Factors Associated With Avoidable Emergency Department Visits in Broward County, Florida

Abstract Objectives To describe clinical characteristics and management of acute lymphadenitis and to identify risk factors for complications. Methods Health record review of children ≤17 years with acute lymphadenitis (≤2 weeks) in a tertiary paediatric emergency department (2009–2014); 10% of charts were reviewed by a blinded second reviewer. Multivariate logistic regression identified factors associated with intravenous antibiotic treatment, unplanned return visits warranting intervention, and surgical drainage. Results Of 1,023 health records, 567 participants with acute lymphadenitis were analyzed. The median age = 4 years (interquartile range [IQR]: 2 to 8 years), and median duration of symptoms = 1.0 day (IQR: 0.5 to 3.0 days). Cervical lymphadenitis was most common. Antibiotics were prescribed in 73.5% of initial visits; 86.9% of participants were discharged home. 29.0% received intravenous antibiotics, 19.3% had unplanned emergency department return visits, and 7.4% underwent surgical drainage. On multivariate analysis, factors associated with intravenous antibiotic use included history of fever (odds ratio [OR]=2.07, 95% confidence interval [CI]: 1.11 to 3.92), size (OR=1.74 per cm, 95% CI: 1.44 to 2.14), age (OR=0.84 per year, 95% CI: 0.76 to 0.92), and prior antibiotic use (OR=4.45, 95% CI: 2.03 to 9.88). The factors associated with unplanned return visit warranting intervention was size (OR=1.30 per cm, 95% CI: 1.06 to 1.59) and age (OR=0.89, 95% CI: 0.80 to 0.97). Factors associated with surgical drainage were age (OR=0.68 per year, 95% CI: 0.53 to 0.83) and size (OR=1.80 per cm, 95% CI: 1.41 to 2.36). Conclusions The vast majority of children with acute lymphadenitis were managed with outpatient oral antibiotics and did not require return emergency department visits or surgical drainage. Larger lymph node size and younger age were associated with increased intravenous antibiotic initiation, unplanned return visits warranting intervention and surgical drainage.

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Emergency department visits by children with sickle hemoglobinopathies: Factors associated with hospital admission

Journal of Emergency Medicine ◽

10.1016/0736-4679(96)88472-1 ◽

1996 ◽

Vol 14 (1) ◽

pp. 127

Author(s):

Ted Chan

Keyword(s):

Emergency Department ◽

Hospital Admission ◽

Emergency Department Visits ◽

Factors Associated

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Evaluation of compliance with early postbirth follow-up and unnecessary visits to the paediatric emergency department: a prospective observational study at the Lenval Children’s Hospital in Nice

BMJ Open ◽

10.1136/bmjopen-2021-056476 ◽

2022 ◽

Vol 12 (1) ◽

pp. e056476

Author(s):

Antoine Tran ◽

Anne-Laure Hérissé ◽

Marion Isoardo ◽

Petri Valo ◽

Anne-Marie Maillotte ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Care Pathway ◽

Emergency Department Visits ◽

Secondary Outcome ◽

Medical Visit ◽

Paediatric Emergency Department ◽

Factors Associated ◽

Paediatric Emergency

ObjectiveTo evaluate compliance with the French National Authority for Health’s (Haute Autorité de Santé, HAS) postbirth follow-up recommendations for newborns attending our paediatric emergency department (PED) and identify risk factors associated with non-compliance and unnecessary emergency department utilisation.DesignProspective, single centre.SettingFourth biggest PED in France in terms of attendance (CHU-Lenval).Patients280 patients of whom 249 were included in the statistical analysis.Main outcome measuresThe primary outcome of this study was the evaluation of compliance of the care pathway for newborns consulting at the PED with respect to the French postbirth follow-up recommendations. Secondary outcome was the assessment of whether the visit to the PED was justified by means of PED reception software and two postconsultation interviewsResults77.5% (193) of the newborns had non-compliant care pathways and 43% (107) of PED visits were unnecessary. Risk factors associated with a non-compliance regarding the HAS’s postbirth follow-up recommendations were: unnecessary visit to the PED (OR 2.0, 95% CI 1.1 to 3.9), precariousness (OR 2.8, 95% CI 1.4 to 6.2), birth in a public maternity hospital (OR 2.5, 95% CI 1.3 to 4.8) and no information about HAS’s postbirth follow-up recommendations on discharge from maternity ward (OR 11.4, 95% CI 5.8 to 23.3). Risk factors for unnecessary PED visits were: non-compliant care pathway (OR 2.0, 95% CI 1.1 to 3.9) and a first medical visit at a PED (OR 1.8, 95% CI 1.1 to 3.1).ConclusionPostbirth follow-up may lead to decrease unnecessary emergency department visits unnecessary emergency department visits.Trial registration numberThe study bears the clinical trial number NCT02863627.

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Factors Associated with Drug-Related Emergency Department Visits at a Teaching Hospital in Malaysia

Pharmaceutical Medicine ◽

10.1007/s40290-017-0187-5 ◽

2017 ◽

Vol 31 (3) ◽

pp. 175-181 ◽

Cited By ~ 3

Author(s):

Ab Fatah Ab Rahman ◽

Abubakar Ibrahim Jatau ◽

Myat Moe Thwe Aung ◽

Tuan Hairulnizam Tuan Kamauzaman

Keyword(s):

Emergency Department ◽

Teaching Hospital ◽

Emergency Department Visits ◽

Factors Associated

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Incidence and factors associated with emergency department visits for recurrent skin and soft tissue infections in patients in California, 2005–2011

Epidemiology and Infection ◽

10.1017/s0950268816002855 ◽

2016 ◽

Vol 145 (4) ◽

pp. 746-754 ◽

Cited By ~ 8

Author(s):

L. MAY ◽

E. Y. KLEIN ◽

E. M. MARTINEZ ◽

N. MOJICA ◽

L. G. MILLER

Keyword(s):

Emergency Department ◽

Soft Tissue ◽

Geographical Location ◽

Risk Groups ◽

Primary Diagnosis ◽

Emergency Department Visits ◽

Soft Tissue Infections ◽

Discharge Data ◽

Factors Associated ◽

Ed Visits

SUMMARYMore than 2 million visits for skin and soft tissue infections (SSTIs) are seen in US emergency departments (EDs) yearly. Up to 50% of patients with SSTIs, suffer from recurrences, but associated factors remain poorly understood. We performed a retrospective study of patients with primary diagnosis of SSTI between 2005 and 2011 using California ED discharge data from the State Emergency Department Databases and State Inpatient Databases. Using a multivariable logistic regression, we examined factors associated with a repeat SSTI ED visits up to 6 months after the initial SSTI. Among 197 371 SSTIs, 16·3% were associated with a recurrent ED visit. We found no trend in recurrent visits over time (χ2 trend = 0·68, P = 0·4). Race/ethnicity, age, geographical location, household income, and comorbidities were all associated with recurrent visits. Recurrent ED visits were associated with drug/alcohol abuse or liver disease [odds ratio (OR) 1·4, 95% confidence interval (CI) 1·3–1·4], obesity (OR 1·3, 95% CI 1·2–1·4), and in infections that were drained (OR 1·1, 95% CI 1·1–1·1) and inversely associated with hospitalization after initial ED visit (OR 0·4, 95% CI 0·3–0·4). In conclusion, we found several patient-level factors associated with recurrent ED visits. Identification of these high-risk groups is critical for future ED-based interventions.

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