Revisit Rates for Pediatric Tonsillectomy: An Analysis of Admit and Discharge Times

2019 ◽  
Vol 129 (2) ◽  
pp. 110-114
Author(s):  
Sapideh Gilani ◽  
Neil Bhattacharyya
Keyword(s):  
Emergency Department ◽  
New York ◽  
Acute Pain ◽  
Ambulatory Surgery ◽  
Early Morning ◽  
Cross Sectional ◽  
Late Afternoon ◽  
Early Evening ◽  
Early Afternoon ◽  
Sectional Analysis

Objective: To determine the association between intraday timing of outpatient pediatric tonsillectomy and revisit outcomes and complications. Study Design: Cross-sectional analysis of New York databases. Setting: Ambulatory surgery, emergency department and inpatient hospital settings. Subjects and Methods: The State Ambulatory Surgery, State Emergency Department and State Inpatient Databases for 2010-2011 were analyzed for revisits. Outcomes assessed were revisits for any reason, bleeding, acute pain or fever, nausea, vomiting and dehydration. The relationships between the hour of admission for surgery, the hour of discharge and the revisit outcomes were analyzed. Results: The study included 33,611 children (mean age, 6.62 years; 45.7% female) and 62.0% were admitted in the early morning. Discharges were most common in the early afternoon (28.3%). Revisit rates were significantly higher for the early evening discharges (6.0%) versus late morning discharges (3.1%) ( P < .001). Revisits for bleeding were 1.8% for discharge in the early evening versus 0.6% in the late morning ( P < .001). Revisits for fever, nausea, vomiting or dehydration were 1.8% for discharge in the early evening versus 0.9% in the late morning ( P = .002). Late afternoon admission was significantly associated with higher revisit rates (10.9%, P < .001). Bleeding revisits were highest for late afternoon admit hour (1.5%, P = .001). Revisits for acute pain were also highest for late afternoon admit hour (2.3%, P = .005). Conclusion: Revisit are significantly higher when the patient is discharged late. Late afternoon surgery is also significantly associated with higher revisit rates. Surgeons may wish to consider these findings when a late tonsillectomy or late discharge is anticipated post-tonsillectomy.

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department

2021 ◽  
pp. 089826432110455
Author(s):  
Ginah Nightingale ◽  
Emily M. Scopelliti ◽  
Robin Casten ◽  
Monica Woloshin ◽  
Shu Xiao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Controlled Trial ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Inappropriate Medication Use ◽  
Sectional Analysis

Background: Medication-related problems in older Blacks with diabetes mellitus (DM) are not well established. Objectives: To describe the frequency of medication-related problems in older Blacks with DM presenting to the emergency department (ED). Methods: The study was a cross-sectional analysis of baseline data from a randomized controlled trial evaluating Blacks aged ≥60 years of age presenting to the ED. Polypharmacy, potentially inappropriate medication (PIM) use, and anticholinergic score were evaluated. Results: Of 168 patients (median age = 68, range 60–92), most ( n = 164, 98%) were taking ≥5 medications, and 67 (39.9%) were taking a PIM. A majority ( n = 124, 74%) were taking a medication with an anticholinergic score ≥1. Number of medications was correlated with number of PIMs ( r = .22, p = .004) and anticholinergic score ( r = .50, p < .001). Conclusion: Polypharmacy and PIM use was common in older Blacks with DM.

Reduced rate of postpartum readmissions among homeless compared with non-homeless women in New York: a population-based study using serial, cross-sectional data

2021 ◽  
pp. bmjqs-2020-012898
Author(s):  
Rie Sakai-Bizmark ◽  
Hiraku Kumamaru ◽  
Dennys Estevez ◽  
Sophia Neman ◽  
Lauren E M Bedel ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
Random Effect ◽  
Safety Net ◽  
Homeless Women ◽  
Homeless Population ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Ed Visits ◽  
Income Quartile

ObjectiveTo assess differences in rates of postpartum hospitalisations among homeless women compared with non-homeless women.DesignCross-sectional secondary analysis of readmissions and emergency department (ED) utilisation among postpartum women using hierarchical regression models adjusted for age, race/ethnicity, insurance type during delivery, delivery length of stay, maternal comorbidity index score, other pregnancy complications, neonatal complications, caesarean delivery, year fixed effect and a birth hospital random effect.SettingNew York statewide inpatient and emergency department databases (2009–2014).Participants82 820 and 1 026 965 postpartum homeless and non-homeless women, respectively.Main outcome measuresPostpartum readmissions (primary outcome) and postpartum ED visits (secondary outcome) within 6 weeks after discharge date from delivery hospitalisation.ResultsHomeless women had lower rates of both postpartum readmissions (risk-adjusted rates: 1.4% vs 1.6%; adjusted OR (aOR) 0.87, 95% CI 0.75 to 1.00, p=0.048) and ED visits than non-homeless women (risk-adjusted rates: 8.1% vs 9.5%; aOR 0.83, 95% CI 0.77 to 0.90, p<0.001). A sensitivity analysis stratifying the non-homeless population by income quartile revealed significantly lower hospitalisation rates of homeless women compared with housed women in the lowest income quartile. These results were surprising due to the trend of postpartum hospitalisation rates increasing as income levels decreased.ConclusionsTwo factors likely led to lower rates of hospital readmissions among homeless women. First, barriers including lack of transportation, payment or childcare could have impeded access to postpartum inpatient and emergency care. Second, given New York State’s extensive safety net, discharge planning such as respite and sober living housing may have provided access to outpatient care and quality of life, preventing adverse health events. Additional research using outpatient data and patient perspectives is needed to recognise how the factors affect postpartum health among homeless women. These findings could aid in lowering readmissions of the housed postpartum population.

Perceptual Distortions and Hallucinations Reported during the Course of Sleep Deprivation

1989 ◽  
Vol 68 (3) ◽  
pp. 787-798 ◽  
Author(s):  
Harvey Babkoff ◽  
Helen C. Sing ◽  
David R. Thorne ◽  
Sander G. Genser ◽  
Frederick W. Hegge
Keyword(s):  
Sleep Deprivation ◽  
Early Morning ◽  
Visual Task ◽  
Late Afternoon ◽  
Late Night ◽  
Early Evening ◽  
Perceptual Distortions

Subjects worked 30 to 45 min. of each hour for either 48 ( n = 2) or 2 hr. ( n = 8) without sleep. The frequency of reported visual task-related perceptual distortions and hallucinations showed both a linear increasing component and a strong circadian component. Perceptual distortions were most frequent in the late night-early morning hours (0400) and least frequent in the late afternoon-early evening hours (1600–2000).

The age-structure and biting behaviour of Stomoxys calcitrans (L.) (Diptera: Muscidae) from Manaus, Brazil

1980 ◽  
Vol 70 (4) ◽  
pp. 549-555 ◽  
Author(s):  
J. D. Charlwood ◽  
J. Lopes
Keyword(s):  
Relative Humidity ◽  
Age Structure ◽  
Rainy Season ◽  
Early Morning ◽  
Stomoxys Calcitrans ◽  
Physiological Age ◽  
Late Afternoon ◽  
Early Afternoon ◽  
Biting Behaviour

AbstractThe physiological age of female Stomoxys calcitrans (L.) caught biting horses during seven all-day catches and 20 catches in the morning or afternoon during the rainy season (January-July) in Manaus, Amazonas, Brazil, was determined by examination of their ovaries. Males and unmated females with undeveloped ovaries had similar biting patterns, with peaks of activity in the early morning and late afternoon, when the relative humidity was between 50 and 80%. Nulliparous inseminated females with ovaries at Stages II to V attacked throughout the day, with no pronounced peaks, whereas parous females showed a peak of biting in the late morning and early afternoon. The majority of parous flies had oviposited less than four times and had distended overiolar sacs, indicative of recent oviposition.

scholarly journals Seroconversion of a city: Longitudinal monitoring of SARS-CoV-2 seroprevalence in New York City

2020 ◽  
Author(s):  
Daniel Stadlbauer ◽  
Jessica Tan ◽  
Kaijun Jiang ◽  
Matthew M. Hernandez ◽  
Shelcie Fabre ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
General Population ◽  
Metropolitan Area ◽  
York City ◽  
Mount Sinai Hospital ◽  
Plasma Samples ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

AbstractBy conducting a retrospective, cross-sectional analysis of SARS-CoV-2 seroprevalence in a ‘sentinel group’ (enriched for SARS-CoV-2 infections) and a ‘screening group’ (representative of the general population) using >5,000 plasma samples from patients at Mount Sinai Hospital in New York City (NYC), we identified seropositive samples as early as in the week ending February 23, 2020. A stark increase in seropositivity in the sentinel group started the week ending March 22 and in the screening group in the week ending March 29. By the week ending April 19, the seroprevalence in the screening group reached 19.3%, which is well below the estimated 67% needed to achieve community immunity to SARS-CoV-2. These data potentially suggest an earlier than previously documented introduction of SARS-CoV-2 into the NYC metropolitan area.One Sentence SummarySeroprevalence of SARS-CoV-2 in cross-sectional samples from New York City rose from 0% to 19.3% from early February to mid-April.

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