Impact of emergency department length of stay on in-hospital mortality: a retrospective cohort study.

Background And Importance: Emergency Department (ED) workload may lead to ED crowding and increased ED length of stay (LOS). ED crowding has been shown to be associated with adverse events and increasing mortality. We hypothesised that ED-LOS is associated with mortality.

The Association between Emergency Department Length of Stay and In-Hospital Mortality in Older Patients Using Machine Learning: An Observational Cohort Study.

The association between emergency department (ED) length of stay (EDLOS) with in-hospital mortality (IHM) in older patients remains unclear. This retrospective study aims to delineate the relationship between EDLOS and IHM in elderly patients. From the ED patients (n = 383,586) who visited an urban academic tertiary care medical center from January 2010 to December 2016, 78,478 older patients (age ≥60 years) were identified and stratified into three age subgroups: 60-74 (early elderly), 75-89 (late elderly), and ≥90 years (longevous elderly).

Length-of-Stay in the Emergency Department and In-Hospital Mortality: A Systematic Review and Meta-Analysis.

The effect of emergency department (ED) length of stay (EDLOS) on in-hospital mortality (IHM) remains unclear. The aim of this systematic review and meta-analysis was to determine the association between EDLOS and IHM. We searched the PubMed, Medline, Embase, Web of Science, Cochrane Controlled Register of Trials, CINAHL, PsycInfo, and Scopus databases from their inception until 14−15 January 2022.

Factors associated with Emergency Medical Dispatcher request and residents' inappropriate transfers from Nursing Homes to Emergency Department.

Purpose: In the last decades, the amount of emergency department (ED) transfers of nursing home (NH) residents has disproportionally increased in western countries. The main role of emergency medical dispatcher (EMD) among this population is to refer residents to EDs in the most appropriate way. The aim of this study was to assess risk factors of inappropriate transfers from NH to ED after EMD request.

Factors Associated with Potentially Inappropriate Transfer to the Emergency Department among Nursing Home Residents.

Objectives: To determine the factors associated with the potentially inappropriate transfer of nursing home (NH) residents to emergency departments (EDs) and to compare hospitalization costs before and after transfer of individuals addressed inappropriately vs those addressed appropriately.

Design: Multicenter, observational, case-control study.

Setting And Participants: 17 hospitals in France, 1037 NH residents.

Impact of Teamwork and Communication Training Interventions on Safety Culture and Patient Safety in Emergency Departments: A Systematic Review.

Objectives: This study aimed to narratively summarize the literature reporting on the effect of teamwork and communication training interventions on culture and patient safety in emergency department (ED) settings.

Methods: We searched PubMed, EMBASE, Psych Info CINAHL, Cochrane, Science Citation Inc, the Web of Science, and Educational Resources Information Centre for peer-reviewed journal articles published from January 1, 1988, to June 8, 2018, that assessed teamwork and communication interventions focusing on how they influence patient safety in the ED. One additional search update was performed in July 2019.

Diagnostic performances of lung ultrasound associated with inferior vena cava assessment for the diagnosis of acute heart failure in elderly emergency patients: a diagnostic study.

Background And Importance: Few studies are looking at the usefulness of lung ultrasound combined with inferior vena cava (ultrasound strategy) in the particularly challenging diagnosis of acute heart failure (AHF) in elderly dyspneic patients attending the emergency department (ED).

Objective, Design, Settings, And Participants: This was a prospective diagnostic study conducted in two French EDs from December 2015 to March 2019, aimed to determine the accuracy of an ultrasound strategy for the diagnosis of AHF in the elderly. Patients aged 65 and older referred to the ED for dyspnea were screened for inclusion.

Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?

Background: Mild traumatic brain injury is the leading cause of arrivals to emergency department due to trauma in the 65-year-old population and over. Recent studies conducted in ED suggested a low intracranial lesion prevalence. The objectives of this study were to assess the prevalence and risk factors of intracranial lesion in older patients admitted to emergency department for mild traumatic brain injury by reporting in the emergency department the precise anamnesis of injury and clinical findings.

Derivation of a clinical predicting rule for obstructive urolithiasis and alternative diagnosis requiring urgent intervention: the CLAD score.

Most patients with renal colic are discharged from the emergency department (ED) after evaluation and pain alleviation. These patients may not require urgent imaging by computed tomography. We derived a clinical prediction score in patients with renal colic to identify those at very low risk for complications and alternative diagnoses requiring urgent intervention.

Association between boarding in the emergency department and in-hospital mortality: A systematic review.

Importance: Boarding in the emergency department (ED) is a critical indicator of quality of care for hospitals. It is defined as the time between the admission decision and departure from the ED. As a result of boarding, patients stay in the ED until inpatient beds are available; moreover, boarding is associated with various adverse events.

The Temporal Trend in the Transfer of Older Adults to the Emergency Department for Traumatic Injuries: A Retrospective Analysis According to Their Place of Residence.

Objectives: There has been an increase in the number of visits by older individuals to emergency departments (EDs). The primary cause of this is trauma. The objective of this study was to evaluate the temporal changes in the use of EDs by older individuals for traumatic injuries, characterize their trauma, and specify the mode of transport to the ED according to their place of residence (community-dwelling or nursing home resident).

Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study.

Background: Despite a wide range of literature on emergency department (ED) overcrowding, scientific knowledge on emergency physicians' cognitive processes coping with overcrowding is limited.

Objective: This study aimed to develop and evaluate a virtual research environment that will allow us to study the effect of physicians' strategies and behaviors on quality of care in the context of ED overcrowding.

Methods: A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation.

How spontaneous pneumothorax is managed in emergency departments: a French multicentre descriptive study.

Background: Management of spontaneous pneumothorax (SP) is still subject to debate. Although encouraging results of recent studies about outpatient management with chest drains fitted with a one-way valve, no data exist concerning application of this strategy in real life conditions. We assessed how SP are managed in Emergency departments (EDs), in particular the role of outpatient management, the types of interventions and the specialty of the physicians who perform these interventions.

Factors predisposing nursing home resident to inappropriate transfer to emergency department. The FINE study protocol.

Background: Each year, around one out of two nursing home (NH) residents are hospitalized in France, and about half to the emergency department (ED). These transfers are frequently inappropriate. This paper describes the protocol of the FINE study.

Levocetirizine and Prednisone Are Not Superior to Levocetirizine Alone for the Treatment of Acute Urticaria: A Randomized Double-Blind Clinical Trial.

Study Objective: We evaluate the efficacy of a 4-day course of prednisone added to antihistamine for the management of acute urticaria in an emergency department (ED).

Methods: In this double-blind randomized clinical trial, patients were eligible for inclusion if aged 18 years or older and with acute urticaria of no more than 24 hours' duration. Patients with anaphylaxis or who had received antihistamines or glucocorticoids during the previous 5 days were not included.

Treatment of Acute Renal Colic in US and French EDs: Simulated Cases and Real Cases in Acute Pain Management.

Objectives: To assess the prescribing patterns in acute renal colic in emergency departments in US and France, by comparing physicians' intended prescription practices with actual prescription data in a sample of emergency practitioners.

Methods: Pharmaco-epidemiological international study in two phases. First, we surveyed emergency physicians in US and France as to what analgesics they would use for simulated cases of renal colic.

Blood alcohol concentration in intoxicated patients seen in the emergency department: does it influence discharge decisions?

Objective: The purpose of this study was to investigate whether blood alcohol concentration (BAC) measurement was routinely requested in emergency departments and whether the observation period in the emergency department allowed sufficient time for alcohol elimination before the patient was discharged.

Method: A retrospective review of medical records of all emergency alcohol-related admissions over a 12-month period from January 2012, in patients older than 18 years, was conducted. We estimated BAC at discharge for each patient by using the following formula: [BAC at admission--(length of stay × 15)].

Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department.

Objectives: Heart-type fatty acid-binding protein (h-FABP), sensitive troponins, natriuretic peptides, and clinical scores such as the Pulmonary Embolism Severity Index (PESI) are candidates for risk stratification of patients with acute pulmonary embolism (PE). The aim was to compare their respective prognostic values to predict an adverse outcome at 1 month.

Methods: The authors prospectively included 132 consecutive patients with confirmed acute PE.

Self-intoxication with baclofen in alcohol-dependent patients with co-existing psychiatric illness: an emergency department case series.

Aims: The aim of the study was to describe the characteristics and management of alcohol-dependent patients with co-existing psychiatric illness seen after self-intoxication with oral baclofen in an emergency department (ED).

Methods: A retrospective review of medical records of such patients over a 12-month period from January 2012.

Results: Twelve such patients were identified, median age 39.

Copeptin improves the diagnostic performance of sensitive troponin I-Ultra but cannot rapidly rule out non-ST-elevation myocardial infarction at presentation to an emergency department.

Study Objective: We assess the performance of a single multimarker strategy, using a combination of sensitive troponin I-Ultra and copeptin assays to rule out non-ST-elevation myocardial infarction (NSTEMI) at presentation to an emergency department (ED).

Methods: A secondary analysis was carried out on 587 consecutive patients with chest pain who presented to the ED without ST elevation on ECG and were included in a single-site, prospective observational study. Samples for copeptin and combination of sensitive troponin I-Ultra assays were collected at presentation.

Morbidity and mortality conferences in emergency departments: the French National Survey.

In France, emergency departments (EDs) are not yet required to implement Morbidity and Mortality Conferences (M&MCs), but it is likely that they will soon be a requirement. We conducted a national survey through e-mail to evaluate current M&MC practices in EDs in France. Of the 232 questionnaires sent out, 149 responses were analyzed (64%).

New diploma in emergency medicine in France: the students' perspective.

French emergency medicine (EM) has undergone rapid changes with the establishment of a diploma in emergency medicine (DES). We aimed to question medicine students on their knowledge of and apprehensions regarding this new DES. We conducted an email cross-sectional survey among second-cycle medical students before their choice of resident speciality.