scholarly journals Results of Classification of Korean Triage And Acute Scale of Patients Visiting The Emergency Department

2021 ◽  
Author(s):  
Kyeongmin Jang ◽  
Sung Hwan Kim
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Research Study ◽  
Emergency Department Visits ◽  
Descriptive Research ◽  
High Severity ◽  
Emergency Department Stay ◽  
Scale Levels ◽  
The Mean

Abstract BackgroundNot much is known about the results of the severity classification according to the time of visit to the emergency department and the appropriateness of using a public ambulance when visiting the emergency department.MethodsThis descriptive research study retrospectively reviewed and analyzed the medical records of patients who visited the emergency department of the B general hospital in Seoul from January to December 2019.ResultsA total of 54,297 patients were included in the analysis. Of the total, 34,629 (63.8%) patients visited directly while 14,065 (25.9%) visited through public ambulances, and 10,328 (73.4%) of patients using public ambulances were discharged home. The numbers of daytime and nighttime patients were 24,891 (45.8%) and 29,406 (54.2%), respectively. The mean length of emergency department stay (LoS) of patients classified as emergency was 326 minutes, while that of non-emergency patients was 159 minutes. In addition, the mean LoS of patients classified as Korean triage and acuity scale levels 1 and 2 was 427 min and 430 min, respectively, which was longer than the total of 236 minutes.ConclusionWe confirmed that patients who visited the emergency department using public ambulances accounted for about 25% of all emergency department visits, and of which 70% were discharged home. In addition, patients with high severity showed a longer mean LoS, and daytime showed higher severity and more patients than nighttime.

scholarly journals Improving Nursing Care Documentation in Emergency Department: A Participatory Action Research Study in Iran

2018 ◽  
Vol 6 (8) ◽  
pp. 1527-1532 ◽  
Author(s):  
Seyed Majid Vafaei ◽  
Zahra Sadat Manzari ◽  
Abbas Heydari ◽  
Razieh Froutan ◽  
Leila Amiri Farahani
Keyword(s):  
Emergency Department ◽  
Action Research ◽  
Nursing Care ◽  
Medical Records ◽  
Research Study ◽  
Collaborative Action Research ◽  
Second Phase ◽  
Monitoring And Control ◽  
Action Research Study

BACKGROUND: Standardization of documentation has enabled the use of medical records as a primary tool for evaluating health care functions and obtaining appropriate credit points for medical centres. However, previous studies have shown that the quality of medical records in emergency departments is unsatisfactory.AIM: The aim of this study was improving the nursing care documentation in an emergency department, in Iran.MATERIAL AND METHODS: This collaborative action research study was carried out in two phases to improve nursing care documentation in cooperation with individuals involved in the process, from February 2015 to December 2017 in an affiliated academic hospital in Iran. The first phase featured virtual training, an educational workshop, and improvements to the hospital information system. The second phase involved the recruitment of human resources, the implementation of continuous codified training, the establishment of an appropriate reward and penalty system, and the review of patient education forms.RESULTS: The interventions improved nursing documentation quality score of 73.20%, which was the highest accreditation ranking provided by Iran’s Ministry of Health and Medical Education in 2017. In other words, this study caused a 32% improvement in the quality of nursing care documentation in the hospital.CONCLUSION: The appropriate practices for improving nursing care documentation are employee participation, managerial accountability, nurses’ adherence to documentation standards, improved leadership style, and continuous monitoring and control.

scholarly journals Assessing direct costs of treating metastatic triple-negative breast cancer in the USA

2020 ◽  
Author(s):  
Karen E Skinner ◽  
Amin Haiderali ◽  
Min Huang ◽  
Lee S Schwartzberg
Keyword(s):  
Breast Cancer ◽  
Emergency Department ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Emergency Department Visits ◽  
Monthly Cost ◽  
Effective Interventions ◽  
The Usa ◽  
The Mean ◽  
Record Review

Aim: Evaluation of monthly cost during metastatic triple-negative breast cancer (mTNBC) treatment. Patients & methods: Retrospective electronic medical record review of US females aged ≥18 years diagnosed with mTNBC between 1 January 2010 and 31 January 2016. Mean monthly costs per patient were evaluated from start of mTNBC treatment until transfer to hospice, end of record or 3 months prior to death. Results: The mean monthly cost of first line was $21,908 for 505 treated patients; 50.2% of cost was attributable to hospitalization and emergency department visits, and 32.7% to anticancer therapy. Similar patterns were observed for subsequent lines of therapy. Conclusion: The majority of costs were attributable to hospitalization and emergency department services, suggesting a need for effective interventions to reduce utilization of costly services.

Abstract P168: Impact of Oral Anticoagulation Choice on Healthcare Utilization for the Primary Treatment of Venous Thromboembolism

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rob F Walker ◽  
Richard F Maclehose ◽  
J'Neka Claxton ◽  
Terrence Adam ◽  
Alvaro Alonso ◽  
...  
Keyword(s):  
Emergency Department ◽  
Healthcare Utilization ◽  
Oral Anticoagulation ◽  
Primary Treatment ◽  
Emergency Department Visits ◽  
Office Visits ◽  
International Classification Of Disease ◽  
Hospitalization Rates ◽  
The Impact

Introduction: Little is known about the impact of oral anticoagulation (OAC) choice on healthcare encounters during the primary treatment of VTE. Hypothesis: Among anticoagulant-naïve VTE patients we tested the hypotheses that the number of hospitalizations, days hospitalized, emergency department visits, and outpatient office visits would be lower among users of rivaroxaban or apixaban than among users of warfarin. Methods: MarketScan databases for years 2016 and 2017 were used to identify VTE cases and comorbidities using international classification of disease codes, and prescriptions for OACs via outpatient pharmaceutical claims data. Healthcare utilization was identified in the first 6 months after initial VTE diagnoses. Results: The 23,864 individuals with VTE cases were on average (± standard deviation) 55.7 ± 16.1 years old and 50.6% female. Participants had on average 0.2 ± 0.5 hospitalizations, spent 1.3 ± 5.2 days in the hospital, had 5.7 ± 5.1 outpatient encounters, and visited an emergency department 0.4 ± 1.1 times. As compared to warfarin, rivaroxaban and apixaban were associated with fewer hospitalizations, days hospitalized, office visits and emergency department visits, after accounting for age, sex, comorbidities and medications (Table 1). For example, hospitalization rates were 24% lower [IRR: 0.76 (95% CI: 0.69, 0.83)] for patients prescribed rivaroxaban and 22% lower [IRR: 0.78 (95% CI: 0.71, 0.87)] for patients prescribed apixaban, as compared to those prescribed warfarin. When comparing apixaban to rivaroxaban, there were no differences in healthcare utilization. Conclusions: VTE patients prescribed rivaroxaban and apixaban had lower healthcare utilization than did those prescribed warfarin, while there was no difference when comparing apixaban to rivaroxaban. These findings complement existing literature supporting the use of direct OACs over warfarin given their similar effectiveness, slightly better safety profile, and perceived lower patient burden.

scholarly journals Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017

2019 ◽  
Vol 134 (2) ◽  
pp. 132-140 ◽  
Author(s):  
Grace E. Marx ◽  
Yushiuan Chen ◽  
Michele Askenazi ◽  
Bernadette A. Albanese
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Medical Records ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Marijuana Use ◽  
Emergency Department Visits ◽  
Diagnostic Codes ◽  
Icd 10 ◽  
Ed Visits

Objectives: In Colorado, legalization of recreational marijuana in 2014 increased public access to marijuana and might also have led to an increase in emergency department (ED) visits. We examined the validity of using syndromic surveillance data to detect marijuana-associated ED visits by comparing the performance of surveillance queries with physician-reviewed medical records. Methods: We developed queries of combinations of marijuana-specific International Classification of Diseases, Tenth Revision (ICD-10) diagnostic codes or keywords. We applied these queries to ED visit data submitted through the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) syndromic surveillance system at 3 hospitals during 2016-2017. One physician reviewed the medical records of ED visits identified by ≥1 query and calculated the positive predictive value (PPV) of each query. We defined cases of acute adverse effects of marijuana (AAEM) as determined by the ED provider’s clinical impression during the visit. Results: Of 44 942 total ED visits, ESSENCE queries detected 453 (1%) as potential AAEM cases; a review of 422 (93%) medical records identified 188 (45%) true AAEM cases. Queries using ICD-10 diagnostic codes or keywords in the triage note identified all true AAEM cases; PPV varied by hospital from 36% to 64%. Of the 188 true AAEM cases, 109 (58%) were among men and 178 (95%) reported intentional use of marijuana. Compared with noncases of AAEM, cases were significantly more likely to be among non-Colorado residents than among Colorado residents and were significantly more likely to report edible marijuana use rather than smoked marijuana use ( P < .001). Conclusions: ICD-10 diagnostic codes and triage note keyword queries in ESSENCE, validated by medical record review, can be used to track ED visits for AAEM.

scholarly journals Quantifying Emergency Department Visits From Sport and Recreation: Focus on the Lower Extremity and Knee, 1997–2009

2016 ◽  
Vol 51 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Matthew S. Tenan
Keyword(s):  
Emergency Department ◽  
Lower Extremity ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Emergency Department Visits ◽  
Sample Survey ◽  
Ed Visits ◽  
Nationally Representative ◽  
Sport And Recreation

Few authors have reported nationally representative data on the number of sport and recreation (SR) injuries resulting in emergency department (ED) visitation. The existing studies have only provided 1 or 2 years of data and are not longitudinal in nature.Context: To use a novel algorithmic approach to determine if ED visitation is due to SR, resulting in a substantially larger longitudinal dataset.Objective: Descriptive epidemiology study.Design: Hospital.Setting: The National Hospital Ambulatory Medical Care Survey, a stratified random-sample survey of US hospital EDs was combined for years 1997–2009. There were 15 699 unweighted patient visits determined to be from SR.Patients or Other Participants: A custom algorithm classified SR visits based on the International Classification of Diseases, Ninth Revision, Clinical Modification E-code and pattern recognition of narrative text. Sport and recreation visits were assessed by age and categorized according to broad injury classifications. Additional quantification was performed on SR visits for lower extremity and knee-specific injuries. Sample weights were applied to provide national annual estimates.Main Outcome Measure(s): Annually, 4 243 000 ED visits resulted from SR. The largest classification of injury from SR was sprains and strains (896 000/y). Males had substantially more SR-related ED visits than females (2 929 000/y versus 1 314 000/y). For patients 10–49 years old, 1 093 000 lower extremity and 169 000 knee-specific injury visits annually were from SR. For both injury types, males had a higher rate of ED visitation; however, females had 25% and 39% greater odds of visitation for lower extremity and knee-specific injury, respectively.Results: The burden on the health system of ED visits from SR was substantial. Males presented in the ED at a higher rate for SR injury, though females had a higher proportion of lower extremity and knee-specific injury ED visitations from SR. This longitudinal analysis of population-level data provides the information to target research on specific subpopulations to mitigate SR injury.Conclusions:

scholarly journals Morphological Associations between the Distal Radioulnar Joint and the Lunate

2017 ◽  
Vol 07 (02) ◽  
pp. 148-155
Author(s):  
Jean-Yves Beaulieu ◽  
Flavien Mauler
Keyword(s):  
Emergency Department ◽  
Distal Radioulnar Joint ◽  
Ulnar Variance ◽  
Mean Values ◽  
Lunate Bone ◽  
Future Studies ◽  
Morphological Variations ◽  
Radioulnar Joint ◽  
The Mean

Background Variations in morphology of the carpal bones have been described. Their implication in wrist disease and specific kinematic features has been recognized, and a better knowledge of these variations is essential. Questions/Purpose To radiographically determine any association between the morphological variations of the distal radioulnar joint (DRUJ) and the lunate bone. Materials and Methods Radiographs of 100 wrists of patients presenting to the emergency department with wrist pain and referred to our outpatient clinic were retrospectively reviewed for DRUJ inclination, ulnar variance, and radiocarpal and midcarpal morphology of the lunate. Results There were 51 females and 49 males, mean age 51.2 years (range: 21–94). There was a statistically significant association between the DRUJ inclination and the morphology of the radiocarpal side of the lunate (p < 0.001). The mean values of ulnar variance changed according to DRUJ inclination and the radiocarpal side of the lunate (p < 0.001) but not according to the midcarpal side of the lunate. There was no significant association between the morphology of the DRUJ and the midcarpal side of the lunate or between the midcarpal and the radiocarpal morphology of the lunate. Conclusion This study demonstrated a statistically significant association at the radiocarpal level between the DRUJ inclination, ulnar variance, and the morphology of the lunate. No association was found with the morphology of the midcarpal side of the lunate. Accordingly, a classification of these carpal associations is proposed, highlighting seven main wrist configurations. Clinical Relevance These associations can guide future studies of wrist kinematics.

scholarly journals Chronic Kidney Disease Prediction based on Blood Potassium Levels using Machine Learning

2019 ◽  
Vol 9 (2) ◽  
pp. 4194-4199
Keyword(s):  
Machine Learning ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Records ◽  
Research Study ◽  
Machine Learning Algorithms ◽  
Disease Prediction ◽  
Blood Potassium ◽  
Gain Access

Machine learning is an artificial intelligence(AI) technology that provides the systems with the knowledge and capability to learn and evolve automatically from specifically programmed experiences. This focuses on designing computer programs that are able to gain access and use information on their own. Kidney damage or decreased activity for more than three months is known as chronic kidney disease.This illness occurs when the kidneys can no longer expel extra water or waste from human blood. The goal of this research study is to prepare a predictive modeling for chronic kidney disease data to analyze the different open source python module and output the results predicted by machine learning algorithms and determine the accuracy by comparing different algorithms such as KNN and Logistic Regression which are primarily used for classification of data. This algorithm makes predictions on a dataset collected from the patient's medical records. It gives us the clarity that if someone has chronic kidney disease or not primarily based on a person's blood potassium levels present in their body.

scholarly journals Adverse drug events leading to emergency department visits in elderly: the role of inappropriate prescription

2010 ◽  
Vol 8 (2) ◽  
pp. 175-179 ◽  
Author(s):  
José Marcelo Farfel ◽  
Tarso Augusto Duenhas Accorsi ◽  
Marcelo Franken ◽  
Sueli Pinto Doudement ◽  
Mariane Moran ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Drug Events ◽  
Inappropriate Medication ◽  
Albert Einstein ◽  
The Elderly ◽  
Emergency Department Visits ◽  
Drug Event ◽  
Inappropriate Prescription ◽  
The Mean

ABSTRACT Objective: Adverse drug reactions are more incident among the elderly and are frequently associated to inappropriate prescription for this group. The objective of the current study was to investigate the incidence and the characteristics of emergency department visits, related to inappropriate prescription, at the Hospital Israelita Albert Einstein. Methods: Patients aged 60 years or older, admitted to the emergency department at Unidade Avançada Ibirapuera of Hospital Israelita Albert Einstein, were included in the study. Potentially inappropriate medication for the elderly was evaluated using updated 2003 Beers criteria. Results: Over a period of 6 months, 214 individuals were included in the study, being 53.7% male. The mean age was 70.8 years (60-107). A total of 48 registries of inappropriate prescription were recorded in 42 patients (19.6% of sample). An emergency visit related to adverse drug event was verified in 27 individuals (12.5% of the sample). From these patients, 34.5% were admitted to the emergency department because of an adverse event caused by an inappropriate medication. Conclusion: Inappropriate prescription is frequent among elderly patients admitted to emergency department. A surveillance system and a program to educate physicians on the most recent criteria of appropriate prescription may help reducing emergency visits and adverse drug events in the elderly population.

scholarly journals Usefulness of a new semiological classification for characterizing psychogenic nonepileptic seizures

2021 ◽  
Vol 79 (4) ◽  
pp. 278-282
Author(s):  
Bárbara Ingrid ROSSO ◽  
Juan Carlos AVALOS ◽  
Ana Gabriela BESOCKE ◽  
Maria del Carmen GARCÍA
Keyword(s):  
Early Diagnosis ◽  
Medical Records ◽  
Daily Practice ◽  
Clinical Suspicion ◽  
Health Costs ◽  
Subjective Symptoms ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
The Mean

ABSTRACT Background: Nonepileptic events misdiagnosed as epilepsy lead to a risk of iatrogenic morbidity, which increases health costs. Among the patients affected by nonepileptic events, 11-46% are psychogenic nonepileptic seizures (PNESs). Objective: To investigate the usefulness of the semiological classification of PNESs among patients diagnosed by means of video electroencephalograms (vEEGs). Methods: This was a retrospective review of the medical records of patients admitted to the adult vEEG unit between April 2007 and December 2016, who were diagnosed with PNES that was confirmed through vEEG. Analysis on demographic and clinical data and classification of PNESs according to the Magaudda classification were performed. Results: We identified 143 patients, among whom 31.5% had also epilepsy. According to the Magaudda classification, the events were: hypermotor (58%); subjective symptoms (21.7%); akinetic (14.7%) and focal motor (5.6%). Hypermotor predominated in both genders, followed by subjective symptoms in women (23.9%) and akinetic in men (19.2%). The mean number of antiepileptic drugs (AEDs) prescribed per patient was 2.3. Thirty-two patients (22.4%) required at least one hospitalization for PNESs. 48.3% of the patients had psychiatric comorbidities. Conclusion: The proposed semiological classification of PNESs is a relevant tool that general neurologists can use to characterize these events in their daily practice. Correct use of this classification, together with vEEG and appropriate clinical suspicion, makes it possible to reach an accurate early diagnosis, thus reducing morbidity and, possibly, the high costs associated with PNESs

Sport and Recreational Causes of Nasal Bone Fractures

2021 ◽  
pp. 000348942110424
Author(s):  
Christopher C. Xiao ◽  
Rijul S. Kshirsagar ◽  
Jacob E. Hoerter ◽  
Alexander Rivero
Keyword(s):  
Emergency Department ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Emergency Department Visits ◽  
Injury Surveillance System ◽  
The Past ◽  
Total Incidence ◽  
Common Causes ◽  
The Mean ◽  
Nasal Fractures

Objective: Nasal bone fractures are the most common facial bone fractures. However, there is limited literature on the etiology of these fractures, particularly distribution across sports and other recreational activities. Methods: The Nationwide Electronic Injury Surveillance System (NEISS) national injury database was queried for emergency department visits involving the diagnosis of nasal or nose fractures associated with sports and recreation activities over the most recent 10 year span available. Demographic, disposition, and weighted incidence were analyzed. Results: Total incidence of nasal fractures across 10 years was 158 979. The mean age of nasal bone fractures was 20.4 years old. Nasal fractures were more common in males (74.6%) and white patients (54.1%). National estimated incidence of nasal fractures decreased from 21 028 in 2009 to 11 108 in 2018, a reduction of 47.2%. The most common causes among all patients were basketball (23.2%), baseball (17.1%), softball (9.8%), soccer (7.4%), and football (7%). In pediatric patients, the most common cause was baseball (25.1%). The majority (98.1%) of patients were discharged from the emergency department, while 0.9% of patients were admitted. Conclusion: The most common recreational causes of nasal fractures are sports, with the most common being non-contact sports like basketball and baseball. However, the incidence of nasal bone fractures due to recreational causes nationwide has decreased significantly over the past 10 years. This may reflect improved safety protocols among athletes.

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