European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Utilization of a UK emergency department by care home residents: a retrospective observational study.
There is little information available on the impact of care home residents upon emergency departments (EDs) in the UK. Our objective was to determine utilization of a UK ED by local care home residents. This study took place in a busy district general ED in an urban setting. ⋯ Most common presentation categories were trauma (38%), respiratory disorders (11.2%), cardiovascular disorders (10.8%), gastrointestinal disorders (9.3%) and genitourinary disorders (6.4%). Although accounting only for 1.5% of daily attendances, care home residents have a high admission and inpatient mortality rate. This study provides important information on presentation patterns for this subgroup of the population and identifies areas for further study.
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The primary purpose of this prospective cohort study was to characterize the use of the Emergency Department (ED) in patients with chronic obstructive pulmonary disease (COPD) exacerbations and determine the factors affecting the revisit of COPD patients. This is a prospective cohort study on ambulatory patients with exacerbated chronic bronchitis in an ED setting. Patients included in the study were above 18 years of age, had a previous diagnosis of COPD, and presented to the ED for the treatment of COPD exacerbation. ⋯ Home oxygen therapy, intensive care admission, previous intubation, increased cough, and the number of ED visits in the previous year were associated with increased risk of revisit in the univariate analysis. Increased cough (odds ratio: 0.232; 95% confidence interval: 0.063-0.853) and the number of ED visits in the previous year (odds ratio: 1.166; 95% confidence interval: 1.005-1.353) were still significant after multivariate analysis. In conclusion, the number of ED visits previous year and increased cough can predict the revisit of a COPD exacerbated patient within 14 days of an ED visit.