Predictors of High-Risk Unscheduled Return Visits to the Pediatric Emergency Department: A Case-Control Study

BackgroundHigh-risk unscheduled return visits (HRURVs), defined as return visits within 72 hours that require admission or die in the emergency department (ED) on representation, are a key quality metric in the ED. The objective of this study was to determine the incidence and describe the characteristics and predictors of HRURVs to the ED.MethodsCase–control study, conducted between 1 November 2014 and 31 October 2015. Cases included all HRURVs over the age of 18 that presented to the ED. Controls were selected from patients who were discharged from the ED during the study period and did not return in the next 72 hours. Controls were matched to cases based on gender, age (±5 years) and date of presentation.ResultsOut of 38 886 ED visits during the study period, 271 are HRURVs, giving an incidence of HRURV of 0.70% (95% CI 0.62% to 0.78%). Our final analysis includes 270 HRURV cases and 270 controls, with an in-ED mortality rate of 0.7%, intensive care unit admission of 11.1% and need for surgical intervention of 22.2%. After adjusting for other factors, HRURV cases are more likely to be discharged with a diagnosis related to digestive system or infectious disease (OR 1.64, 95% CI 1.02 to 2.65 and OR 2.81, 95% CI 1.05 to 7.51, respectively). Furthermore, presentation to the ED during off-hours is a significant predictor of HRURV (OR 1.64, 95% CI 1.11 to 2.43) as is the presence of a handover during the patient visit (OR 1.68, 95% CI 1.02 to 2.75).ConclusionHRURV is an important key quality outcome metric that reflects a subgroup of ED patients with specific characteristics and predictors. Efforts to reduce this HRURV rate should focus on interventions targeting patients discharged with digestive system, kidney and urinary tract and infectious diseases diagnosis as well as exploring the role of handover tools in reducing HRURVs.

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Does Placental Weight Affects Perinatal Outcome? A Prospective Case-control Study

Current Women s Health Reviews ◽

10.2174/1573404815666191113111447 ◽

2020 ◽

Vol 16 (1) ◽

pp. 52-59

Author(s):

Naina Kumar ◽

Himani Agarwal

Keyword(s):

Birth Weight ◽

High Risk ◽

Perinatal Outcome ◽

Case Control Study ◽

Neonatal Outcome ◽

Case Control ◽

Placental Weight ◽

Tertiary Center ◽

Control Study ◽

Prospective Case Control Study

Background: Placenta plays a very important role in the growth and development of fetus. Objective: To know the correlation between placental weight and perinatal outcome in term antenatal women. Methods: Present prospective case-control study was conducted in the rural tertiary center of Northern India over one year (January-December 2018) on 1,118 term (≥37-≤42 weeks) antenatal women with singleton pregnancy fulfilling inclusion criteria with 559 women with high-risk pregnancy as cases and 559 low-risk pregnant women as controls. Placental weight, birth weight was measured immediately after delivery and compared between the two groups along with gestation, parity, fetal gender, and neonatal outcome. Statistical analysis was done using SPSS 22 version. Results: Mean placental weight [481.98±67.83 gm vs. 499.47±59.59 gm (p=.000)] and birth weight [2.68±0.53 Kg vs. 2.88±0.4 Kg (p=.000)] was significantly lower in high risk as compared to lowrisk participants, whereas placental birth weight ratio was higher in high-risk cases [18.35±2.37 vs. 17.41±1.38 (p=.000)] respectively. Placental weight was positively correlated with birth weight and placental weight and birth weight increased with increasing gestation in both cases and controls. Male neonates had higher placental weight [492.74±68.24 gm vs. 488±58.8 gm (p=0.224)] and birth weight [2.81±0.5 Kg vs. 2.74±0.45 Kg (p=0.033)] as compared to females. Neonatal Intensive Care Unit admission was significantly associated with low placental and birth weight (p=.000). Conclusion: There is a significant correlation between placental weight, birth weight and neonatal outcome, hence placental weight can be used as an indirect indicator of intrauterine fetal growth.

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Electrolyte imbalance in COVID-19 patients admitted to the Emergency Department: a case–control study

Internal and Emergency Medicine ◽

10.1007/s11739-021-02632-z ◽

2021 ◽

Author(s):

Hugo De Carvalho ◽

Marie Caroline Richard ◽

Tahar Chouihed ◽

Nicolas Goffinet ◽

Quentin Le Bastard ◽

...

Keyword(s):

Emergency Department ◽

Case Control Study ◽

Case Control ◽

Electrolyte Imbalance ◽

Control Study

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A case control study in the Indian subcontinent ethnic population on the effect of return visits and the subsequent development of tuberculosis

Journal of Infection ◽

10.1016/j.jinf.2005.08.029 ◽

2006 ◽

Vol 52 (6) ◽

pp. 440-442 ◽

Cited By ~ 4

Author(s):

H. Singh ◽

M. Joshi ◽

L.P. Ormerod

Keyword(s):

Case Control Study ◽

Indian Subcontinent ◽

Subsequent Development ◽

Case Control ◽

Ethnic Population ◽

Return Visits ◽

Control Study

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Risks associated with alcohol-positive status among adolescents in the emergency department: A matched case-control study

The Journal of Pediatrics ◽

10.1067/mpd.2001.118400 ◽

2001 ◽

Vol 139 (5) ◽

pp. 694-699 ◽

Cited By ~ 27

Author(s):

Anthony Spirito ◽

Nancy P. Barnett ◽

William Lewander ◽

Suzanne M. Colby ◽

Damaris J. Rohsenow ◽

...

Keyword(s):

Emergency Department ◽

Case Control Study ◽

Case Control ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Risk factors of acute diarrhoea in summer – a nation-wide French case-control study

Epidemiology and Infection ◽

10.1017/s0950268899003982 ◽

2000 ◽

Vol 124 (3) ◽

pp. 409-416 ◽

Cited By ~ 16

Author(s):

Y. YAZDANPANAH ◽

L. BEAUGERIE ◽

P. Y. BOËLLE ◽

L. LETRILLIART ◽

J. C. DESENCLOS ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Case Control Study ◽

National Level ◽

Acute Diarrhoea ◽

Case Control ◽

French Case ◽

Risk Areas ◽

Matched Case ◽

Control Study

The aim of this study was to identify risk factors for acute diarrhoea (AD) during the summer in France. A matched case-control study was conducted at a national level among patients of 500 general practitioners (GPs). From July to September 1996, 468 case-control pairs were included. Cases were more likely than controls (i) to live away from their main residence (OR 3·0; 95% CI 1·6–5·7), (ii) to have returned from a country at high risk of AD (OR 4·6; CI 0·9–23·1), and (iii) to have been in contact with a case of AD (OR 2·0; CI 1·3–3·1). A significantly decreased risk of AD was found for consumption of well-cooked chicken (OR 0·5; CI 0·3–0·8) and raw or undercooked home-made egg-containing products (OR 0·6; CI 0·4–0·8). These findings suggest that travel to high-risk areas, or travel within France, and being in contact with a case of AD, are risk factors for the occurrence of AD in summer in France.

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Twenty-one-gene recurrence score (RS) in germline (g)CHEK2 mutation-associated versus sporadic breast cancers (BC): A multi-site case-control study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10531 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10531-10531

Author(s):

Anosheh Afghahi ◽

Sydney Marsh ◽

Alyse Winchester ◽

Dexiang Gao ◽

Hannah Parris ◽

...

Keyword(s):

Lymph Node ◽

Genetic Testing ◽

High Risk ◽

Case Control Study ◽

Case Control ◽

Low Risk ◽

Mutation Status ◽

T Stage ◽

Chek2 Mutation ◽

Control Study

10531 Background: Genomic assays, such as RS, are used to determine chemotherapy benefit in early-stage, estrogen receptor (ER)- and/or progesterone receptor (PR)-positive, HER2 negative BC patients (pts). Currently, guidelines to use pts’ germline genetic testing results to guide adjuvant therapy are lacking. Several reports have indicated worse outcomes for BC pts with g CHEK2 pathogenic variants (PV). We investigated whether PV in CHEK2 were associated with increased RS. Methods: Patient-level clinical data and RS were derived from electronic medical records of seven medical centers between years 2013-17. Confirmation of RS using the Genomic Health provider portal was performed. 38 pts with germline PV in CHEK2 (15 pts/39.5% with c.1100delC mutation) and RS score (cases) were matched with BC pts whose genetic testing did not identify PV (controls) using a 1:2 matching schema. Pts were matched based on age at diagnosis and lymph node (LN) status. LN negative pts were further matched based on T-stage. A multivariate random intercept linear mixed model of CHEK2 mutation status on RS was performed, adjusting for PR. A secondary ordinal univariate analysis was conducted that categorized RS into low, intermediate and high risk ( < 18, 18-30, and > 30, respectively). P-values were reported based on a null hypothesis of no effect against a two-sided alternative. Results: The median RS for cases was 19.5 (interquartile range [IQR]: 15 to 25) and the median RS for controls was 18 (IQR: 12 to 22). A greater proportion of cases were categorized as high risk (10.5%) compared to controls (5.6%), and a smaller proportion of cases were categorized as low risk (36.8%) compared to controls (49.3%). Cases had higher grade and increased proportion of PR-negative BC as compared with controls (grade 1: 12.1% of cases versus 32.4% of controls; PR-negative: 7.9% of cases versus 5.6% of controls). The variables used to match cases and controls (age, lymph node status, and T-stage) had similar summary statistics. The RS was 1.97-point higher in pts with g CHEK2 PV compared to controls, after adjusting for PR (95% confidence interval [CI]: 1.02-point lower to 4.96-point higher; p = 0.194). The secondary analysis of CHEK2 mutation status on an ordinal RS risk group yielded comparable results; on average, the odds of being high risk compared to the combined intermediate/low risk groups was 1.72 times higher in cases compared to controls (95% CI: 0.77 to 3.80; p = 0.181), but these differences were not significant. Conclusions: Our case-control study did not show a statistically higher RS for BC that develops in pts with g CHEK2 PV. Further studies are warranted to evaluate the association between type of CHEK2 PV (frameshift versus missense) and other modifying genetic variables and RS.

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