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

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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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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The Social and Psychological Impact of Superficial Dermatophytic Infection using Dlqi and Ghq-12: A Cross-Sectional Study in 174 Patients at a Tertiary Care Centre in Southern-East Rajasthan

10.47363/jdmrs/2021(2)133 ◽

2021 ◽

pp. 1-6

Author(s):

Shivani Saini ◽

◽

Agarwal Shail ◽

Jain Manish ◽

Yadav Devendra ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Impact ◽

Cross Sectional Study ◽

World Population ◽

Sectional Study ◽

Cross Sectional ◽

Number Of Patients ◽

The Mean ◽

The Impact

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications

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The influence of coronavirus disease 2019 on emergency department visits in Nanjing, China: A multicentre cross-sectional study

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2020.07.086 ◽

2020 ◽

Vol 38 (10) ◽

pp. 2101-2109

Author(s):

Hao Sun ◽

Keqin Liu ◽

Meng Li ◽

Shaowen Tang ◽

Andrew A. Monte ◽

...

Keyword(s):

Emergency Department ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Sectional Study ◽

Cross Sectional

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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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A Cross-Sectional Study of Emergency Department Visits by Children After All-Terrain Vehicle Crashes, Motor Vehicle Crashes, and Sports Activities

Pediatric Emergency Care ◽

10.1097/pec.0000000000000776 ◽

2018 ◽

Vol 34 (7) ◽

pp. 479-483 ◽

Cited By ~ 4

Author(s):

Rosemary Nabaweesi ◽

James M. Robbins ◽

Anthony Goudie ◽

Jennifer I. Onukwube ◽

Stephen M. Bowman ◽

...

Keyword(s):

Emergency Department ◽

Motor Vehicle ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Motor Vehicle Crashes ◽

Vehicle Crashes ◽

Sectional Study ◽

Cross Sectional ◽

Sports Activities

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P084: Hard-to-reach populations and administrative health data: a serial cross-sectional study and application of data to improve interventions for people experiencing homelessness

CJEM ◽

10.1017/cem.2020.290 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S94-S95

Author(s):

R. Hossain ◽

Z. Ma ◽

J. Dai ◽

S. Jamani ◽

R. Hossain ◽

...

Keyword(s):

Emergency Department ◽

Vulnerable Populations ◽

Cross Sectional Study ◽

Models Of Care ◽

Health Data ◽

Emergency Department Visits ◽

Sectional Study ◽

Cross Sectional ◽

Administrative Health Data ◽

Hard To Reach Populations

Introduction: Administrative data can aid in study and intervention design, incorporating hard-to-reach individuals who may otherwise be poorly represented. We aim to use administrative health data to examine emergency department visits by people experiencing homelessness and explore the application of this data for planning interventions. Methods: We conducted a serial cross-sectional study examining emergency department use by people experiencing homelessness and non-homeless individuals in the Niagara region of Ontario, Canada. The study period included administrative health data from April 1st, 2010 to March 31st, 2018. Outcomes included number of visits, number of unique patients; group proportions of Canadian Triage and Acuity Scale (CTAS) scores; time spent in emergency; and time to see an MD. Descriptive statistics were generated, and t-tests were performed for point estimates and a Mann-Whitney U test for distributional measures. Results: Our data included 1,486,699 emergency department visits. The number of unique people experiencing homelessness ranged from 91 in 2010 to 344 in 2017, trending higher over the study period compared to non-homeless patients. The rate of visits increased from 1.7 to 2.8 per person. People experiencing homelessness tend to present later in the day and with higher overall acuity as compared to the general population. Time in emergency department and time to see an MD were greater among people experiencing homelessness. Conclusion: Administrative health data allows researchers to enhance interventions and models of care to improve services for vulnerable populations. Given the challenging fiscal realities of research, our study provides insights to more effectively target interventions for vulnerable populations.

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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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