National trends in chest pain visits in US emergency departments (2006–2016)

2020 ◽  
Vol 37 (11) ◽  
pp. 696-699
Author(s):  
Ahmad A Aalam ◽  
Awad Alsabban ◽  
Jesse M Pines
Keyword(s):  
Chest Pain ◽  
Admission Rate ◽  
National Sample ◽  
Admission Rates ◽  
Common Complaint ◽  
Inpatient Hospitalisation ◽  
The Usa ◽  
Ed Visits ◽  
Using Data ◽  
National Trends

BackgroundChest pain is a common complaint in EDs. In this study, we describe demographic, care and cost trends in US ED visits for chest pain over 11 years.MethodsThis is a retrospective descriptive study of trends in utilisation and care of ED chest pain visits from 2006 to 2016) using data from the Healthcare Cost and Utilization Project database, a national sample of US ED visits and hospitalisations.ResultsFrom 2006 to 2016, there were 42.48 million chest pain visits. Visits per 100 000 persons increased from 1140.4 in 2006 to 1611.7 in 2016 (p<0.001). The chest pain inpatient admission rate declined from 19% in 2006 to 3.9% in 2016 (p<0.001); associated inpatient hospitalisation costs declined from $10.4 billion (2006–2008) to $6.2 billion (2012–2014).ConclusionFrom 2006 to 2016, ED visits in the USA for chest pain increased with a significant decline in admission rates and inpatient hospitalisation costs.

Social determinants of self-reported pre-exposure prophylaxis use among a national sample of US men who have sex with men

2019 ◽  
Vol 96 (5) ◽  
pp. 368-374
Author(s):  
Brian A Chu ◽  
Erick R Castellanos ◽  
Manuel M Gonzales ◽  
Thomas W Gaither
Keyword(s):  
Social Determinants ◽  
Hiv Transmission ◽  
National Sample ◽  
Black Msm ◽  
The South ◽  
Southern Us ◽  
The Usa ◽  
Sex With Men ◽  
Using Data ◽  
Exposure Prophylaxis

PurposeVarious disparities exist in HIV transmission among men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has been shown to decrease the acquisition of HIV, but there is variation in uptake within the MSM population. We aim to characterise PrEP use and correlates of self-reported PrEP use in a large national sample of urban MSM in the USA.MethodsUsing data from a geosocial-networking application, a national sample (n=3744) from the largest 50 metropolitan centres in the USA was obtained.ResultsWe found 18.1% (95% CI 16.8 to 19.3) of profiles reported using PrEP, with decreased reported PrEP use in younger MSM aged 18–24 years (adjusted OR (aOR)=0.5, 95% CI 0.3 to 0.7), obese MSM (aOR=0.5, 95% CI 0.3 to 0.9), black MSM (aOR=0.6, 95% CI 0.4 to 0.9) and MSM in the South (aOR=0.7, 95% CI 0.5 to 0.9).ConclusionSignificant disparities exist in PrEP reporting by age and among black, Southern US and obese MSM. More research is needed to better understand these disparities.

scholarly journals Methamphetamine Use and Emergency Department Utilization: 20 Years Later

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
John R. Richards ◽  
Sheiva Hamidi ◽  
Connor D. Grant ◽  
Colin G. Wang ◽  
Nabil Tabish ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Resource Utilization ◽  
Admission Rate ◽  
Lower Proportion ◽  
Emergency Department Utilization ◽  
Older Patient ◽  
Methamphetamine Use ◽  
The Past ◽  
Ed Visits

Background. Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. The purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed.Methods. Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED.Results. 638 MAP-positive patients, 3,013 toxicology screens, and 20,203 ED visits represented an increase in prevalence compared to 1996: 461 MAP-positive patients, 3,102 screens, and 32,156 visits. MAP patients were older compared to the past. Mode of arrival was most frequently by ambulance but at a lower proportion than 1996, as was the proportion of MAP patients with positive cocaine toxicology screens and ethanol coingestion. Admission rate was lower compared to the past, as was discharge to jail. The proportion of MAP patients presenting with blunt trauma was lower compared to the past and higher for chest pain.Conclusion. A significant increase in the prevalence of MAP-positive patients was found. Differences in presenting complaints and resource utilization may reflect the shifting demographics of MAP users, as highlighted by an older patient population relative to the past.

scholarly journals Epidemiological trends in COVID-19 pandemic: prospective critical appraisal of observations from six countries in Europe and the USA

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045782
Author(s):  
Maria Alexandra Velicu ◽  
Luciano Furlanetti ◽  
Josephine Jung ◽  
Keyoumars Ashkan
Keyword(s):  
Public Health ◽  
Hospital Admissions ◽  
Disease Prevalence ◽  
Warning Signs ◽  
Contributing Factors ◽  
Admission Rates ◽  
Health Measures ◽  
The Usa ◽  
Using Data ◽  
Over Time

IntroductionEurope was the epicentre of the COVID-19 pandemic in March 2020, with the highest number of cases and deaths between March and April. In May, the infection numbers registered a fall followed by a second new rise, not proportionally reflected by an increase in the number of deaths. We aimed to investigate the relationship between disease prevalence and infection fatality rate (IFR), and the number of intensive care unit (ICU) and hospital admissions over time, to develop a predictive model, as well as appraising the potential contributing factors underpinning this complex relationship.MethodsA prospective epidemiological study using data from six countries collected between 10 March and 4 September 2020. Data on the number of daily hospital and ICU admissions with COVID-19 were gathered, and the IFR and the prevalence were calculated. Trends over time were analysed. A linear regression model was used to determine the association between the fatality rates and the number of admissions.FindingsThe prediction model confirmed the linear association between the fatality rates and the numbers of ICU and hospital admissions. The exception was during the peak of the COVID-19 pandemic when the model underestimated the fatalities indicating that a substantial number of deaths occurred outside of the hospitals. The fatality rates decreased in all countries from May until September regardless of the trends in prevalence, differences in healthcare systems or strategic variations in handling the pandemic.InterpretationThe observed gradual reduction in COVID-19 fatality rates over time despite varying disease prevalence and public health measures across multiple countries warrants search for a biological explanation. While our understanding of this novel virus grows, hospital and ICU admission rates remain effective predictors of patient outcomes which can be used as early warning signs for escalation of public health measures.

Headache in United States Emergency Departments

Cephalalgia ◽  
2006 ◽  
Vol 26 (6) ◽  
pp. 684-690 ◽  
Author(s):  
JN Goldstein ◽  
CA Camargo ◽  
AJ Pelletier ◽  
JA Edlow
Keyword(s):  
Private Insurance ◽  
Multivariable Analysis ◽  
Pathological Diagnosis ◽  
Common Complaint ◽  
The Usa ◽  
Presentation Time ◽  
Care Survey ◽  
Ed Visits ◽  
Ambulatory Medical Care ◽  
To Receive

Headache is a common complaint in the emergency department (ED). In order to examine headache work-ups and diagnoses across the USA, we queried a representative sample of adult ED visits (the National Hospital Ambulatory Medical Care Survey) for the years 1992–2001. Headache accounted for 2.1 million ED visits per year (2.2% of visits). Of the 14% of patients who underwent neuroimaging, 5.5% received a pathological diagnosis. Of the 2% of patients who underwent lumbar puncture, 11% received a pathological diagnosis. On multivariable analysis, a decreased rate of imaging was noted for patients without private insurance [odds ratio (OR) 0.61, confidence interval (CI) 0.44, 0.86] and for those presenting off-hours (OR 0.55, CI 0.39, 0.77). Patients over 50 were more likely to receive a pathological diagnosis (OR 3.3, CI 1.2, 9.3). In conclusion, clinicians should ensure that appropriate work-ups are performed regardless of presentation time or insurance status, and be vigilant in the evaluation of older patients.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

scholarly journals 272 Morbid Obesity in Lower Limb Arthroplasty: Short Length of Stay and Favourable One-Year Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Sharrock ◽  
A Nugur ◽  
S Hossain
Keyword(s):  
Morbid Obesity ◽  
Length Of Stay ◽  
Lower Limb ◽  
Average Length ◽  
Perioperative Complications ◽  
Joint Infection ◽  
Admission Rate ◽  
Tendon Injury ◽  
Morbidly Obese ◽  
Admission Rates

Abstract Introduction There are concerns that BMI is associated with a greater length of stay (LOS) and perioperative complications in lower limb arthroplasty. Method We analysed data from a six-month period to see if there was a correlation between BMI and LOS. We performed a subgroup analysis for patients with morbid obesity (BMI &gt;40). Results 285 TKRs and 195 THRs were analysed. For TKRs, the average length of stay was 2.7 days. There was no significant correlation between BMI and LOS (r=-0.0447, p = 0.2267). The morbidly obese category (n = 33) had the shortest LOS (2.5 days) compared to other BMI categories. 30-day readmission rate was 6%. 90-day re-admission rate was 12%. Six patients had minor wound issues requiring no intervention or antibiotics only. The was one prosthetic joint infection, one stitch abscess, one DVT and one patellar tendon injury. For THRs, the average LOS was 2.9 days. There was no significant correlation between BMI and LOS (r = 0.007, p = 0.4613). The morbid obese category (n = 9) had the shortest LOS (1.9 days) compared to other BMI categories. No patients were readmitted within 90 days or had documented complications. Conclusions Increased BMI is not associated with increased LOS. The morbidly obese had the shortest LOS, and commendable complication and re-admission rates.

Association between E-cigarette use and chronic obstructive pulmonary disease in non-asthmatic adults in the USA

2020 ◽  
Author(s):  
Godfred O Antwi ◽  
Darson L Rhodes
Keyword(s):  
Sex Education ◽  
Smoking Status ◽  
Secondary Data ◽  
Chronic Obstructive ◽  
Behavioral Risk ◽  
Cigarette Use ◽  
Obstructive Pulmonary Disease ◽  
The Usa ◽  
Potential Link ◽  
Using Data

Abstract Background Concern about the health impacts of e-cigarette use is growing; however, limited research exists regarding potential long-term health effects of this behavior. This study explored the relationship between e-cigarette use and COPD in a sample of US adults. Methods A secondary data analysis using data from the 2018 Behavioral Risk Factor Surveillance Survey in the USA was computed to examine associations between e-cigarette use and COPD controlling for conventional cigarette smoking status, past month leisure physical activity and demographic characteristics including age, sex, education, race, marital status and body mass index. Results Significant associations between e-cigarette use and COPD among former combustible cigarette smokers and those who reported never using combustible cigarettes were found. Compared with never e-cigarette users, the odds of having COPD were significantly greater for daily e-cigarette users (OR = 1.53; 95% CI: 1.11–2.03), occasional users (OR = 1.43, 95% CI: 1.13–1.80) and former users (OR = 1.46 95% CI: 1.28–1.67). Conclusions Findings from this study indicate a potential link between e-cigarette use and COPD. Further research to explore the potential effects of e-cigarette on COPD is recommended.

Multi-stakeholder initiatives and the divergent construction and implementation of sustainable agriculture in the USA

2017 ◽  
Vol 34 (04) ◽  
pp. 293-303 ◽  
Author(s):  
Jason Konefal ◽  
Maki Hatanaka ◽  
Douglas H. Constance
Keyword(s):  
Sustainable Agriculture ◽  
Ecological Systems ◽  
Agricultural Sustainability ◽  
Power Relationships ◽  
Specialty Crops ◽  
Institutional Approach ◽  
Governance Practices ◽  
The Usa ◽  
Using Data ◽  
Multi Stakeholder

AbstractMulti-stakeholder initiatives (MSIs) have emerged as a leading institutional approach for advancing sustainability globally. This paper examines three prominent MSIs that have developed sustainability metrics and a standard for US agriculture: Field to Market, the Stewardship Index for Specialty Crops and the National Sustainable Agricultural Standard Initiative. Using data from interviews and content analysis of initiative reports, two sets of analyses are presented. First, building on Paul Thompson's tri-partite theorization of sustainability, how each initiative is conceptualizing agricultural sustainability is analyzed. We find that two contrasting visions of sustainable agriculture for the USA have emerged from the three MSIs. One vision is a resource sufficiency approach focused on eco-efficiencies and the other vision is a functional integrity approach that emphasizes the maintenance of resilient agricultural and ecological systems. Second, we examine the governance practices of the MSIs to explain why such divergent conceptualizations of sustainability have been mapped out. We find that far from being a neutral forum, the internal dynamics of MSIs often reflect and reproduce existing power relationships among stakeholders. In concluding, we suggest that incremental improvements in sustainability can be achieved using MSIs, but more transformative changes may require other forms of governance.

The Utility of Family Life Cycle as a Theoretical and Empirical Tool

2003 ◽  
Vol 24 (2) ◽  
pp. 155-184 ◽  
Author(s):  
Carolyn A. Kapinus ◽  
Michael P. Johnson
Keyword(s):  
Life Cycle ◽  
Family Life ◽  
Predictive Power ◽  
National Sample ◽  
Family Life Cycle ◽  
Predictive Tool ◽  
The Family ◽  
Dependent Variables ◽  
Married Men ◽  
Using Data

Using data from a 1980 national sample of married men and women, the analysis examines the utility of the family life cycle concept, employing as dependent variables constructs from Johnson’s conceptualization of commitment. They argue, in disagreement with two classic critiques of the family life cycle concept, that the predictive power of family life cycle is, for many dependent variables, quite independent of age or length of marriage. Their analyses demonstrate that, when using dependent variables one would expect to be related to the presence and ages of children, family life cycle remains a useful predictive tool.

Sign in / Sign up

Export Citation Format

Share Document