Articles: emergency-department.
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Emerg Med Australas · Dec 2023
Comment Observational StudyEvaluating the use of the ABCD2 score as a clinical decision aid in the emergency department: Retrospective observational study.
Clinical decision aids (CDAs) can help clinicians with patient risk assessment. However, there is little data on CDA calculation, interpretation and documentation in real-world ED settings. The ABCD2 score (range 0-7) is a CDA used for patients with transient ischaemic attack (TIA) and assesses risk of stroke, with a score of 0-3 being low risk. The aim of this study was to describe ABCD2 score documentation in patients with an ED diagnosis of TIA. ⋯ The ABCD2 score was documented in less than half of eligible patients. When documented, clinicians were generally accurate with their calculation and application of the ABCD2. No independent predictors of ABCD2 documentation were identified.
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Pediatric emergency care · Dec 2023
Observational StudySocial Determinants of Health Are Associated With Visits for Ambulatory Care Sensitive Conditions.
Population health experts have described the link between social factors and health, but few studies link specific social needs to disease processes. Nationwide Children's Hospital implemented a universal, annual screener for social determinants of health (SDH) in 2018. Early analyses have shown that patients identifying an SDH need were more likely to have an emergency department (ED) or inpatient stay. The objective of this study is to identify links between SDH and ED presentation for ambulatory care sensitive conditions (ACSCs). ⋯ The odds of ED presentation for ACSCs are higher in patients with expressed social needs. Further delineating the connections between specific SDH and health outcomes can inform timely and appropriate interventions.
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Pediatric emergency care · Dec 2023
Nucleated Red Blood Cells Are Predictive of In-Hospital Mortality for Pediatric Patients.
We sought to establish whether nucleated red blood cells (NRBCs) are predictive of disposition, morbidity, and mortality for pediatric patients presenting to the emergency department (ED). ⋯ The presence of NRBCs is an independent predictor for mortality, including in-hospital mortality, ICU admission, CPR, and readmission within 30 days for children presenting to the ED.
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J Coll Physicians Surg Pak · Dec 2023
Developing and Validating a New Model to Predict In-Hospital Mortality in Patients with Acute Myocardial Infarction.
To derive and validate a regression model that can successfully and robustly predict in-hospital mortality of patients who underwent percutaneous coronary intervention (PCI) after admission to the Department of Emergency Medicine (ED) with acute myocardial infarction (AMI). ⋯ Percutaneous coronary intervention, Mortality, In-hospital mortality, Prediction model, Logistic regression.
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Optimally, cancer is diagnosed through periodic screening or detection of early symptoms in primary care settings. However, an estimated 23%-52% of gastrointestinal (GI) cancers are diagnosed in the emergency department (ED). Cancer diagnosed in the ED has been associated with worse clinical and patient-reported outcomes even after adjustment for cancer stage. We sought to explore patients' accounts of patient and health care system factors related to their diagnosis in the ED and their lived experience of receiving a diagnosis in this setting. ⋯ This study highlights the unmet needs in identifying and diagnosing patients who ultimately present to the ED for evaluation and eventual diagnosis of cancer. Our results shed light on several modifiable factors, including the need for increased public awareness of the asymptomatic nature of cancer and the importance of cancer screening. Additionally, health care systems modifications beyond the ED are needed to improve access to timely care when symptoms arise.