scholarly journals Factors Affecting Length of Stay in the Emergency Department in Patients Who Presented with Abdominal Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ar-aishah Dadeh ◽  
Pitshaya Phunyanantakorn
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Length Of Stay ◽  
Final Diagnosis ◽  
Chief Complaint ◽  
Factors Affecting ◽  
Examination Time ◽  
Baseline Characteristics ◽  
Attending Physicians ◽  
Significant Factors

Objective. We aimed to identify factors affecting length of stay in the emergency department in patients who presented with abdominal pain. Methods. A retrospective cohort study was conducted from 1 January 2017 to 31 December 2017. The medical records were reviewed from 217 patients older than 15 years with the chief complaint of abdominal pain. The patients were divided into emergency department length of stay (EDLOS) < 4 hours and ≥4 hours. The two groups were compared in terms of baseline characteristics, physical examination, time of presenting, attending physicians, interdepartmental consultations, investigations, ED disposition, final diagnosis, and mortality. The significant factors affecting longer EDLOS were examined using univariate and multivariate analyses by logistic regression. Results. Factors affecting longer EDLOS were age ≥50 (odds ratio (OR) 3.17, 95% confidence interval (CI) 1.36–7.42), interdepartmental consultation ≥2 specialists (OR 71.82, 95% CI 5.67–909.51), blood testing ≥2 rounds (OR 85.6, 95% CI 4.22–1734.6), and ultrasonography (OR 8.28, 95% CI 1.84–37.26). Conclusion. The study found that the statistically significant factors that prolonged EDLOS in patients with the chief complaint of abdominal pain were age, rounds of blood test, interdepartmental consultation, and the need for ultrasonography.

scholarly journals Investigating the Factors Affecting the Length of Stay of Patients Admitted To Psychiatry Hospital at North of Iran

2020 ◽  
Author(s):  
Pezhman Hadinezhad ◽  
Javad Setareh ◽  
Mahmood Moosazadeh
Keyword(s):  
Length Of Stay ◽  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Psychiatric Hospitals ◽  
Final Diagnosis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Quality Of Control ◽  
North Of Iran

Background and Purpose: Length of stay is one of the most useful indicators, which can be used for aims, such as managing hospital, determining quality of control and available resources of the hospital. Concerning the high prevalence of psychiatric disorders in the community, studying the factors affecting the length of stay of these patients in psychiatric hospitals seemed to be useful and significant. Materials and methods: The present research was a cross-sectional study. The sample consisted of 152 patients with psychiatric disorders hospitalized in the Psychiatry Hospital of Mazandaran University of Medical Sciences. The final diagnosis of psychiatric disorder based on the DSM-V criteria and the length of stay at the end was recorded. The collected data were then analyzed by SPSS Software ver. 16 Results: Length of stay was significantly higher in men than women (p <0.001). In terms of diagnosis, the maximum duration of hospitalization was related to psychotic disorders (p = 0.001), and the length of stay increased significantly 0.21 day for each time of hospitalization. (p=0.008) Conclusion: The length of stay in men with psychotic disorders and more frequent hospitalization was found to be higher than others. Hence, it seemed necessary to consider plans about these patients.

scholarly journals Heart Failure is Highly Prevalent and Difficult to Diagnose in Severe Exacerbations of COPD Presenting to the Emergency Department

2020 ◽  
Vol 9 (8) ◽  
pp. 2644
Author(s):  
Mariaenrica Tinè ◽  
Erica Bazzan ◽  
Umberto Semenzato ◽  
Davide Biondini ◽  
Elisabetta Cocconcelli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Retrospective Chart Review ◽  
Care Program ◽  
Final Diagnosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting ◽  
Risk Of Death ◽  
Copd Patients

Background: Some 20% of patients with stable Chronic Obstructive Pulmonary Disease (COPD) might have heart failure (HF). HF contribution to acute exacerbations of COPD (AECOPD) presenting to the emergency department (ED) is not well established. Aims: To assess (1) the HF incidence in patients presenting to the ED with AECOPD; (2) the concordance between ED and respiratory ward (RW) diagnosis; (3) the factors associated with risk of death after hospital discharge. Methods: Retrospective chart review of 119 COPD patients presenting to ED for acute exacerbation of respiratory symptoms and then admitted to RW where a final diagnosis of AECOPD, AECOPD and HF and AECOPD and OD (other diagnosis), was obtained. ED and RW diagnosis were then compared. Factors affecting survival at follow-up were investigated. Results: At RW, 40.3% of cases were diagnosed of AECOPD, 40.3% of AECOPD and HF and 19.4% of AECOPD and OD, with ED diagnosis coinciding with RW’s in 67%, 23%, and 57% of cases respectively. At RW, 60% of patients in GOLD1 had HF, of which 43% were diagnosed at ED, while 40% in GOLD4 had HF that was never diagnosed at ED. Lack of inclusion in a COPD care program, HF, and early readmission for AECOPD were associated with mortality. Conclusions: HF is highly prevalent and difficult to diagnose in patients in all GOLD stages presenting to the ED with severe AECOPD, and along with lack of inclusion in a COPD care program, confers a high risk for mortality.

scholarly journals Children’s Mental Health Visits to the Emergency Department: Factors Affecting Wait Times and Length of Stay

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Amanda S. Newton ◽  
Sachin Rathee ◽  
Simran Grewal ◽  
Nadia Dow ◽  
Rhonda J. Rosychuk
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Length Of Stay ◽  
Wait Time ◽  
Factors Affecting ◽  
Hazard Ratios ◽  
Laboratory Investigations ◽  
Logistic Regressions ◽  
Pediatric Mental Health ◽  
Triage Level

Objective. This study explores the association of patient and emergency department (ED) mental health visit characteristics with wait time and length of stay (LOS).Methods. We examined data from 580 ED mental health visits made to two urban EDs by children aged ≤18 years from April 1, 2004, to March 31, 2006. Logistic regressions identified characteristics associated with wait time and LOS using hazard ratios (HR) with 95% confidence intervals (CIs).Results. Sex (male:HR=1.48, 95%CI=1.20–1.84), ED type (pediatric ED:HR=5.91, 95%CI=4.16–8.39), and triage level (Canadian Triage and Acuity Scale (CTAS) 2:HR=3.62, 95%CI=2.24–5.85) were statistically significant predictors of wait time. ED type (pediatric ED:HR=1.71, 95%CI=1.18–2.46), triage level (CTAS 5:HR=2.00, 95%CI=1.15–3.48), number of consultations (HR=0.46, 95%CI=0.31–0.69), and number of laboratory investigations (HR=0.75, 95%CI=0.66–0.85) predicted LOS.Conclusions. Based on our results, quality improvement initiatives to reduce ED waits and LOS for pediatric mental health visits may consider monitoring triage processes and the availability, access, and/or time to receipt of specialty consultations.

scholarly journals Diagnostic anticipation to reduce emergency department length of stay: a cohort study in Ferrara University Hospital, Italy

2020 ◽  
Author(s):  
Andrea Strada ◽  
Niccolò Bolognesi ◽  
Lamberto Manzoli ◽  
Giorgia Valpiani ◽  
Chiara Morotti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Abdominal Pain ◽  
Chest Pain ◽  
Length Of Stay ◽  
Diagnostic Algorithm ◽  
University Hospital ◽  
Blood Tests ◽  
Traumatic Bleeding ◽  
Ed Crowding

Abstract Background : Emergency Department (ED) crowding reduces staff satisfaction and healthcare quality and safety, which in turn increase costs. Despite a number of proposed solutions, ED length of stay (LOS) - a main cause of overcrowding - remains a major issue worldwide. This cohort study was aimed at evaluating the effectiveness on ED LOS of a procedure called “diagnostic anticipation”, which consisted in anticipating the ordering of blood tests by nurses, at triage, following a diagnostic algorithm approved by physicians. Methods : In the second half of 2019, the ED of the University Hospital of Ferrara, Italy, adopted the diagnostic anticipation protocol on alternate weeks for all patients with chest pain, abdominal pain, and non-traumatic bleeding. Using ED electronic data, LOS independent predictors were evaluated through multiple regression. Results : During the weeks when diagnostic anticipation was adopted, as compared to control weeks, the mean LOS was shorter by 18.2 minutes for chest pain, but longer by 15.7 minutes for abdominal pain, and 33.3 for non-traumatic bleeding. At multivariate analysis, adjusting for age, gender, triage priority and ED crowding, the difference in visit time was significant for chest pain only (p<0.001). Conclusions : The effectiveness of the anticipation of blood testing by nurses varied by patients' condition, being significant for chest pain only. Further research is needed before the implementation, estimating the potential proportion of inappropriate blood tests and ED crowding status

scholarly journals Etiologies of abdominal pain emergencies in pediatrics

2021 ◽  
Author(s):  
Hala Atta Youssef ◽  
Aishah Mohammad Alkhaldi ◽  
Manar Mohammed Alshahrani ◽  
Abdullah Tariq Almalki ◽  
Amjad Ali Alahmari ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Clinical Importance ◽  
Healthcare Settings ◽  
Common Causes ◽  
The Common ◽  
Attending Physicians

Reports showed that children usually complained of acute abdominal pain, which indicated the presence of severe underlying conditions and can have significant clinical importance. Serious challenges have been reported in healthcare settings where an urgent evaluation of the cases was necessary to adequately manage the patient before developing serious complications that might even end up with death. Some of these conditions included intussusception, appendicitis, volvulus and adhesions. Although estimates indicated that only around 1% of pediatric patients with acute abdominal pain usually required surgical intervention, concerns regarding the overlooking and misdiagnosis of significant conditions that might have severe prognostic outcomes were aroused among the different emergency departments. This study reviewed the common causes of acute abdominal pain among children admitted to the emergency department. Our results indicated that various etiologies can develop acute abdominal pain and therefore, establishing an adequate diagnosis by differentiating between the different etiologies should be done by the attending physicians to enhance the outcomes and adequately manage the admitted patients. Gastrointestinal causes of acute abdominal pain were the commonest to cause admissions to the emergency department. However, care should also be provided to the less common conditions, which might include genitourinary and pulmonary disorders and therefore, a thorough examination of children should be provided not to conduct a misdiagnosis of the underlying condition.

scholarly journals Factors Affecting 72-Hour Unplanned Return Visits after Emergency Department Index Discharge of a Tertiary Private Hospital in the Philippines

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Ma. Lourdes Concepcion D. Jimenez ◽  
Rafael L. Manzanera ◽  
Ronne D. Abeleda ◽  
Diego A. Moya ◽  
Jose V. Segura ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Strong Association ◽  
Tertiary Hospital ◽  
The Philippines ◽  
Third Party ◽  
Factors Affecting ◽  
Premature Discharge ◽  
Return Visits ◽  
Emergency Department Patients

Objectives. This study aimed to analyze if the indicator 72-hours Unplanned Return Visits after EmergencyDepartment (ED) index discharge was influenced by the patient’s age, triage severity, month, payment methods,and length of stay. Likewise, it aimed to determine if the 72-hour Unplanned Return Visits was a robust indicator inassessing the quality of Emergency Department services. Methods. This was a retrospective single-center study from January to December 2017. Data were retrievedfrom a tertiary hospital in the Philippines. All Emergency Department patients discharged on their index visitwere monitored for Unplanned Return Visits within 72 hours in the hospital. A univariate and multivariate logisticregression model was used to assess the variables associated with the 72-hour Unplanned Return Visits. Results. The 72-hour Unplanned Return Visits rate was measured at 2.67%, with the highest occurrence on thefirst 24 hours, and with predominance on third-party payer (p.<.0001), pediatrics (p.<0001), January (p<.0001),February (p<.0001), November (p<.0001), December (p<0001), and shorter length of stay (p<.0001) dischargedafter ED index visit. Conclusions. Strong association of Unplanned Return Visits during the first 72 hours after Emergency Departmentindex discharge was found for patients financed through third party-payers, with seasonal variations andinclination to the younger population with shorter length of stay. These findings warrant exploratory studies todetermine the reasons for the 72-hour Unplanned Return Visits after Emergency Department index discharge andinvestigation on the association of premature discharge, socio-economic, health structure, and illness progression.

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