scholarly journals Thirty-day hospital readmission and emergency department visits after vascular surgery: a Canadian prospective cohort study

2018 ◽  
Vol 61 (4) ◽  
pp. 257-263 ◽  
Author(s):  
Muzammil H. Syed ◽  
Mohamad A. Hussain ◽  
Zeyad Khoshhal ◽  
Konrad Salata ◽  
Beidaa Altuwaijri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Vascular Surgery ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Emergency Department Visits ◽  
Day Hospital

scholarly journals Hospital Readmission and Emergency Department Visits After Vascular Surgery: A Prospective Cohort Study

2017 ◽  
Vol 66 (3) ◽  
pp. e80
Author(s):  
Mohamad A. Hussain ◽  
Zeyad Khoshhal ◽  
Konrad Salata ◽  
Baidaa Altuwaijri ◽  
Norah Alsaif ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Vascular Surgery ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Emergency Department Visits

scholarly journals P143: A prospective cohort study characterizing 30-day recurrent emergency department visits for hyperglycemia

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S116
Author(s):  
J. Yan ◽  
D. Azzam ◽  
M. Columbus ◽  
K. Van Aarsen
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Diabetes Management ◽  
Care Delivery ◽  
Tertiary Care ◽  
Emergency Department Visits ◽  
Local Health

Introduction: Hyperglycemic emergencies, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), often recur in patients who have poorly controlled diabetes. Identification of those at risk for recurrent hyperglycemia visits may improve health care delivery and reduce ED utilization for these patients. The objective of this study was to prospectively characterize patients re-presenting to the emergency department (ED) for hyperglycemia within 30 days of an initial ED visit. Methods: This is a prospective cohort study of patients ≥18 years presenting to two tertiary care EDs (combined annual census 150,000 visits) with a discharge diagnosis of hyperglycemia, DKA or HHS from Jul 2016-Nov 2018. Trained research personnel collected data from medical records, telephoned patients at 10-14 days after the ED visit for follow-up, and completed an electronic review to determine if patients had a recurrent hyperglycemia visit to any of 11 EDs within our local health integration network within 30 days of the initial visit. Descriptive statistics were used where appropriate to summarize the data. Results: 240 patients were enrolled with a mean (SD) age of 53.9 (18.6) years and 126 (52.5%) were male. 77 (32.1%) patients were admitted from their initial ED visit. Of the 237 patients (98.8%) with 30-day data available, 55 (23.2%) had a recurrent ED visit for hyperglycemia within this time period. 21 (8.9%) were admitted on this subsequent visit, with one admission to intensive care and one death within 30 days. For all patients who had a recurrent 30-day hyperglycemia visit, 22/55 (40.0%) reported having outpatient follow-up with a physician for diabetes management within 10-14 days of their index ED visit. 7/21 (33.3%) patients who were admitted on the subsequent visit had received follow-up within the same 10-14 day period. Conclusion: This prospective study builds on our previous retrospective work and describes patients who present recurrently for hyperglycemia within 30 days of an index ED visit. Further research will attempt to determine if access to prompt follow-up after discharge can reduce recurrent hyperglycemia visits in patients presenting to the ED.

scholarly journals Investigating the effect of sociodemographic factors on 30-day hospital readmission among medical patients in Toronto, Canada: a prospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017956
Author(s):  
Robert W Smith ◽  
Kerry Kuluski ◽  
Andrew P Costa ◽  
Samir K Sinha ◽  
Richard H Glazier ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Final Analysis ◽  
Sociodemographic Factors ◽  
Emergency Department Visits ◽  
Charlson Comorbidity Index Score ◽  
Medical Patients ◽  
Patient Level

ObjectiveTo examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city.DesignProspective cohort study.Setting and participantsPatients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control. Included in the final analysis was a diverse cohort of 1427 adult, non-palliative, patients who were discharged home.MeasuresThirteen patient-level sociodemographic variables were examined in relation to time to unplanned all-cause readmission within 30 days. Illness level was accounted for by the following covariates: self-perceived health status, previous hospital utilisation, primary diagnosis case mix group, Charlson Comorbidity Index score and inpatient length of stay.ResultsApproximately, 14.4% (n=205) of patients experienced readmission within 30 days. Sociodemographic factors were not significantly associated with time to readmission in unadjusted and adjusted analyses. Indicators of illness level, namely, previous hospitalisations, were the strongest risk factors for readmission within this cohort. One previous admission (adjusted HR 1.78; 95% CI 1.22 to 2.59, P<0.01) and at least four previous emergency department visits (adjusted HR 2.33; 95% CI 1.46 to 4.43, P<0.01) were associated with increased hazard of readmission within 30 days.ConclusionsPatient-level sociodemographic factors did not influence the incidence of unplanned all-cause readmission within 30 days. Further research is needed to understand the generalisability of our findings and investigate whether contextual factors, such as access to universal health insurance coverage, attenuate the effects of sociodemographic factors.

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