Visits to the Emergency Department during the 2020 COVID-19 Outbreak in Thailand

Background: The emergency department (ED) can be thought of as the “front door” to the 2019 coronavirus (COVID-19) pandemic. However, there have yet been no studies conducted examining ED patients in this situation. Objective: To determine the numbers of ED visits by level urgency during the COVID-19 pandemic. Materials and Methods: This was a cross-sectional study. The sample consisted of patients who presented at the Srinagarind Hospital ED from January 13 to April 21, 2020 (the date of the first confirmed case of COVID-19 in Thailand according to the Ministry of Public Health and day 100). We compared these data with those from the same period over the past three years. Results: In 2020, the total number of ED visits was 13,263, with a mean patient age of 50.14+6.40 years. Over half of these patients (56.2%; n = 7,467) were female. Most visits (50.6%) occurred between 4.00 PM to 0.00 AM (afternoon shift). The majority of were walk-ins (84.2%) and ESI 3 (non-urgent; 79.9%). The average numbers of ESI 3 patients who visited the ED over the same period in 2017 to 2020 were 152.3, 171.5, 153.0 and 105.9 per day, respectively (p<0.001). Conclusion: During the COVID-19 pandemic, the number of ED visits, specifically those of ESI 3 patients, was significantly lower than during the same period in previous years. Keywords: COVID-19, Emergency departments, Pandemics, Triage

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P118: Older adults in the emergency department: a retrospective cross-sectional study of the geriatric population in Edmonton emergency departments

CJEM ◽

10.1017/cem.2019.309 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S106-S107

Author(s):

K. Morch ◽

R. Schonnop ◽

A. Gauri ◽

D. Ha

Keyword(s):

Older Adults ◽

Emergency Department ◽

Geriatric Patient ◽

Geriatric Patients ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Health Region ◽

Area Of Interest ◽

Ed Visits

Introduction: The geriatric patient population accounts for an ever increasing proportion of emergency department (ED) visits. Geriatric centered EDs are an emerging area of interest and research. Though there have been past studies looking at older patient presentations at individual hospitals, there is limited data describing geriatric presentations within an entire Canadian geographic health region. This study characterizes the population of older adults utilizing the EDs in the Edmonton Zone, a health region that comprises a total of eleven tertiary (T), urban community (UC) and rural community (RC) hospitals. Methods: This retrospective cross-sectional study targeted all patients ≥65 years presenting to the Edmonton Zone EDs between April 1, 2017 to March 31, 2018. Data was extracted from the Emergency Department Information System (EDIS) database for ten EDs in the health region. Clinical and administrative data points were extracted and examined for each site. Results: We analyzed 100,813 ED geriatric patient visits during our study period, accounting for 18.7% of total ED visits to the Edmonton Zone. The five most common triage complaints at ED presentation were shortness of breath, abdominal pain, chest pain with cardiac features, general weakness, and back pain. CTAS scores 1-3 were assigned to 77.8% of geriatric presentations (T: 86.3%, UC: 77.4%, RC: 60.9%). 27.3% of geriatric patients had presented to an ED within the past 30 days (T: 30.0%, UC: 25.4%, RC: 27.7%). On average, 35.3% of older adult ED visits involved a consultation (T: 51.7%, UC 30.8%, RC 14.6%) and approximately 25% of geriatric patients were admitted to hospital during their ED visit (T: 42.8%, UC: 19.4%, RC: 7.1%). The average length of stay (LOS) in the ED (hh:mm) was 10:19 (T: 10:24, UC: 11:38, RC: 5:43). Overall, 2.4% of all geriatric patients left an ED without being seen after initial registration (T: 2.7%, UC: 2.2%, RC: 2.1%). Conclusion: Older adults represent a significant proportion of the ED visits in the Edmonton Zone. The triage acuity, LOS, re-presentation, consultation and admission rates varied based on the type of ED, which has implications for resource allocation within the health region. Our results can also direct future targeted initiatives and quality improvement projects to the various types of EDs in the Edmonton Zone, and facilitate planning of ED services for older adults in other health regions who have a similar geographic distribution of care sites.

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COVID-19 Pandemic Impact on Emergency Department Visits and Quality of Service: A Comparative Cross-Sectional Study in a Tertiary Centre

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i58b34227 ◽

2021 ◽

pp. 471-483

Author(s):

Maram Mohammed Jaboua ◽

Warif Jameel Abdulhaq ◽

Nada Saeed Almuntashiri ◽

Sarah Saud Almohammdi ◽

Asayel Qeblan Aldajani ◽

...

Keyword(s):

Emergency Department ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Critical Conditions ◽

Sectional Study ◽

Cross Sectional ◽

Coronary Syndrome ◽

Number Of Patients ◽

Ed Visits

Background: The COVID-19 pandemic has contributed to a devastating impact on emergency departments worldwide, resulting in a global crisis with various health consequences. We aimed to evaluate this impact on an emergency department (ED) visit of critical conditions such as Acute Coronary Syndrome (ACS), Cerebrovascular accident (CVA), Sepsis and Febrile neutropenia (FN), and to assess the quality of the ED after new adaptive measures were applied. Methods: This is a comparative cross-sectional study to assess the number of patients who presented to the ED of King Abdullah Medical city with the specified diagnosis. We collected data via the E-medical records. We compared the data over three periods pre-lockdown, lockdown and post lockdown in years 2019-2021. For quality measurement, Adaa (Ministry of Health's program) was used to calculate the percentage of patients who stayed 4 hours or less in the ED. Results: The total number of ED visits in the specified periods of study was 8387. The total numbers of patients for 2019, 2020, and 2020 respectively were 2011 (, ACS 70.4%, CVA 16.3%, sepsis and FN 13.3%.), 2733 (ACS 73.1%, CVA 9.9%, sepsis and FN 17.0%), and 3643 (ACS 64.0%, CVA 19.4%, sepsis and FN 16.7). The average percentage of patients who stayed 4 hours or less in the ED was 60% and 57.5% for 2020 and 2021, respectively. Conclusion: Although we expected reductions in ED visits during COVID-19 periods, we found that visits were rising through the years 2019-2021.

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Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.190035 ◽

2020 ◽

Vol 41 (2) ◽

pp. 112-119 ◽

Cited By ~ 2

Author(s):

Mohammed S. Shaheen ◽

Jonathan I. Silverberg

Keyword(s):

Emergency Department ◽

The United States ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pathologic Fractures ◽

Ed Visits ◽

National Emergency ◽

The Relationship

Background: Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. Objective: To determine whether asthma is associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. Methods: A cross-sectional study of 198,102,435 children and adults, including 10,129,307 with asthma, from the 2006‐2012 National Emergency Department Sample, which includes a representative 20% sample of emergency department (ED) visits throughout the United States. Results: ED visits of patients with versus without asthma were associated with higher odds of osteopenia (7 of 7 years: multivariable logistic regression of all years pooled; adjusted odds ratio [aOR] 1.45 [95% confidence interval {CI}, 1.41‐1.50]), osteoporosis (7 of 7 years: aOR 1.85 [95% CI, 1.82‐1.88]), osteomalacia (7 of 7 years: aOR 2.00 [95% CI, 1.61‐2.49]), and pathologic fractures (7 of 7 years: OR 1.24 [95% CI, 1.20‐1.27]). Patients with asthma and with long-term glucocorticoid use had higher odds of osteoporosis, osteopenia, osteomalacia, and fractures compared with patients with asthma and without long-term glucocorticoid use. Patients with asthma and with fractures incurred significantly more inpatient admissions, and higher costs of ED and inpatient care. Conclusion: ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.

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Epidemiology of paediatric pain-related visits to emergency departments in the USA: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-046497 ◽

2021 ◽

Vol 11 (8) ◽

pp. e046497

Author(s):

Jana L Anderson ◽

Lucas Oliveira J. e Silva ◽

Shealeigh A. Funni ◽

Fernanda Bellolio ◽

Molly Moore Jeffery

Keyword(s):

Emergency Departments ◽

Private Insurance ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Data Set ◽

Lower Odds ◽

The Usa ◽

Prevalence Of Pain ◽

Ed Visits

ObjectiveTo describe the epidemiology of paediatric pain-related visits to emergency departments (EDs) across the USA.DesignCross-sectional study.SettingA representative sample of US ED visits using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS).ParticipantsPaediatric (age ≤18 years) ED visits in the 2017 NHAMCS data set.Data analysisEach visit was coded as pain-related or non-pain-related using the ‘reason for visit’ variable. Weighted proportions were calculated with 95% CIs. Logistic regression was used to compare odds of pain-related visits.Outcome measuresPrevalence of pain-related visits among paediatric ED visits.ResultsThere were an estimated 35 million paediatric ED visits in the USA in 2017, 55.6% (CI 53.3% to 57.8%) were pain related, which equates to 19.7 million annual visits. The prevalence of pain-related visits reached more than 50% of visits at age 6–7 and plateaued at relatively high proportions. Children of races other than white or black had lower odds of having a pain-related visit (OR 0.48, CI 0.29 to 0.81) than white children, as did children who were black, though the difference was not statistically significant (OR 0.88, CI 0.73 to 1.06). Relative to children covered by private insurance, children with Medicaid or CHIP (Children’s Health Insurance Program) coverage had lower odds of a pain-related visit (OR 0.75, CI 0.60 to 0.93). Injuries represented 46.5% (CI 42.0% to 51.0%) of pain-related visits. Pain scores were reported in less than 50% of pain-related visits.ConclusionPain is the reason for visit in 55.6% of paediatric ED visits across the USA. The prevalence of pain-related visits peak before adolescence and it continues relatively high until the age 18. Injury, racial disparities in pain and poor pain score reporting should remain major topics of study in the paediatric population.

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Emergency department visits and hospitalisations for emergent asthmatic symptoms from 2014 to 2016: cross-sectional study in Korea

BMJ Open ◽

10.1136/bmjopen-2019-036237 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036237

Author(s):

Kyungseon Choi ◽

Sola Han ◽

Hae Sun Suh

Keyword(s):

Emergency Department ◽

Age Groups ◽

International Classification Of Diseases ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Resource Utilisation ◽

Main Diagnosis ◽

Sectional Study ◽

Cross Sectional ◽

Ed Visits

ObjectiveTo evaluate the characteristics of emergent patients with asthma who visited emergency departments (EDs) in Korea, and the consequences of these visits.DesignRetrospective cross-sectional study.SettingWe used data from the National Emergency Department Information System database from 2014 to 2016. The data included reports collected from 408 EDs in Korea.ParticipantsWe analysed the ED cases for asthma-related emergent symptoms that met the following inclusion criteria: (1) had a main diagnosis code of asthma (International Classification of Diseases 10th Revision code: J45/J46), and (2) recorded as an emergent symptom in the EDs.ResultsDuring 2014–2016, there were 58 713 ED visits related to an asthma diagnosis with emergent symptoms. Following an ED visit, 31.69% were hospitalised, of which 89.88% were admitted to the general wards, and 10.12% to the intensive care units (ICUs). More than 50% of the hospitalised cases included in the group ≥70 years of age. The incidence of death during hospitalisation generally increased with age and the proportion of death in ICU exceeded 10% among the group ≥70 years. The ratio of ICU/general ward admission at the arrival time of 0–03:00, in the ≥60 years age group was the highest compared with other times of the day and age groups.ConclusionsWe found that among all age groups, ED visits by older patients resulted in more ICU admissions. Our results can help in providing a better understanding of medical resource utilisation by emergent patients with asthma.

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Changing Rates of Self-Harm and Mental Disorders by Sex in Youths Presenting to Ontario Emergency Departments: Repeated Cross-Sectional Study

The Canadian Journal of Psychiatry ◽

10.1177/0706743719854070 ◽

2019 ◽

Vol 64 (11) ◽

pp. 789-797 ◽

Cited By ~ 12

Author(s):

William Gardner ◽

Kathleen Pajer ◽

Paula Cloutier ◽

Roger Zemek ◽

Lisa Currie ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Confidence Interval ◽

Emergency Departments ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Self Harm ◽

Ed Visits ◽

Observational Design

Objective: To document the rates of intentional self-harm and mental disorders among youths aged 13 to 17 years visiting Ontario emergency departments (EDs) from 2003-2017. Methods: This was a repeated cross-sectional observational design. Outcomes were rates of adolescents with (1) at least 1 self-harm ED visit and (2) a visit with a mental disorder code. Results: Rates of youths with self-harm visits fell 32% from 2.6/1000 in 2003 to 1.8 in 2009 but rose 135% to 4.2 by 2017. The slope of the trend in self-harm visits changed from –0.18 youths/1000/year (confidence interval [CI], –0.24 to –0.13) during 2003 to 2009 to 0.31 youths/1000/year (CI, 0.27 to 0.35) during 2009 to 2017 ( P < 0.001). Rates of youths with mental health visits rose from 11.7/1000 in 2003 to 13.5 in 2009 (15%) and to 24.1 (78%) by 2017. The slope of mental health visits changed from 0.22 youths/1000/year (CI, 0.02 to 0.42) during 2003 to 2009 to 1.84 youths/1000/year (CI, 1.38 to 2.30) in 2009 to 2017 ( P < 0.001). Females were more likely to have self-harm ( P < 0.001) and mental health visits ( P < 0.001). Rates of increase after 2009 were greater for females for both self-harm ( P < 0.001) and mental health ( P < 0.001). Conclusions: Rates of adolescents with self-harm and mental health ED visits have increased since 2009, with greater increases among females. Research is required on the determinants of adolescents’ self-harm and mental health ED visits and how they can be addressed in that setting. Sufficient treatment resources must be supplied to address increased demands for services.

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Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study

Current Drug Safety ◽

10.2174/1574886315666200331140400 ◽

2020 ◽

Vol 15 (2) ◽

pp. 105-110

Author(s):

Haile Kassahun ◽

Dugessa Tesfaye

Keyword(s):

Public Health ◽

Health Care Professionals ◽

Cross Sectional Study ◽

Health Centers ◽

Sectional Study ◽

Cross Sectional ◽

Global Challenge ◽

Northeast Ethiopia ◽

Unused Medications ◽

At Home

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

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