scholarly journals Predictive factors for special care units admission and in-hospital mortality among geriatric patients that presented to the emergency department of a teaching hospital

2018 ◽  
Vol 26 (6) ◽  
pp. 336-342
Author(s):  
Khai Yen Lim ◽  
Nik Hisamuddin Nik Ab Rahman
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Teaching Hospital ◽  
Geriatric Patients ◽  
Inotropic Support ◽  
Special Care ◽  
World Population ◽  
Factors Associated ◽  
Special Care Units ◽  
Number Of Patients

Background: The world population is experiencing ageing and this phenomenon certainly gives significant impact to the social, economic as well as health care services globally. Objectives: This study aimed to determine the prevalence of geriatric patients treated in critical zone in an emergency department of a teaching hospital and the factors associated with special care units admission and in-hospital mortality. Methods: A single-centre prospective cross-sectional study was carried out from 1 January 2016 to 31 December 2016 at the Emergency Department Hospital at Universiti Sains Malaysia, Malaysia. All patients aged 60 years and above were included. Systematic random sampling was used. Variables were analysed using simple and multiple logistic regressions. Results: The total number of patients included in this study was 328, 55.8% were male and the mean age was 70.6 (standard deviation: 7.5) years. The commonly presenting diseases in this study were cardiovascular (31.4%), infectious (29.6%), neurological (14.9%) and respiratory (12.5%). Out of the 328 patients studied, 187 (57.0%) were admitted to general wards and 110 (33.5%) to special care units. A total of 55 patients (16.8%) succumbed within the period of in-hospital treatment. The factors associated with special care units admission were the usage of non-invasive ventilation and the administration of inotropic support. The factors associated with in-hospital mortality were blood urea level, serum albumin level and the application of mechanical ventilation. Conclusion: Geriatric patients who presented to emergency department requiring ventilator and inotropic support had been observed to exhibit worse outcome. The associated factors for special care units admission and in-hospital mortality had been identified, and this will enable better settings cater to the needs for critically ill geriatric patients.

Evaluation of the frequency and obstetric risk factors associated with term neonatal admissions to special care units

2013 ◽  
Vol 53 (3) ◽  
pp. 277-282 ◽  
Author(s):  
Aseel Alkiaat ◽  
Maureen Hutchinson ◽  
Angela Jacques ◽  
Mary J. Sharp ◽  
Jan E. Dickinson
Keyword(s):  
Risk Factors ◽  
Special Care ◽  
Factors Associated ◽  
Special Care Units

scholarly journals Clinical profile of patients of poisoning admitted in emergency department in a teaching hospital, MAMC, Agroha, Haryana, India

2017 ◽  
Vol 5 (8) ◽  
pp. 3767
Author(s):  
Mohd Y. Shah ◽  
Mohd M. Naqash ◽  
Faisal Y. Shah ◽  
Faizan Y. Shah
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Agricultural Land ◽  
Suicide Attempts ◽  
Family Members ◽  
Clinical Profile ◽  
Precipitating Factors ◽  
Number Of Patients ◽  
Catchment Areas ◽  
History Of

3 Million Serious poisoning (1 million accidentals and 2 million suicide attempts) occur each year worldwide.1 India ranks second in Asia in annual pesticide consumption.2 A study was conducted (1 year) wherein patients with history of poisoning were admitted from different catchment areas of hospital (30 Km radius). The total number of patients admitted during study period was 61. Patients had consumed these agents to attempt suicide. Out of 61 patients 26 were male and rest 37 were females. 18 patients died and rest survived. The precipitating factors in the suicide attempts were stranded relations with husband/wife, failure in examination and confrontation with parents. The availability of these poisonous substances in the household make people to consume these agents on slight provocation.3 All our patients, though majority were literate, were from families who had agricultural land and majority of their family members were farmers. Table 1 and Table 2 depict the characteristics and clinical profile of 61 patients admitted during the study period.

Factors Associated With Emergency Department Length of Stay and In-hospital Mortality in Intracerebral Hemorrhage Patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nicolle W. Davis ◽  
Tiffany O. Sheehan ◽  
Yi Guo ◽  
Debra Lynch Kelly ◽  
Ann L. Horgas ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Factors Associated

Factors Associated with Drug-Related Emergency Department Visits at a Teaching Hospital in Malaysia

2017 ◽  
Vol 31 (3) ◽  
pp. 175-181 ◽  
Author(s):  
Ab Fatah Ab Rahman ◽  
Abubakar Ibrahim Jatau ◽  
Myat Moe Thwe Aung ◽  
Tuan Hairulnizam Tuan Kamauzaman
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Emergency Department Visits ◽  
Factors Associated

scholarly journals AB1179 EMERGENCY DEPARTMENT LENGTH OF STAY FOR PATIENTS WITH ACUTE GOUT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1880.1-1881
Author(s):  
N. Mbuyi ◽  
S. Reinert ◽  
R. Hilliard ◽  
A. Reginato ◽  
D. Dalal
Keyword(s):  
United States ◽  
Emergency Department ◽  
Length Of Stay ◽  
Teaching Hospital ◽  
Hospital Setting ◽  
Cost Of Care ◽  
Older Age ◽  
Acute Gout ◽  
Factors Associated ◽  
Acuity Score

Background:Emergency department (ED) visits for acute gout increased by approximately 20% between 2006 and 2014 in the United States. (1) Reducing ED length of stay (LOS) can help improve health outcomes, and reduce ED crowding and cost of care for patients with gout.Objectives:The aim of our study was to assess ED LOS and to identify factors associated with prolonged ED LOS in patients with acute gout.Methods:In this retrospective analysis, we included the first ED visit of adult patients (>18years) with acute gout who presented to the 3 EDs affiliated with Lifespan Health Systems, the largest healthcare provider in Rhode Island. Our study period was 3/30/2015 to 9/30/2017.We calculated ED LOS as the time spent by patients in the ED until they were discharged. Patients presenting to the ED and subsequently admitted to the hospital were excluded given the differential effect of systems factors in these patients. We assessed the following factors’ association with being in the upper quartile of ED LOS: (a) Patient factors – demographics, comorbidities and clinical presentation of gout (number of joints involved, severity as gauged by an ED triage nurse on a scale of 1 to 5; 1 being the worst) and (b) systems factors – time of day, day of the week, and time of year at presentation to the ED, teaching versus non-teaching hospital setting, and performing an arthrocentesis. We performed univariate and multivariable analyses to identify factors associated with prolonged ED LOS in patients with acute gout.Results:A total of 355 patients (mean age 56.6 ± 16.03 years, 81.3% males) were included. The median ED LOS was 2.65 hours (1.75, 4.3 hours). A quarter of the patients spent more than 4.3 hours in the ED; the national average across all medical illnesses being 3.7 hours (2). In the univariate analysis, older age (> 65 years), comorbidities (hypertension, congestive heart failure), worse ED severity score, procedural delays, and teaching hospital setting were associated with being in the upper quartile of ED LOS. In a multivariable analysis, age >65 years, procedural delays, and worse ED acuity score continued to be associated with longer ED LOS.Conclusion:In our study settings, patients with acute gout spent a longer time in the ED than the national median of 120-150 minutes. (2) We noted that older age and higher acuity score in addition to procedural delays led to longer length of stay in the ED. The results of our study should guide future interventions to reduce ED LOS for patients with acute gout.References:[1] Mithal, A., & Singh, G. (2018). OP0185 Emergency department visits for gout: a dramatic increase in the past decade[2]Centers for Disease Control and Prevention. (2014). QuickStats: median emergency department (ED) wait and treatment times, by triage level–National Hospital Ambulatory Medical Care Survey, United States, 2010-2011. Morb Mortal Wkly Rep, 63,439. (https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6319a8.htm)Disclosure of Interests:None declared

scholarly journals Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Pınar Tosun Taşar ◽  
Ömer Karaşahin ◽  
Eda Ural Karaman ◽  
Bilge Nur Serin ◽  
Taha Burak Urvasızoğlu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Geriatric Patients ◽  
Factors Associated

scholarly journals Higher In-Hospital Mortality in Patients with Nonspecific Complaints Presenting to the Emergency Department

2019 ◽  
Vol 18 (4) ◽  
pp. 232-238
Author(s):  
JJH Wachelder ◽  
◽  
Patricia M. Stassen ◽  
RS Fourmanov ◽  
CH Nickel ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adult Patients ◽  
Orange Yellow ◽  
Number Of Patients

Background: Nonspecific complaints (NSC) at the Emergency Department (ED) are not well researched yet. Objective: To investigate the number of patients who could be classified as having NSC early after arrival in the ED using an algorithm. Method: Retrospective cohort study was conducted among all hemodynamically stable non-trauma adult patients with MTS category orange/yellow visiting the ED. Patients who had no specific complaints/signs, predefined on a list, were categorized as NSC. Results: In total, 2419 patients, of whom 102 (4.2%) presented with NSC. Hospitalization was more prevalent (85.3% vs. 69.0%, p<0.001) and in-hospital mortality was higher in the NSC-group (11.8% vs. 3.5%, adjusted OR 2.0, 95% CI 1.0-3.9, p=0.04). Conclusion: Using an algorithm it is possible to identify NSC patients who have (worse) outcomes than those classified as SC.

scholarly journals Methods of deliberate self-harm in a tertiary hospital in South Africa

2020 ◽  
Vol 26 ◽  
Author(s):  
Deirdre Pieterse ◽  
Jacqueline Hoare ◽  
Kerry-Ann Louw ◽  
Elsie Breet ◽  
Michelle Henry ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Emergency Department ◽  
Substance Use ◽  
Healthcare Setting ◽  
Tertiary Hospital ◽  
Deliberate Self Harm ◽  
Factors Associated ◽  
Number Of Patients ◽  
Self Harm

Background: Little is known about the methods of deliberate self-harm (DSH) in South Africa (SA), despite the importance of means restriction as a public health strategy to reduce the morbidity and mortality associated with self-harm.Aim: The aim of this study was to investigate the range of methods used in DSH and identify the socio-demographic and clinical factors associated with violent and non-violent methods of DSH among patients treated at a tertiary hospital in SA.Setting: The study was conducted at an urban, tertiary level emergency department at Groote Schuur hospital in Cape Town, South Africa.Method: Data were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Logistic regression models were used to explore the factors associated with violent and non-violent methods of DSH.Results: Self-poisoning was the most common method of self-harm (80.3%). Prescription medication was the most common form of self-poison (57.6%), while a large number of patients used non-prescription paracetamol (40.9%). In the regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH.Conclusion: Improved monitoring of prescription medications commonly used in DSH is integral to public health suicide prevention strategies in SA. This study underscores the need for substance use interventions in the healthcare setting.

scholarly journals MP06: Impact of anticoagulation on mortality and resource utilization among critically ill patients with major bleeding in the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S44
Author(s):  
G. Mok ◽  
S. Fernando ◽  
L. Castellucci ◽  
D. Dowlatshahi ◽  
B. Rochwerg ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Major Bleeding ◽  
Long Term Care ◽  
Hospital Length Of Stay ◽  
Total Hospital ◽  
Term Care ◽  
Number Of Patients ◽  
The Impact

Introduction: Patients with major bleeding (e.g. gastrointestinal bleeding, and intracranial hemorrhage [ICH]) are commonly encountered in the Emergency Department (ED). A growing number of patients are on either oral or parenteral anticoagulation (AC), but the impact of AC on outcomes of patients with major bleeding is unknown. With regards to oral anticoagulation (OAC), we particularly sought to analyze differences between patients on Warfarin or Direct Oral Anticoagulants (DOACs). Methods: We analyzed a prospectively collected registry (2011-2016) of patients who presented to the ED with major bleeding at two academic hospitals. “Major bleeding” was defined by the International Society on Thrombosis and Haemostasis criteria. The primary outcome, in-hospital mortality, was analyzed using a multivariable logistic regression model. Secondary outcomes included discharge to long-term care among survivors, total hospital length of stay (LOS) among survivors, and total hospital costs. Results: 1,477 patients with major bleeding were included. AC use was found among 215 total patients (14.6%). Among OAC patients (n = 181), 141 (77.9%) had used Warfarin, and 40 (22.1%) had used a DOAC. 484 patients (32.8%) died in-hospital. AC use was associated with higher in-hospital mortality (adjusted odds ratio [OR]: 1.50 [1.17-1.93]). Among survivors to discharge, AC use was associated with higher discharge to long-term care (adjusted OR: 1.73 [1.18-2.57]), prolonged median LOS (19 days vs. 16 days, P = 0.03), and higher mean costs ($69,273 vs. $58,156, P = 0.02). With regards to OAC, a higher proportion of ICH was seen among patients on Warfarin (39.0% vs. 32.5%), as compared to DOACs. No difference in mortality was seen between DOACs and Warfarin (adjusted OR: 0.84 [0.40-1.72]). Patients with major bleeding on Warfarin had longer median LOS (11 days vs. 6 days, P = 0.03) and higher total costs ($51,524 vs. $35,176, P &lt; 0.01) than patients on DOACs. Conclusion: AC use was associated with higher mortality among ED patients with major bleeding. Among survivors, AC use was associated with increased LOS, costs, and discharge to long-term care. Among OAC patients, no difference in mortality was found. Warfarin was associated with prolonged LOS and costs, likely secondary to higher incidence of ICH, as compared to DOACs.

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