Factors associated with undertriage in patients classified by the need to visit a hospital by telephone triage: a retrospective cohort study

Abstract Background Prehospital telephone triage stratifies patients into five categories, “need immediate hospital visit by ambulance,” “need to visit a hospital within 1 hour,” “need to visit a hospital within 6 hours,” “need to visit a hospital within 24 hours,” and “do not need a hospital visit” in Japan. However, studies on whether present and past histories cause undertriage are limited in patients triaged as need an early hospital visit. We investigated factors associated with undertriage by comparing patient assessed to be appropriately triaged with those assessed undertriaged. Methods We included all patients classified by telephone triage as need to visit a hospital within 1 h and 6 h who used a single after-hours house call (AHHC) medical service in Tokyo, Japan, between November 1, 2019, and November 31, 2020. After home consultation, AHHC doctors classified patients as grade 1 (treatable with over-the-counter medications), 2 (requires hospital or clinic visit), or 3 (requires ambulance transportation). Patients classified as grade 2 and 3 were defined as appropriately triaged and undertriaged, respectively. Results We identified 10,742 eligible patients triaged as need to visit a hospital within 1 h and 6 h, including 10,479 (97.6%) appropriately triaged and 263 (2.4%) undertriaged patients. Multivariable logistic regression analyses revealed patients aged 16–64, 65–74, and ≥ 75 years (adjusted odds ratio [OR], 2.40 [95% confidence interval {CI} 1.71–3.36], 8.57 [95% CI 4.83–15.2], and 14.9 [95% CI 9.65–23.0], respectively; reference patients aged < 15 years); those with diabetes mellitus (2.31 [95% CI 1.25–4.26]); those with dementia (2.32 [95% CI 1.05–5.10]); and those with a history of cerebral infarction (1.98 [95% CI 1.01–3.87]) as more likely to be undertriaged. Conclusions We found that older adults and patients with diabetes mellitus, dementia, or a history of cerebral infarction were at risk of undertriage in patients triaged as need to visit a hospital within 1 h and 6 h, but further studies are needed to validate these findings.

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Nasal mucociliary clearance in patients with diabetes mellitus

The Journal of Laryngology & Otology ◽

10.1017/s0022215100110291 ◽

1989 ◽

Vol 103 (9) ◽

pp. 853-855 ◽

Cited By ~ 10

Author(s):

W. L. Yue

Keyword(s):

Diabetes Mellitus ◽

Mucociliary Clearance ◽

Mean Value ◽

Nasal Disease ◽

Patients With Diabetes ◽

History Of ◽

Insulin Dependent ◽

Mucociliary Function ◽

The Mean ◽

Nasal Mucociliary Clearance

AbstractFifty insulin-dependent diabetics and 50 non-diabetics without a history of nasal disease have been studied for nasal problems including mucociliary function complicated by diabetes mellitus. For the diabetics, the mean value of nasal mucociliary clearance was considerably decreased and this was more often associated with dry noses but increased pH-values, both of which were higher than those for non-diabetics (p<0.05). As suggested in earlier literature, more aggressive nasal moistening therapy must be recommended for those patients presenting with these conditions in the light of systemic diabetic abnormalities.

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Risk factors associated with diabetic retinopathy in patients with diabetes mellitus type 2

BMC Research Notes ◽

10.1186/1756-0500-3-153 ◽

2010 ◽

Vol 3 (1) ◽

Cited By ~ 20

Author(s):

Irini P Chatziralli ◽

Theodoros N Sergentanis ◽

Petros Keryttopoulos ◽

Nikolaos Vatkalis ◽

Antonis Agorastos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Diabetic Retinopathy ◽

Diabetes Mellitus Type 2 ◽

Diabetes Mellitus Type ◽

Factors Associated ◽

Patients With Diabetes

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Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal

Nursing Research and Practice ◽

10.1155/2021/8846915 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Kalpana Sharma ◽

Govinda Dhungana ◽

Shailendra Adhikari ◽

Archana Bista Pandey ◽

Muna Sharma

Keyword(s):

Diabetes Mellitus ◽

College Teaching ◽

Educational Status ◽

Current Treatment ◽

Depression And Anxiety ◽

Medical College ◽

Prevalence Of Depression ◽

Patients With Diabetes ◽

History Of ◽

Diabetes Patients

The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.

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Prevalence of Anaemia and Its Associated Factors among Type 2 Diabetes Mellitus Patients in University of Gondar Comprehensive Specialized Hospital

Anemia ◽

10.1155/2021/6627979 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Sewnet Adem Kebede ◽

Biruk Shalmeno Tusa ◽

Adisu Birhanu Weldesenbet

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Associated Factors ◽

Microvascular Complications ◽

Combined Treatment ◽

Factors Associated ◽

Specialized Hospital ◽

Patients With Diabetes

Background. Anaemia is one of the commonest blood disorders seen in patients with diabetes. In Ethiopia, chronic illnesses are tremendously raising with their complications. But very little research has been conducted, particularly on anaemia among diabetes mellitus (DM) patients. Therefore, this study aimed at assessing the prevalence of anaemia and associated factors among type 2 diabetes mellitus patients in Northwest Ethiopia. Methods. A cross-sectional study design was employed at University of Gondar Comprehensive Specialized Hospital from March 1 to April 15, 2019, among 372 type 2 diabetes mellitus patients (T2DM). Multivariable logistic regression analysis was fitted, and the corresponding adjusted odds ratio (AOR) and 95% CI were used to identify factors associated with anaemia. Level of significance was declared at the p value less than 0.05. Results. The study revealed 8.06% (95% CI: 5.68–11.31%) of the participants were anaemic. Being male (AOR = 2.74, CI: 1.02, 7.38), combined type of treatment (AOR = 8.38, CI: 1.66, 42.25), having diabetes-related microvascular complications (AOR = 3.24, CI: 1.14, 9.26), and hypertension (AOR = 0.01, CI: 0.002, 0.06) were the significant factors associated with anaemia. Conclusions. The finding of the current study revealed low prevalence of anaemia among T2DM patients. Sex, type of treatment, diabetes-related microvascular complications, and hypertension were factors associated with anaemia. Assessment of haemoglobin levels among T2DM patients may help to prevent ensuing microvascular complications. Incorporate anaemia screening into the routine assessment of diabetic complication particularly for those who are hypertensive and took combined treatment to allow early appreciation and treatment of anaemia and later improve the overall care of patients with diabetes.

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A Study to Evaluate the Quality of Life of Patients with Diabetes Mellitus

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47b33157 ◽

2021 ◽

pp. 575-585

Author(s):

P. Amulya Reddy ◽

K. Saravanan ◽

A. Madhukar

Keyword(s):

Diabetes Mellitus ◽

Diabetes Management ◽

Study Data ◽

Categorical Variables ◽

P Value ◽

Diabetic Patients ◽

Physical Endurance ◽

Glucose Levels ◽

Patients With Diabetes ◽

History Of

Aim: The aim of the study was to evaluate the QOL of patients with Diabetes Mellitus. Study Design: This was a prospective, observational study. Duration of Study: The study was conducted from August 2019 to January 2021 in Yashoda Hospital, Hyderabad. Methodology: Patients of either sex with ≥1year history of diabetes willing to give the consent were included in the study. Patients of either sex with <1year history of DM, Pregnant/lactating women and patients not willing to give the consent were excluded from the study. Data on Blood glucose levels (FBS, PPBS) and HbA1C was also obtained and assessed. QOLID questionnaire was administered to the patients and assessed which consisted of a set of 34 items representing 8 domains such as Role limitation due to the physical health, Physical endurance, General health, Treatment satisfaction, Symptom botherness, Financial worries, Mental health, and Diet satisfaction). Results: A total of 200 patients were analysed in the study,108(54%) were males and 92(46%) were females. The average age of the patients was 58.5 years with majority being 51-70years (73.5%) of age. Patients with higher age and females had poor QOL compared to others. The correlation between various categorical variables with that of scores of QOL in various domains was assessed, Age of the patients influenced QOL score in various domains like RLPH (p value-0.038), PE (p value-0.0183), and SB (p value-0.0002), Gender has influenced QOL score in domains like RLPH (p value-0.0008), PE (p value-0.0106), TS (p value-0.0005) and Educational Qualification has influenced QOL score in RLPH (p value-0.0008), GH (p value-<0.0001), TS (p value-<0.0001), E/MH (p value-<0.0001). Conclusion: The results concluded that overall QOL was noticeably low in Diabetic patients especially in Women and elderly thus indicating that Diabetes management is not restricted to treatment but also requires attention on QOL of patients.

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