VESAS: A Solution to Seasonal Fluctuations in Emergency Department Census

Abstract Background Hypernatremia is one of the most commonly encountered electrolyte disorders in the emergency department (ED). Few studies have reported the seasonal fluctuations of the prevalence of hypernatremia with conflicting results. We investigated the seasonal prevalence of hypernatremia in an emergency department in Japan. Methods A total of 12,598 patients presented to the ED between January 2015 and December 2017 were reviewed. The adult group aged between 18 and 64 years old consisted of 5427 patients and the elderly group aged over 65 years consisted of 7171 patients. Information collected included age, sex, serum sodium, and serum creatinine. Hypernatremia was defined as a serum sodium leve1 > 145 mEq/L, and moderate to severe hypernatremia was defined as a serum sodium level ≥ 150 mEq/L. Results The prevalence of hypernatremia was significantly higher in the elderly group than in the adult group (2.6% vs. 0.7%; p < 0.001). Similarly, the prevalence of moderate to severe hypernatremia was significantly higher in the elderly group than in the adult group (1.0% vs. 0.1%; p < 0.001). The prevalence of hypernatremia and moderate to severe hypernatremia was significantly higher in the elderly group than in the adult group in all seasons. In the elderly group, the seasonal prevalence of moderate to severe hypernatremia was significantly higher during the winter. Also, there was a correlation between weather temperature and the prevalence of moderate to severe hypernatremia in the elderly group (r = − 0.34, p = 0.04). Conclusions Hypernatremia is prevalent in the elderly and the prevalence is highest during the winter. Special attention should be paid in the elderly patients to prevent hypernatremia especially in the winter.

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532 Clinical characteristics and diagnostic management of patients attended because of syncope in emergency department in Spain: a prospective study

EP Europace ◽

10.1016/s1099-5129(05)80338-1 ◽

2005 ◽

Vol 7 ◽

pp. 115-115

Keyword(s):

Emergency Department ◽

Prospective Study ◽

Clinical Characteristics ◽

Diagnostic Management ◽

A Prospective Study

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Preventing emergency department visits and hospitalizations for asthma by use of oral corticosteroids at home: Are we adhering to national guidelines?

Journal of Asthma ◽

10.1080/02770903.2010.514641 ◽

2010 ◽

pp. 100913044943042-5

Author(s):

Timothy H. Self ◽

Cary R. Chrisman ◽

Anna R. Jacobs ◽

Ngan H. Vo ◽

John C. Winton

Keyword(s):

Emergency Department ◽

Emergency Department Visits ◽

National Guidelines ◽

Oral Corticosteroids ◽

At Home

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Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽

10.1027/0227-5910/a000361 ◽

2016 ◽

Vol 37 (2) ◽

pp. 155-160 ◽

Cited By ~ 2

Author(s):

Jin Kim ◽

Han Joon Kim ◽

Soo Hyun Kim ◽

Sang Hoon Oh ◽

Kyu Nam Park

Keyword(s):

Emergency Department ◽

Medical Records ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Interview ◽

Clinical Variables ◽

Completed Suicide ◽

Number Of Patients ◽

Group A ◽

Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽

10.1027/0227-5910/a000282 ◽

2014 ◽

Vol 35 (6) ◽

pp. 406-414 ◽

Cited By ~ 10

Author(s):

Raimondo Maria Pavarin ◽

Angelo Fioritti ◽

Francesca Fontana ◽

Silvia Marani ◽

Alessandra Paparelli ◽

...

Keyword(s):

Emergency Department ◽

Metropolitan Area ◽

Suicidal Behavior ◽

Mortality Risk ◽

Illicit Drugs ◽

Attempted Suicide ◽

Cox Model ◽

Emergency Department Admission ◽

Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

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