scholarly journals Why Should I Take My Medicine? A Review Of ED Visits For Seizures.

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
John L. Reed ◽  
Thomas E. Gutwein
Keyword(s):  
Relative Rate ◽  
Indirect Costs ◽  
Retrospective Chart Review ◽  
Study Data ◽  
National Institutes Of Health ◽  
Age Difference ◽  
Admission Status ◽  
Ed Visits ◽  
Review Study ◽  
Study Hypothesis

Study hypothesis  The costs of anti-epileptic medication (AED) and poor care coordination result in increased Emergency Department (ED) visits for seizure events and produce both direct and indirect economic burdens on patients with frequent seizures.    Methods  A retrospective chart review study of ED visits with chief concern of seizure from two hospitals over a two-year period was performed; resulting in 152 visits recorded in this study.  Data collected included demographic information, relevant seizure or past medical history (PMH), diagnostics performed in the ED, and the admission status of the patient along with the total charges per encounter.  Data was analyzed descriptively and with logistic regression analysis.    Results  The results yielded by this study were generally in-line with the results of similar studies, indicating a higher relative rate of ED seizure visits for males, people of Black race, and infant and toddler populations. A high proportion of Medicaid/Medicare coverage and indiscernible employment status for most patients were also noted.  Observed differences in average cost among patients with and without epilepsy and male versus female patients were not shown to be statistically significant.  However, the increased likelihood of admission with increasing age was shown to be significant with an average age difference between admitted and discharged populations of approximately 10 years (p= 0.003).    Conclusions  The data provided here is not sufficient to examine the complex relationship between seizures, epilepsy, and costs among various other patient factors.  Further study is necessary to minimize direct and indirect costs of seizures.    Acknowledgments  This project was funded, in part, with support from the Indiana Clinical and Translational Sciences Institute funded, in part by UL1TR002529 from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 

scholarly journals An Analysis of the Profile of Deliberate Self-Harm Cases in South Africa

2021 ◽  
Vol 76 (1-3) ◽  
Author(s):  
A.G. Lentoor
Keyword(s):  
South Africa ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Study Data ◽  
Health Concern ◽  
Global Public Health ◽  
Deliberate Self Harm ◽  
The North ◽  
Self Harm ◽  
Review Study

ABSTRACT Deliberate self-harm (DSH) which includes self-poisoning or self-injurious behavior regardless of intent is a global public health concern. Little is known about the profile of patients admitted following DSH at Dr George Mukhari Tertiary Hospital (DGMTH) in the north region of Gauteng, South Africa. This study aimed to determine the profile of patients and reasons for DSH. In a retrospective chart review study, data was collected on all the patients referred to the Clinical Psychology Unit at DGMTH between January 2018 and January 2019 following DSH. The results showed that the cases of DSH were mostly young, single African females, unemployed with at least a secondarylevel education. Females chose less lethal methods such as poisoning, specifically non-prescriptive drug overdose, while males chose highly lethal methods such as hanging. For females, relationship and family problems remained the main reason for DSH, while males reported financial problems.

Follow up after burn injury is disturbingly low and linked with social factors

2021 ◽  
Author(s):  
Irina P Karashchuk ◽  
Eve A Solomon ◽  
David G Greenhalgh ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
...  
Keyword(s):  
Social History ◽  
Drug Dependence ◽  
Burn Injury ◽  
Retrospective Chart Review ◽  
Burn Patients ◽  
Chi Square ◽  
Factors Associated ◽  
Ed Visits ◽  
Zip Code

Abstract For medical and social reasons, it is important that burn patients attend follow up appointments (FUAs). Our goal was to examine the factors leading to missed FUAs in burn patients. A retrospective chart review was conducted of adult patients admitted to the burn center from 2016-2018. Data collected included burn characteristics, social history, and zip code. Data analysis was conducted using chi-square, Wilcox Rank Sum tests, and multivariate regression models. A total of 878 patients were analyzed, with 224 (25.5%) failing to attend any FUAs and 492 (56.0%) missing at least one appointment (MA). Patients who did not attend any FUAs had smaller burns (4.5 (8)% vs. 6.5 (11)% median (inter quartile range)), traveled farther (70.2 (111.8) vs. 52.5 (76.7) miles), and were more likely to be homeless (22.8% vs. 6.9%) and have drug dependence (47.3% vs. 27.2%). Patients who had at least one MA were younger (42 (26) vs. 46 (28) years) and more likely to be homeless (17.5% vs. 2.6%) and have drug dependence (42.5% vs. 19.4%). On multivariate analysis, factors associated with never attending a FUA were: distance from hospital (odds ratio (OR) 1.004), burn size (OR 0.96), and homelessness (OR 0.33). Factors associated with missing at least one FUA : age (OR 0.99), drug dependence (OR 0.46), homelessness (OR 0.22), and ED visits (OR 0.56). A high percentage of patients fail to make any appointment following their injury and/or have at least one MA. Both FUAs and MAs are influenced by social determinants of health.

Improving patient safety in Palestinian hospitals: a cross-sectional and retrospective chart review study

The Lancet ◽  
2018 ◽  
Vol 391 ◽  
pp. S44
Author(s):  
Shahenaz Najjar ◽  
Nashat Nafouri ◽  
Kris Vanhaecht ◽  
Martin Euwema
Keyword(s):  
Patient Safety ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Cross Sectional ◽  
Review Study

scholarly journals Demographic and Risk Factor Differences between Children with “One-Time” and “Repeat” Visits to the Emergency Department for Asthma

2021 ◽  
Vol 18 (2) ◽  
pp. 486
Author(s):  
Pavani Rangachari ◽  
Jie Chen ◽  
Nishtha Ahuja ◽  
Anjeli Patel ◽  
Renuka Mehta
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Childhood Asthma ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Primary Research ◽  
Ed Visits ◽  
The Individual

This retrospective study examines demographic and risk factor differences between children who visited the emergency department (ED) for asthma once (“one-time”) and more than once (“repeat”) over an 18-month period at an academic medical center. The purpose is to contribute to the literature on ED utilization for asthma and provide a foundation for future primary research on self-management effectiveness (SME) of childhood asthma. For the first round of analysis, an 18-month retrospective chart review was conducted on 252 children (0–17 years) who visited the ED for asthma in 2019–2020, to obtain data on demographics, risk factors, and ED visits for each child. Of these, 160 (63%) were “one-time” and 92 (37%) were “repeat” ED patients. Demographic and risk factor differences between “one-time” and “repeat” ED patients were assessed using contingency table and logistic regression analyses. A second round of analysis was conducted on patients in the age-group 8–17 years to match another retrospective asthma study recently completed in the outpatient clinics at the same (study) institution. The first-round analysis indicated that except age, none of the individual demographic or risk factors were statistically significant in predicting of “repeat” ED visits. More unequivocally, the second-round analysis revealed that none of the individual factors examined (including age, race, gender, insurance, and asthma severity, among others) were statistically significant in predicting “repeat” ED visits for childhood asthma. A key implication of the results therefore is that something other than the factors examined is driving “repeat” ED visits in children with asthma. In addition to contributing to the ED utilization literature, the results serve to corroborate findings from the recent outpatient study and bolster the impetus for future primary research on SME of childhood asthma.

scholarly journals Tuberous sclerosis complex: Clinical spectrum and epilepsy: A retrospective chart review study

2018 ◽  
Vol 9 (1) ◽  
pp. 154-160
Author(s):  
Sulaiman Almobarak ◽  
Mohammad Almuhaizea ◽  
Musaad Abukhaled ◽  
Suad Alyamani ◽  
Omar Dabbagh ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Gene Mutation ◽  
Tuberous Sclerosis Complex ◽  
Chart Review ◽  
Clinical Presentation ◽  
Retrospective Chart Review ◽  
Neurocutaneous Disorder ◽  
Development Delay ◽  
Review Study ◽  
New Onset

Abstract Tuberous sclerosis complex (TSC) is an autosomal dominant genetic neurocutaneous disorder, with heterogeneous manifestations. We aimed to review the clinical presentation of TSC and its association with epilepsy among Saudi population. This was a retrospective chart review study of 88 patients diagnosed with TSC with or without epilepsy. In 38.6% of patients, symptoms began before 1 year of age. The most frequent initial manifestations of TSC were new onset of seizures (68.2%), skin manifestations (46.6%) and development delay (23.9%). During the evolution of the disease 65.9% had epilepsy, 17% facial angiofibromas, 13.6% Shagreen patch, 18.2% heart rhabdomyomas and 12.5% retinal hamartomas. The genetic study for TSC diagnosis was done for 44 patients, 42 (95,4%) of them were genetically confirmed, for whom 13 patients had TSC1 mutation (29.5%), 29 patients were carrying TSC2 gene mutation (65.9%), Genetic test for TSC 1 and TSC 2 were negative for 2 patients (4.5%) despite positive gene mutation in their relative with TSC. The most common manifestations were central nervous system (predominantly epilepsy) and dermatological manifestations. Most of the patients develop epilepsy with multiple seizure types. TSC 2 mutation is more common than TSC 1 mutation.

Oral Dexamethasone to Control Wheezing in Children at an Outpatient Clinic

2018 ◽  
Vol 58 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Angela S. Volk ◽  
Stephanie A. Marton ◽  
Brittany S. Richardson ◽  
Luis Rauda ◽  
Heidi L. Schwarzwald ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Acute Asthma ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
Office Visit ◽  
Asthma Exacerbations ◽  
Oral Dexamethasone ◽  
Cost Effective Treatment ◽  
Ed Visits ◽  
Acute Asthma Exacerbations

Asthma, a chronic childhood disease, has resulted in increased emergency department (ED) visits with high costs. Many asthma ED visits are nonemergent and could be treated in outpatient clinics. Literature has concluded that a 2-day course of oral dexamethasone has comparable outcomes to a 5-day course of prednisone in the ED and hospital setting. A retrospective chart review was performed on children requiring in-house treatment with a corticosteroid (dexamethasone n = 23, prednisone n = 40) for acute asthma exacerbations at an ambulatory medical home. The rates of hospital admissions, ED visits, and symptom follow-up were similar between the 2 groups ( P > .05). The cost for a course of dexamethasone was US$1.28 versus US$16.20 for prednisolone. The average cost for an asthma exacerbation office visit was US$79.89 compared with US$3113.28 for an ED visit. A 2-day course of oral dexamethasone appears to be a promising clinical and cost-effective treatment for acute asthma exacerbations at the primary care level.

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