Risk factors for severe anaphylaxis in patients receiving anaphylaxis treatment in US emergency departments and hospitals

2014 ◽  
Vol 134 (5) ◽  
pp. 1125-1130 ◽  
Author(s):  
Sunday Clark ◽  
Wenhui Wei ◽  
Susan A. Rudders ◽  
Carlos A. Camargo
Keyword(s):  
Risk Factors ◽  
Emergency Departments ◽  
Severe Anaphylaxis

The Epidemiology of Household Rodenticides Poisoning in Hong Kong and its Risk Factors for Developing Coagulopathy

2014 ◽  
Vol 21 (6) ◽  
pp. 339-345 ◽  
Author(s):  
N Othman ◽  
Ck Chan ◽  
Fl Lau
Keyword(s):  
Risk Factors ◽  
Hong Kong ◽  
Emergency Departments ◽  
Multiple Logistic Regression Analysis ◽  
Case Series ◽  
Female Ratio ◽  
Intentional Ingestion ◽  
Accident And Emergency ◽  
Case Series Study ◽  
Clinically Significant

Objective To (1) describe the epidemiology of household rodenticides poisoning in Hong Kong, (2) evaluate the proportion of patients who have develop coagulopathy after rodenticide poisoning, (3) identify the risk factors for developing coagulopathy in rodenticide poisoning. Design Case series study. Setting Sixteen accident and emergency departments in Hong Kong. Patients Patients with household rodenticide ingestion who presented to accident and emergency departments during the period from July 2008 to February 2012. Results 110 patients were reported to have rodenticide exposure during the study period. Eighty-seven patients were included in the final analysis. The mean age was 40.1 and the male-to-female ratio was 1.29:1 (49:38). Most patients (91%) took the rodenticide intentionally. Sixty-nine patients (79%) exposed to anticoagulants type of rodenticide based on history or laboratory findings. The ingredient of the rodenticide ingested in 18 patients (21%) was untraceable. The only clinically significant presentation reported after rodenticide exposure was coagulopathy. Thirty-one patients (36%) developed coagulopathy with an international normalised ratio greater or equal to 1.3. Clinical significant bleeding was only observed in one patient. Presence of coagulopathy in rodenticide poisoning was significantly associated with older patient, intentional ingestion, ingestion of warfarin, ingestion of more than one pack and presence of co-ingestion. Multiple logistic regression analysis showed that only two factors were independent predictor of coagulopathy: Ingestion of warfarin rodenticide (p=0.001, odds ratio [OR] = 18.20, 95% confidence interval [CI]=3.44-96.42), and ingestion of more than one pack of rodenticide (p=0.02, OR=10.01, 95% CI=1.43-69.87). Conclusions Clinically significant household rodenticide poisoning in Hong Kong is solely related to ingestion of anticoagulant type of rodenticide. Patients who have ingested warfarin rodenticide and higher ingestion dose are more likely in developing coagulopathy. (Hong Kong j.emerg.med. 2014;21:339-345)

scholarly journals Secondary analysis of frequency, circumstances and consequences of calculation errors of the HEART (history, ECG, age, risk factors and troponin) score at the emergency departments of nine hospitals in the Netherlands

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017259 ◽  
Author(s):  
Marten Ras ◽  
Johannes B Reitsma ◽  
Arno W Hoes ◽  
Alfred Jacob Six ◽  
Judith M Poldervaart
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Emergency Departments ◽  
Clinical Decision Making ◽  
Troponin T ◽  
Secondary Analysis ◽  
Daily Practice ◽  
Heart Score ◽  
Risk Categorisation ◽  
Made In

ObjectiveThe HEART score can accurately stratify the risk of major adverse cardiac events (MACE) in patients with chest pain. We investigated the frequency, circumstances and potential consequences of errors in its calculation.MethodsWe performed a secondary analysis of a stepped wedge trial of patients with chest pain presenting to nine Dutch emergency departments. We recalculated HEART scores for all patients by re-evaluating the elements age (A), risk factors (R) and troponin (T) and compared these new scores with those given by physicians in daily practice. We investigated which circumstances increased the probability of incorrect scoring and explored the potential consequences.ResultsThe HEART score was incorrectly scored in 266 out of 1752 patients (15.2%; 95% CI 13.5% to 16.9%). Most errors occurred in the R (‘Risk factors’) element (61%). Time of admission, and patient’s age or gender did not contribute to errors, but more errors were made in patients with higher scores. In 102 patients (5.8%, 95% CI 4.7% to 6.9%) the incorrect HEART score resulted in incorrect risk categorisation (too low or too high). Patients with an incorrectly calculated HEART score had a higher risk of MACE (OR 1.85; 95% CI 1.37 to 2.50), which was largely related to more errors being made in patients with higher HEART scores.ConclusionsOur results show that the HEART score was incorrectly calculated in 15% of patients, leading to inappropriate risk categorisation in 5.8% which may have led to suboptimal clinical decision-making and management. Actions should be taken to improve the score’s use in daily practice.

scholarly journals Psychological Risk Factors of Suicide Attempts in Patients Admitted to Emergency Departments

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Ali Asghar Manouchehri Amoli ◽  
Malihe Allahyari ◽  
Sussan Moudi ◽  
Mehryar Nader Mohammadi ◽  
Ali Bijani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Departments ◽  
Suicide Attempts ◽  
Psychological Risk Factors ◽  
Psychological Risk

scholarly journals Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based case-control study

2019 ◽  
Vol 41 ◽  
pp. e2019016 ◽  
Author(s):  
Hamideh Feiz Disfani ◽  
Mostafa Kamandi ◽  
Seyed Mohammad Mousavi ◽  
Sayyed Majid Sadrzadeh ◽  
Roohie Farzaneh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Departments ◽  
Case Control Study ◽  
Multiple Logistic Regression Analysis ◽  
Case Control ◽  
Incidence And Mortality ◽  
Childhood Poisoning ◽  
History Of ◽  
Emergency Department Patients ◽  
Control Study

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

scholarly journals Carrier prevalence and risk factors for colonisation of multiresistant bacteria in Danish emergency departments: a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029000 ◽  
Author(s):  
Helene Skjøt-Arkil ◽  
Christian Backer Mogensen ◽  
Annmarie Touborg Lassen ◽  
Isik S Johansen ◽  
Ming Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Departments ◽  
Respiratory Infections ◽  
Age Groups ◽  
Antibiotic Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Multiresistant Bacteria ◽  
Significant Difference

ObjectivesThe aim of this study was to describe the carrier prevalence and demographic variation of four different multiresistant bacteria (MRB) among acute patients in Danish emergency departments (EDs): methicillin-resistantStaphylococcus aureus(MRSA), carbapenemase-producing enterobacteria (CPE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE), and to analyse the association of MRB carriage to a range of potential risk factors.DesignMulticentre descriptive and analytic cross-sectional survey.SettingEight EDs and four clinical microbiology departments in Denmark.ParticipantsAdults visiting the ED.Main outcome measuresSwabs from nose, throat and rectum were collected and analysed for MRSA, ESBL, VRE and CPE. The primary outcome was the prevalence of MRB carriage, and secondary outcomes relation to risk factors among ED patients.ResultsWe included 5117 patients in the study. Median age was 68 years (54–77) and gender was equally distributed. In total, 266 (5.2%, 95% CI 4.6 to 5.8) were colonised with at least one MRB. No significant difference was observed between male and female patients, between age groups and between university and regional hospitals. Only 5 of the 266 patients with MRB were colonised with two of the included bacteria and none with more than two. CPE prevalence was 0.1% (95% CI 0.0 to 0.2), MRSA prevalence was 0.3% (95% CI 0.2 to 0.5), VRE prevalence was 0.4% (95% CI 0.3 to 0.6) and ESBL prevalence was 4.5% (95% CI 3.9 to 5.1). Risk factors for MRB carriage were previous antibiotic treatment, previous hospital stay, having chronic respiratory infections, use of urinary catheter and travel to Asia, Oceania or Africa.ConclusionEvery 20th patient arriving to a Danish ED brings MRB to the hospital. ESBL is the most common MRB in the ED. The main risk factors for MRB carriage are recent antibiotic use and travel abroad.Trial registration numberNCT03352167;Post-results.

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