Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 7 Articles
Abdominal pain is one of the most common complaints among patients admitted to the Emergency\nDepartment (ED). Diagnosis and management of abdominal pain may be a challenge and there are patients who\nrequire admission to the ED more than once in a short period of time. Our purpose was to assess the incidence of\nreadmissions among patients treated in the ED due to abdominal pain and to investigate the impact of\nreadmission on the further course of treatment.\nMethods: We conducted a prospective observational study, which included patients admitted to the ED in one\nacademic, teaching hospital presenting with non-traumatic abdominal pain in a three-month period. Analyzed\nfactors included demographic data, details related to first and subsequent visits in the ED and the course of\nhospitalization.\nResults: Overall, 928 patient................
Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for\nyoung women with acute abdominal pain. However, there are few established clinical prediction rules for screening\nOBGY diseases in emergency departments (EDs). This study aimed to develop a prediction model for diagnosing\nOBGY diseases in the ED.\nMethods: This single-center retrospective cohort study included female patients with acute abdominal pain who\npresented to our ED. We developed a logistic regression model for predicting OBGY diseases and assessed its\ndiagnostic ability. This study included young female patients aged between 16 and 49 years who had abdominal\npain and were examined at the ED between April 2017 and March 2018. Trauma patients and patients who were\nreferred from other hospitals or from the OBGY department of our hospital were excluded.\nResults: Out of 27,991 patients, 740 were included. Sixty-five patients were diagnosed with OBGY diseases (8.8%)...................
Suspected urinary tract infection (UTI) syndromes are a common reason for empirical antibiotics to\nbe prescribed in the Emergency Department (ED), but differentiating UTI from other conditions with a similar\npresentation is challenging. We investigated how often an ED diagnosis of UTI is confirmed clinically/\nmicrobiologically, and described conditions which present as UTI syndromes.\nMethods: Observational study using electronic health records from patients who attended the ED with suspected\nUTI and had a urine sample submitted for culture. We compared the ED diagnosis to diagnosis at discharge from\nhospital (ICD-10 codes), and estimated the proportion of cases with clinical/microbiological evidence of UTI.\nResults: Two hundred eighty nine patients had an ED diagnosis of UTI syndrome comprising: lower UTI (191),\npyelonephritis (56) and urosepsis (42). In patients admitted to hospital with an ED diagnosis of lower UTI,\npyelonephritis or urosepsis, clinical/microbiological evidence of UTI was lacking in 61/103, 33/54 and 31/42 cases\nrespectively. The ED diagnosis was concordant with the main reason for admission in less than 40% of patients\nwith UTI syndromes, and antibiotics were stopped within 72 h in 37/161 patients.................
We quantified, among diabetic adults, the frequency, costs, and factors associated with visits to the\nemergency department (EDs) and subsequent hospitalizations for acute hypoglycaemic and hyperglycaemic events.\nMethods: We included adults with diabetes residing in the Milan Agency for Health Protection between 2015 and\n2017. From healthcare databases, we identified demographic variables, comorbidities, type of treatment, insulin\ntreatment duration, previous ED attendances for acute glycaemic events, and two indicators of glycaemic\nmonitoring. Using a validated ICD-9-CM coding algorithm, we identified all ED attendances for acute glycaemic\nevents from the ED database and calculated their incidence. We computed the direct costs from health databases\nand presented them as average annual mean costs for those having had at least an ED attendance. The analysis of\nthe association between the number of ED attendances and potential determinants was performed using zeroinflated\nnegative binomial regression models. These two-part models concomitantly estimate two sets of\nparameters: the odds-ratios (ORs) of having no attendances and the incidence rate ratios (IRRs) of attendance.\nResults: The cohort included 168,285 subjects, 70% of subjects were older than 64 years, 56% were males, and 26%\nwere treated with insulin. The incidence of acute glycaemic events for those attending the ED was 7.0 per 1000\npatient-years, followed by hospitalization 26.0% of the time. The total annual direct cost for ED attendances due to\nacute glycaemic events was 174,000 â?¬. Type of antidiabetic treatment had the strongest association with ED\nattendances for hypoglycaemia. Patients assuming insulin only had a lower probability of having no attendances (OR.....................
Background: Pediatric abdominal surgical emergencies are major causes of\nmorbidity and mortality. The goal was to identify the main determinants of\ntheir management and access to assess their evolution. Patients and methods:\nThis is a prospective, descriptive and analytical study performed at\nParakou teaching hospital and Tanguieta district hospital. It has been conducted\nfrom January 1st to July 31st 2016. All children were included aged 0\nto 15 years and admitted for an abdominal surgical emergency with a Clinical\nClassification of Emergency Patients listed from 3 to 5. Results: Pediatric\nabdominal surgical emergencies accounted for 42.8% of pediatric surgical\nemergencies. The average age was.......................
Tranexamic acid (TXA) may be a useful adjunct for military patients with severe traumatic brain injury\n(TBI). These patients are often treated in austere settings without immediate access to neurosurgical intervention.\nThe purpose of this study was to evaluate any association between TXA use and progression of intracranial\nhemorrhage (ICH), neurologic outcomes, and venous thromboembolism (VTE) in TBI.\nMethods: This was a retrospective cohort study of military casualties from October 2010 to December 2015 who were\ntransferred to a military treatment facility (MTF) in the United States. Data collected included: demographics, types of\ninjuries, initial and interval head computerized tomography (CT) scans, Glasgow Coma Scores (GCS), and six-month\nGlasgow Outcome Scores (GOS). Results were stratified based on TXA administration, progression of ICH, and VTE................
Several scores and codes are used in prehospital clinical quality registries but little is known of their\nreliability. The aim of this study is to evaluate the inter-rater reliability of the American Society of Anesthesiologists\nphysical status (ASA-PS) classification system, HEMS benefit score (HBS), International Classification of Primary Care,\nsecond edition (ICPC-2) and Eastern Cooperative Oncology Group (ECOG) performance status in a helicopter\nemergency medical service (HEMS) clinical quality registry (CQR).\nMethods: All physicians and paramedics working in HEMS in Finland and responsible for patient registration were\nasked to participate in this study. The participants entered data of...................
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