Articles: emergency-services.
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Yonsei medical journal · Apr 2023
Multicenter StudyPediatric Age-Adjusted Shock Index as a Predictor of Mortality by Sex Disparity in Pediatric Trauma: A Pan-Asian Trauma Outcome Study.
There has been no report of sex-specific, pediatric age-adjusted shock index (PASI) for pediatric trauma patients in previous studies. We aimed to determine the association between the PASI and in-hospital mortality of pediatric trauma patients and whether this association differs depending on sex. ⋯ Abnormal PASI is associated with increased in-hospital mortality in pediatric trauma patients. The prediction power of PASI for in-hospital mortality was maintained only in male patients.
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Observational Study
Acute Care Surgery and Surgical Rescue: Expanding the Definition.
Surgical rescue (SR) is the recovery of patients with surgical complications. Patients transferred (TP) for surgical diagnoses to higher-level care or inpatients (IP) admitted to nonsurgical services may develop intra-abdominal infection (IAI) and require emergency surgery (ES). The aims were to characterize the SR population by the site of ES consultation, open abdomen (OA), and risk of mortality. ⋯ IP had the highest unadjusted mortality after ES for IAI and was followed by the TP; SOI drove the risk of mortality. SR must be extended to IP for timely recognition of the IAI.
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Emergency department (ED) use is often seen as a source of excess health care spending, prompting managers to limit ED capacity in their health systems. However, if limited ED capacity in a delivery system leads patients to seek emergency care elsewhere, then health care quality and efficient management may be compromised within the system. ⋯ Our findings imply that offering more in-house ED care, in the form of clinician capacity, can substantially reduce out-of-system ED use. The results may be of interest to integrated health care system managers who prefer their patients to stay within network.
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Observational Study
Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study.
Patients aged 65 and above constitute a large and growing part of emergency department (ED) visits in western countries. ⋯ The characteristics of ED elderly patients and their subsequent hospital stay are reported in this prospective study.
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Emerg Med Australas · Apr 2023
Using network analyses to characterise Australian and Canadian frequent attenders to the emergency department.
To explore and compare the characteristics of frequent attenders to the ED at an Australian and a Canadian tertiary hospitals by utilising a network analysis approach. ⋯ Younger, middle-aged and older frequent attenders have distinct characteristics, made readily apparent by using network analyses. Future interventions to reduce ED visits should consider the heterogeneity of frequent attenders who have needs specific to their age, presenting problems and jurisdiction.