult-patients-evaluated-in-an-emergency-department
#4
Lucas Oliveira J E Silva, M Fernanda Bellolio, Elisa M Smith, David J Daniels, Christine M Lohse, Ronna L Campbell
BACKGROUND: Motor vehicle-related injuries (including off-road) are the leading cause of traumatic brain injury (TBI) and acute traumatic spinal cord injury in the United States. OBJECTIVES: To describe motocross-related head and spine injuries of adult patients presenting to an academic emergency department (ED). METHODS: We performed an observational cohort study of adult ED patients evaluated for motocross-related injuries from 2010 through 2015...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28476551/emergency-department-visits-involving-benzodiazepines-and-non-benzodiazepine-receptor-agonists
#5
Christopher N Kaufmann, Adam P Spira, G Caleb Alexander, Lainie Rutkow, Ramin Mojtabai
OBJECTIVE: Sedative-hypnotic medications (e.g., Benzodiazepines [BZDs] and non-benzodiazepine receptor agonists [nBZRAs]) are associated with adverse events, especially in the elderly, that may require emergency department (ED) treatment. This study assessed outcomes from ED visits attributed to BZDs and/or nBZRAs, and variations in these associations by age group. METHODS: Data came from the 2004-2011 waves of the Drug Abuse Warning Network (DAWN). Visits were categorized as involving: (1) BZDs-only, (2) nBZRAs-only, (3) combination of BZDs and nBZRAs, or (4) any other sedative-hypnotic medication...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28466184/thirty-day-emergency-room-visits-and-hospital-admissions-after-outpatient-non-vascular-image-guided-procedures
#6
Quang Nguyen, Sahil V Mehta, Jieming Fang, Robert Sheiman, Robert Kane, Muneeb Ahmed, Ammar Sarwar, Bettina Siewert, Olga R Brook
PURPOSE: To evaluate the rate of post-procedure emergency department (ED) visits and hospital admissions following outpatient non-vascular image-guided interventions performed under moderate sedation and to identify common and preventable causes of emergency department visits and hospital admissions. MATERIALS AND METHODS: Institutional review board approval was acquired for this HIPAA-compliant retrospective study with waiver of informed consent. 1426 consecutive patients undergoing 1512 outpatient image-guided procedures under moderate sedation from November 2012 to August 2014 were included...
May 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28456130/suicide-prevention-in-an-emergency-department-population-the-ed-safe-study
#7
MULTICENTER STUDY
Ivan W Miller, Carlos A Camargo, Sarah A Arias, Ashley F Sullivan, Michael H Allen, Amy B Goldstein, Anne P Manton, Janice A Espinola, Richard Jones, Kohei Hasegawa, Edwin D Boudreaux
Importance: Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. Objective: To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. Design, Setting, and Participants: This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013...
June 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28455163/sex-differences-in-outcomes-after-discharge-from-the-emergency-department-for-atrial-fibrillation-flutter
#8
Rhonda J Rosychuk, Brian R Holroyd, Xuechen Zhang, Brian H Rowe, Michelle M Graham
BACKGROUND: Atrial fibrillation and flutter (AFF) are the most common arrhythmias presenting to emergency departments (EDs). We examined sex differences in outcomes for patients with AFF discharged from the ED in Alberta, Canada. METHODS: ED presentations for AFF during 1999-2011 that ended in discharge were extracted from administrative databases for all Alberta residents (age ≥ 35 years). Multivariable models determined the effect of sex on the time to ED return for AFF, the first follow-up visit with a physician, the first follow-up visit with a specialist (cardiologist or internal medicine physician), and death...
April 17, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28453819/evaluation-of-a-care-transition-program-with-pharmacist-provided-home-based-medication-review-for-elderly-singaporeans-at-high-risk-of-readmissions
#9
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...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28448329/effect-of-educational-program-on-self-care-behaviors-and-health-outcome-among-patients-with-heart-failure-an-experimental-study
#10
Manal M Al-Sutari, Muayyad M Ahmad
OBJECTIVES: To implement an educational program for patients with heart failure and to assess its effectiveness on self-care behaviors and health outcomes (frequency of hospitalizations, emergency department visits, and deaths). METHODS: A comparative-experimental design was used. A total of 144 participants were randomized into the intervention group (who received individualized education session, self-care manual, and weekly phone calls) and the control group (who received usual care)...
April 26, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28438951/team-based-versus-traditional-primary-care-models-and-short-term-outcomes-after-hospital-discharge
#11
Bruno D Riverin, Patricia Li, Ashley I Naimi, Erin Strumpf
BACKGROUND: Strategies to reduce hospital readmission have been studied mainly at the local level. We assessed associations between population-wide policies supporting team-based primary care delivery models and short-term outcomes after hospital discharge. METHODS: We extracted claims data on hospital admissions for any cause from 2002 to 2009 in the province of Quebec. We included older or chronically ill patients enrolled in team-based or traditional primary care practices...
April 24, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#12
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28431769/trends-in-admissions-for-chest-pain-after-the-introduction-of-high-sensitivity-cardiac-troponin-t
#13
Nadia Bandstein, Rickard Ljung, Magnus Lundbäck, Magnus Johansson, Martin J Holzmann
BACKGROUND: The aim was to describe temporal trends in admission rates for chest pain and patient outcomes after the clinical introduction of the high-sensitivity cardiac troponin T (hs-cTnT) assay. METHODS: We included all patients aged >25years presenting with chest pain to the emergency department (ED) at our hospital during 2011-2014. For each year, rates of admissions, coronary angiographies, and revascularizations were determined. After adjustment for confounders, hazard ratios (HR) with 95% confidence intervals (CI) were calculated for mortality or major adverse cardiac events (MACE) within 1year of the ED visit per year, using 2011 as referent...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28408815/mid-regional-pro-adrenomedullin-and-copeptin-to-predict-short-term-prognosis-of-copd-exacerbations-a-multicenter-prospective-blinded-study
#14
Martin Dres, Pierre Hausfater, Frantz Foissac, Maguy Bernard, Luc-Marie Joly, Mustapha Sebbane, Anne-Laure Philippon, Cédric Gil-Jardiné, Jeannot Schmidt, Maxime Maignan, Jean-Marc Treluyer, Nicolas Roche
BACKGROUND: Exacerbations of COPD (ECOPD) are a frequent cause of emergency room (ER) visits. Predictors of early outcome could help clinicians in orientation decisions. In the current study, we investigated whether mid-regional pro-adrenomedullin (MR-proADM) and copeptin, in addition to clinical evaluation, could predict short-term outcomes. PATIENTS AND METHODS: This prospective blinded observational study was conducted in 20 French centers. Patients admitted to the ER for an ECOPD were considered for inclusion...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28398566/twelve-month-health-care-use-and-mortality-in-commercially-insured-young-people-with-incident-psychosis-in-the-united-states
#15
Michael Schoenbaum, Jason M Sutherland, Andre Chappel, Susan Azrin, Amy B Goldstein, Agnes Rupp, Robert K Heinssen
OBJECTIVE: To assess 12-month mortality and patterns of outpatient and inpatient treatment among young people experiencing an incident episode of psychosis in the United States. METHOD: Prospective observational analysis of a population-based cohort of commercially insured individuals aged 16-30 receiving a first observed (index) diagnosis of psychosis in 2008-2009. Data come from the US Department of Health and Human Services' Multi-Payer Claims Database Pilot...
April 7, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28392080/an-exploratory-analysis-of-the-competing-effects-of-aggressive-decongestion-and-high-dose-loop-diuretic-therapy-in-the-dose-trial
#16
Jennifer S Hanberg, W H Wilson Tang, F Perry Wilson, Steven G Coca, Tariq Ahmad, Meredith A Brisco, Jeffrey M Testani
BACKGROUND: Effective decongestion of heart failure patients predicts improved outcomes, but high dose loop diuretics (HDLD) used to achieve diuresis predict adverse outcomes. In the DOSE trial, randomization to a HDLD intensification strategy (HDLD-strategy) improved diuresis but not outcomes. Our objective was to determine if potential beneficial effects of more aggressive decongestion may have been offset by adverse effects of the HDLD used to achieve diuresis. METHODS AND RESULTS: A post hoc analysis of the DOSE trial (n=308) was conducted to determine the influence of post-randomization diuretic dose and fluid output on the rate of death, rehospitalization or emergency department visitation associated with the HDLD-strategy...
August 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28350719/previous-emergency-medical-services-use-by-victims-of-child-homicide
#17
Rohit P Shenoi, Anriada Nassif, Elizabeth A Camp, Faria A Pereira
INTRODUCTION: The medical diagnoses and frequency of emergency department visits made by children who are later given a diagnosis of maltreatment do not differ much from those of nonabused children. However, the type of medical complaints and frequency of emergency medical services (EMS) use by child homicide victims before their death are not known. We compared EMS use between child homicide victims and children who died from natural causes before their death. METHODS: This was a retrospective case-control study of children 0 to 5 years old who died in Houston, Texas, from 2005 to 2010...
March 27, 2017: Pediatric Emergency Care
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
#18
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
#19
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-patients-with-traumatic-brain-injury-at-the-university-teaching-hospital-of-kigali-rwanda
#20
Elizabeth Krebs, Charles J Gerardo, Lawrence P Park, Joao Ricardo Nickenig Vissoci, Jean Claude Byiringiro, Fidele Byiringiro, Stephen Rulisa, Catherine A Staton, Nathan M Thielman
OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with TBI in low and middle-income countries have worse outcomes than patients in high-income countries. We evaluated important clinical indicators associated with mortality for patients with TBI at University Teaching Hospital of Kigali, Kigali, Rwanda. METHODS: A prospective consecutive sampling of patients with TBI presenting to University Teaching Hospital of Kigali Accident and Emergency Department was screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, and visible head trauma...
June 2017: World Neurosurgery
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