scholarly journals Factors associated with hospital admission in patients reaching the emergency department with COPD exacerbation

2012 ◽  
Vol 7 ◽  
Author(s):  
Maria Teresa García-Sanz ◽  
Carlos Pol-Balado ◽  
Concepción Abellás ◽  
Juan Carlos Cánive-Gómez ◽  
Diana Antón-Sanmartin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Multivariate Analysis ◽  
Observational Study ◽  
Hospital Admission ◽  
Prospective Observational Study ◽  
County Hospital ◽  
Copd Exacerbation ◽  
Related Factors ◽  
Factors Associated ◽  
Copd Exacerbations

Background: The aim of this study was to determine the frequency of COPD exacerbations in our Emergency Department, as well as the hospitalization-related factors. Methods: Prospective observational study conducted in the Emergency Department of Salnés County Hospital among patients admitted for COPD exacerbation. Admission predictors were determined by multivariate analysis. Results: There were 409 exacerbations in 239 patients (79% male, mean age 75). 57% of exacerbations required hospitalization. Hospitalization-related factors were impaired oxygenation (p<0.001), presence of neutrophilia (p<0.01) and prescription of antibiotics in the Emergency Department (p<0.05). Conclusions: COPD exacerbation accounts for over 1% of all visits to our Emergency Department. 57% of them required hospitalization. Impaired oxygenation, greater neutrophilia and prescription of antibiotics in the Emergency Department were associated with greater probability of admission.

scholarly journals Comparison of the Contamination Rate and Risk Factor Profile of Blood Culture Done in Emergency Department and MHDU/MICUs

2021 ◽  
pp. 1-8
Author(s):  
Dr. Pankaj Kumar Singh
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Blood Culture ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Contamination Rate ◽  
Medical Illness ◽  
Inclusion Criteria ◽  
Factors Associated

Aims and objectives: To determine the risk factors of blood culture contamination done in ED and those done in the MHDU/MICU among patients admitted with medical illness. Material and Methods: This is a two months’ prospective observational study comparing blood culture contamination rate and risk factors associated with contamination between ED and MICU/MHDU. A total of 998 patients were included in the study who underwent blood culture in ED and MICU/MHDU. 570 in ED and 428 in MICU/MHDU were included after meeting exclusion and inclusion criteria. Results: Blood culture growths were higher in ED (19%). Most common growth was CoNS (4%). The overall contamination rate in this study was (4.8%) The contamination rate was lower in ED (4.4%) when compared to MICU/MHDU (5.4%).

scholarly journals Correlation of Vitamin D Deficiency with Predictors of Mortality in Critically Ill Children at a Tertiary Care Centre in North India—A Prospective, Observational Study

2020 ◽  
Author(s):  
Shilpa Bansal ◽  
Amarpreet Kaur ◽  
Seema Rai ◽  
Gurmeet Kaur ◽  
Gitanjali Goyal ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
North India ◽  
Factors Associated ◽  
Predictors Of Mortality ◽  
The Relationship

AbstractThis study was conducted to assess the relationship of vitamin D deficiency (VDD) with various demographic characteristics, laboratory parameters, and predictors of mortality. This prospective observational study was performed at pediatric intensive care unit (PICU) of a tertiary care hospital situated in north India. A total of 125 children admitted in PICU with age from 2 months to 14 years were analyzed. The subjects were classified as Vitamin D deficient (≤20 ng/mL) and nondeficient (>20 ng/mL). The relationship between VDD and predictors of mortality were analyzed using correlation and multivariate analysis. Respiratory system (40%) was most commonly involved. VDD was seen in 72% of the patients. There was statistically significant correlation of VDD with age (p = 0.019), season (p = 0.018), height (p = 0.005), and weight (p = 0.003). On multivariate analysis factors associated with VDD were age (odds ratio [OR] = 1.01, 95% confidence interval [CI] 1.00–1.03, p = 0.006), season (OR = 3.98, 95% CI 1.09–14.50, p = 0.036). VDD was also correlated to bacteriuria (p = 0.033), cardiovascular sequential sepsis-related organ failure assessment score (CV-SOFA score) (p = 0.001), and mechanical ventilation (p = 0.043). On multivariate analysis, factors associated with VDD were bacteriuria (OR = 4.88, 95% CI 1.04–22.89, p = 0.04), mechanical ventilation requirement (OR = 2.95, 95% CI 1.12–7.85, p = 0.029), and CV-SOFA score (OR = 2.33, 95% CI 1.14–4.76, p = 0.021). Median (interquartile range) duration of PICU stay in VDD patients was (3–7) days while in nondeficient patients it was (2–6) days (p = 0.107). VDD was a significant risk factor for the need of mechanical ventilation, bacteriuria, and mortality among patients in our cohort.

scholarly journals Acute hypoxaemic respiratory failure in a low-income country: a prospective observational study of hospital prevalence and mortality

2020 ◽  
Vol 7 (1) ◽  
pp. e000719
Author(s):  
Arthur Kwizera ◽  
Jane Nakibuuka ◽  
Lydia Nakiyingi ◽  
Cornelius Sendagire ◽  
Janat Tumukunde ◽  
...  
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Observational Study ◽  
Critically Ill ◽  
Low Income ◽  
Prospective Observational Study ◽  
Ventilatory Support ◽  
Factors Associated ◽  
Common Diagnosis ◽  
The Mean

IntroductionLimited data exist on the epidemiology of acute hypoxaemic respiratory failure (AHRF) in low-income countries (LICs). We sought to determine the prevalence of AHRF in critically ill adult patients admitted to a Ugandan tertiary referral hospital; determine clinical and treatment characteristics as well as assess factors associated with mortality.Materials and methodsWe conducted a prospective observational study at the Mulago National Referral and Teaching Hospital in Uganda. Critically ill adults who were hospitalised at the emergency department and met the criteria for AHRF (acute shortness of breath for less than a week) were enrolled and followed up for 90 days. Multivariable analyses were conducted to determine the risk factors for death.ResultsA total of 7300 patients was screened. Of these, 327 (4.5%) presented with AHRF. The majority (60 %) was male and the median age was 38 years (IQR 27–52). The mean plethysmographic oxygen saturation (SpO2) was 77.6% (SD 12.7); mean SpO2/FiO2 ratio 194 (SD 32) and the mean Lung Injury Prediction Score (LIPS) 6.7 (SD 0.8). Pneumonia (80%) was the most common diagnosis. Only 6% of the patients received mechanical ventilatory support. In-hospital mortality was 77% with an average length of hospital stay of 9.2 days (SD 7). At 90 days after enrolment, the mortality increased to 85%. Factors associated with mortality were severity of hypoxaemia (risk ratio (RR) 1.29 (95% CI 1.15 to 1.54), p=0.01); a high LIPS (RR 1.79 (95% CI 1.79 1.14 to 2.83), p=0.01); thrombocytopenia (RR 1.23 (95% CI 1.11 to 1.38), p=0.01); anaemia (RR 1.15 (95% CI 1.01 to 1.31), p=0.03) ; HIV co-infection (RR 0.84 (95% CI 0.72 to 0.97), p=0.019) and male gender (RR 1.15 (95% CI 1.01 to 1.31) p=0.04).ConclusionsThe prevalence of AHRF among emergency department patients in a tertiary hospital in an LIC was low but was associated with very high mortality. Pneumonia was the most common cause of AHRF. Mortality was associated with higher severity of hypoxaemia, high LIPS, anaemia, HIV co-infection, thrombocytopenia and being male.

scholarly journals Factors associated with hospital admission in patients reaching the emergency department with COPD exacerbation

2012 ◽  
Vol 7 (1) ◽  
Author(s):  
Maria Teresa García-Sanz ◽  
Carlos Pol-Balado ◽  
Concepción Abellás ◽  
Juan Carlos Cánive-Gómez ◽  
Diana Antón-Sanmartin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Copd Exacerbation ◽  
Factors Associated

scholarly journals Root causes and preventability of emergency department presentations of older patients: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049543
Author(s):  
Babiche Driesen ◽  
Hanneke Merten ◽  
Rosalie Barendregt ◽  
H Jaap Bonjer ◽  
Cordula Wagner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Older Patients ◽  
Prospective Observational Study ◽  
Care Pathway ◽  
Related Factors ◽  
Root Cause ◽  
Underlying Diseases ◽  
To Receive ◽  
Optimal Quality

ObjectiveMore older patients are presenting to the emergency department (ED). It is important to know why these patients present and if the ED is the best place for them to receive the care they need. The primary aim of this study was to identify organisational-related, technical-related, healthcare worker-related and patient-related factors leading to ED presentations of older patients. The secondary aim was to determine patients’ and caregivers’ perspectives on what kinds of ED presentations are potentially preventable.DesignThis is a prospective observational study. A root cause analysis was performed by the Prevention and Recovery Information System for Monitoring and Analysis method. It used basic administrative data collected from patient records and interviews of patients, general practitioners (GPs) and physicians at the ED.SettingThe ED of an academic hospital in the Netherlands.Participants100 older patients (aged ≥70 years) who attended the ED between November 2017 and March 2018.ResultsIn 100 patients presenting to the ED, 159 factors that contributed to presentation were identified; most of these factors were related to underlying diseases (59%) and patient-related factors (18%). These presentations were considered potentially preventable by 23% of the physicians at the ED and 21% of the GPs, but only 10% of the patients. In only four cases was there overall agreement between the patients and the healthcare workers.ConclusionThe most frequent underlying factors contributing to an ED presentation in older patients are disease-related and patient-related. The low percentage of ED presentations considered potentially preventable shows that a ‘preventable ED presentation’ is difficult to define and therefore interventions to reduce them are unlikely to be simple. Novel solutions within the acute care pathway are required in order to deliver care of optimal quality and safety to older patients.

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