scholarly journals PL004: A population-based analysis of outcomes in patients with a primary diagnosis of hypertension in the emergency department, using linked datasets

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S30-S30
Author(s):  
S. Masood ◽  
C.L. Atzema ◽  
P. Austin
Keyword(s):  
Emergency Department ◽  
Population Level ◽  
Population Based ◽  
Primary Diagnosis ◽  
Emergency Department Visits ◽  
Annual Number ◽  
Complication Rates ◽  
Number Of Visits ◽  
Diagnosis Of Hypertension ◽  
Age And Sex

Introduction: Patients seen primarily for hypertension are common in the emergency department. The outcomes of these patients have not been described at a population level. In this study we describe the characteristics and outcomes of the patients making these visits, as well as changes over time. Methods: This retrospective cohort study used linked health databases from the province of Ontario, Canada, to assess emergency department visits made between April 1, 2002 and March 31, 2012 with a primary diagnosis of hypertension. We determined the annual number of visits as well as the age and sex standardized rates. We examined visit disposition and assessed mortality outcomes and potential hypertensive complications at 7, 30, 90, 365 days and 2 years subsequent to the ED visit. Results: There were 206,147 qualifying ED visits from 180 sites. Visits increased by 64% between 2002 and 2012, from 15793 to 25950 annual visits, respectively. The age- and sex-standardized rate increased from 170/100,000 persons to 228/100,000 persons over the same time period, a 34% increase. Eight percent of visits ended in hospitalization, but this proportion decreased from 9.9% to 7.1% over the study period. Mortality was very low, at less than 1% within 90 days, 2.5% within 1 year, and 4.1% within 2 years. Among subsequent hospitalizations for potential hypertensive complications, stroke was the most frequent admitting diagnosis, but the frequency was still <1% within 1 year. Together hospitalizations for stroke, heart failure, acute myocardial infarction, atrial fibrillation, renal failure, hypertensive encephalopathy and dissection were <1% at 30 days. Conclusion: The number of visits made primarily for hypertension has increased dramatically over the last decade. While some of the increase is due to aging of the population, other forces are contributing to the increase. Subsequent mortality and complication rates are low and have declined. With current practice patterns, the feared complications of hypertension are extremely infrequent.

Socioeconomic and Geographic Disparities in Emergency Department Visits due to Alcohol in Ontario: A Retrospective Population-level Study from 2003 to 2017: Disparités Socio-Économiques et Géographiques Dans les Visites au Service D’urgence en raison de L’alcool en Ontario: Une étude Rétrospective Dans la Population, de 2003 à 2017

2021 ◽  
pp. 070674372110273
Author(s):  
Daniel Myran ◽  
Amy Hsu ◽  
Elizabeth Kunkel ◽  
Emily Rhodes ◽  
Haris Imsirovic ◽  
...  
Keyword(s):  
Emergency Department ◽  
Low Income ◽  
Population Level ◽  
Emergency Department Visits ◽  
Income Quintile ◽  
Urban Settings ◽  
Rural Settings ◽  
Ed Visits ◽  
Over Time ◽  
Age And Sex

Objective: While the overall health system burden of alcohol is large and increasing in Canada, little is known about how this burden differs by sociodemographic factors. The objectives of this study were to assess sociodemographic patterns and temporal trends in emergency department (ED) visits due to alcohol to identify emerging and at-risk subgroups. Methods: We conducted a retrospective population-level cohort study of all individuals aged 10 to 105 living in Ontario, Canada. We identified ED visits due to alcohol between 2003 and 2017 using defined International Classification of Diseases, 10th edition, codes from a pre-existing indicator. We calculated annual age- and sex-standardized, and age- and sex-specific rates of ED visits and compared overall patterns and changes over time between urban and rural settings and income quintiles. Results: There were 829,662 ED visits due to alcohol over 15 years. Rates of ED visits due to alcohol were greater for individual living in the lowest- compared to the highest-income quintile neighbourhoods, and disparities (rate ratio lowest to highest quintile) increased with age from 1.22 (95% CI, 1.19 to 1.25) in 15- to 18-year-olds to 4.17 (95% CI, 4.07 to 4.28) in 55- to 59-year-olds. Rates of ED visits due to alcohol were significantly greater in rural settings (56.0 per 10,000 individuals, 95% CI, 55.7 to 56.4) compared to urban settings (44.8 per 10,000 individuals, 95% CI, 44.7 to 44.9), particularly for young adults. Increases in rates of visits between 2003 and 2017 were greater in rural versus urban settings (82 vs. 68% increase in age- and sex-standardized rates) and varied across sociodemographic subgroups with the largest annual increases in rates of visits in young (15 to 29) low-income women (6.9%, 95%CI, 6.7 to 7.3) and the smallest increase in older (45 to 59) high-income men (2.7, 95%CI, 2.4 to 3.0). Conclusion: Alcohol harms display unique patterns with the highest burden in rural and lower-income populations. Rural–urban and income-based disparities differ by age and sex and have increased over time, which offers an imperative and opportunity for further interventions by clinicians and policy makers.

scholarly journals Patterns of healthcare utilisation for respiratory complications of adults with neuromuscular disease: a population study

2018 ◽  
Vol 52 (3) ◽  
pp. 1800754 ◽  
Author(s):  
Louise Rose ◽  
Douglas McKim ◽  
David Leasa ◽  
Mika Nonoyama ◽  
Anu Tandon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Neuromuscular Disease ◽  
Healthcare Utilisation ◽  
Population Level ◽  
Emergency Department Visits ◽  
Service Utilisation ◽  
Substantial Variation ◽  
Specialist Care ◽  
Respiratory Complications ◽  
Respiratory Specialist

Our objective was to quantify health service utilisation including monitoring and treatment of respiratory complications for adults with neuromuscular disease (NMD), identifying practice variation and adherence to guideline recommendations at a population level.We conducted a population-based longitudinal cohort study (2003–2015) of adults with NMD using hospital diagnostic and health insurance billing codes within administrative health databases.We identified 185 586 adults with NMD. Mean age 52 years, 59% female. 41 173 (22%) went to an emergency department for respiratory complications on average 1.6 times every 3 years; 14 947 (8%) individuals were admitted to hospital 1.4 times every 3 years. Outpatient respiratory specialist visits occurred for 64 084 (35%) with four visits every 3 years, although substantial variation in visit frequency was found. 157 285 (85%) went to the emergency department (all-cause) almost 4 times every 3 years, 100 052 (54%) were admitted to hospital. Individuals with amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) had more emergency department visits compared with other types of NMD (p<0.0001).One-third of adults with NMD received respiratory specialist care at a frequency recommended by professional guidelines, although substantial variation exists. Emergent healthcare utilisation was substantial, emphasising the burden of NMD on the healthcare system and urgent need to improve community and social supports, particularly for ALS/MND patients.

scholarly journals Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007−2014: a population-based cohort study from the North Denmark Region

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014508 ◽  
Author(s):  
Erika Frischknecht Christensen ◽  
Mette Dahl Bendtsen ◽  
Thomas Mulvad Larsen ◽  
Flemming Bøgh Jensen ◽  
Tim Alex Lindskou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Population Based ◽  
Ambulance Service ◽  
Annual Number ◽  
Adjusted Relative Risk ◽  
Risk Of Death ◽  
The North ◽  
Emergency Ambulance ◽  
Age And Sex

ObjectiveDemand for ambulances is growing. Nevertheless, knowledge is limited regarding diagnoses and outcomes in patients receiving emergency ambulances. This study aims to examine time trends in diagnoses and mortality among patients transported with emergency ambulance to hospital.DesignPopulation-based cohort study with linkage of Danish national registries.SettingThe North Denmark Region in 2007–2014.ParticipantsCohort of 148 757 patients transported to hospital by ambulance after calling emergency services.Main outcome measuresThe number of emergency ambulance service patients, distribution of their age, sex, hospital diagnoses, comorbidity, and 1-day and 30-day mortality were assessed by calendar year. Poisson regression with robust variance estimation was used to estimate both age-and sex-adjusted relative risk of death and prevalence ratios for Charlson Comorbidity Index (CCI) to allow comparison by year, with 2007 as reference year.ResultsThe annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48.6%, respectively. The proportion of injuries gradually declined, non-specific diagnoses increased, especially the last year. Proportion of patients with high comorbidity (CCI≥3) increased from 6.4% in 2007 to 9.4% in 2014, corresponding to an age- and sex-adjusted prevalence ratio of 1.27 (95% CI 1.16 to 1.39). The 1-day and 30 day mortality decreased from 2.40% to 1.21% and from 5.01% to 4.36%, respectively, from 2007 to 2014, corresponding to age-adjusted and sex-adjusted relative risk of 0.43 (95% CI 0.37 to 0.50) and 0.72 (95% CI 0.66 to 0.79), respectively.ConclusionDuring the 8-year period, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased.

scholarly journals A population-based epidemiologic study of emergency department visits for anaphylaxis in Florida

2011 ◽  
Vol 128 (3) ◽  
pp. 594-600.e1 ◽  
Author(s):  
Laurel Harduar-Morano ◽  
Michael R. Simon ◽  
Sharon Watkins ◽  
Carina Blackmore
Keyword(s):  
Emergency Department ◽  
Epidemiologic Study ◽  
Population Based ◽  
Emergency Department Visits
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