The American journal of emergency medicine
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Despite the advantages of bone marrow transplantation (BMT), patients receiving this intervention visit the emergency department (ED) frequently and for various reasons. Many of those ED visits result in hospitalization, and the length of stay varies. ⋯ In our study, we have shown that BMT patients visit the ED frequently and many of those visits result in a short hospitalization. Our study showed that patients presenting with fever/chills are less likely to have a short hospitalization. We also showed a significant association between a short hospitalization and BMT patients without GvHD, with normal RR, normal T °C and a normal platelet count.
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Comparative Study
Differences in clinical characteristics and outcomes for blunt versus penetrating traumatic pulmonary pseudocysts.
Traumatic pulmonary pseudocysts (TPPs) are under-reported in blunt trauma and rarely reported in penetrating trauma. Little is known about the impact of injury mechanism on the pathophysiology or the risk factors that predispose to worse patient outcomes. We hypothesized that blunt and penetrating TPPs have different clinical characteristics and outcomes. ⋯ Penetrating TPPs demonstrate a unique pattern of concurrent lung injury and increased complication risk. Importantly, severe hemoptysis and air-fluid level may indicate risk of impending morbidity and mortality regardless of injury mechanism and should serve as an early warning sign for the trauma physician.
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Children with traumatic head injury are often transferred from community Emergency Departments (ED) to a Pediatric Emergency Department (PED). The primary objective of this study was to describe the outcomes of minor head injury (MHI) transfers to a PED. The secondary objective was to report Computed Tomography (CT) utilization rates for MHI. ⋯ The majority of pediatric MHI transfers are discharged home following a subspecialty consultation and/or neuroimaging. Despite guidelines and a low incidence of ciTBI, CT utilization remains high in the intermediate and low risk MHI groups, especially in the community settings. Targeted interventions are needed to reduce the potentially avoidable transfers and low-value performance of CT in children with MHI.
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Observational Study
The prognostic value of HEART score in patients with cocaine associated chest pain: An age-and-sex matched cohort study.
HEART score is widely used to stratify patients with chest pain in the emergency department but has never been validated for cocaine-associated chest pain (CACP). We sought to evaluate the performance of HEART score in risk stratifying patients with CACP compared to an age- and sex-matched cohort with non-CACP. ⋯ In patients with CACP, HEART score performs poorly in stratifying risk and is not recommended as a rule out tool to identify those at low risk of MACE.
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Observational Study
Serum cholesterol as a predictor of mortality among the elderly patients with pneumonia in the emergency department.
Reduced cholesterol levels are associated with poor outcomes in critically ill patients. However, the effect of reduced cholesterol levels on the prognosis of patients with community-acquired pneumonia (CAP) is unclear. This study aimed to investigate the association between serum total cholesterol levels and the clinical outcomes of elderly patients with CAP. ⋯ A decreased level of total cholesterol was associated with increased short-term mortality in elderly patients with CAP. Initial total cholesterol levels may be a useful biomarker to predict the outcome of patients with CAP.