Background: Unnecessary emergency department (ED) visits are a crucial consideration in discharge planning for acutely admitted patients. This study aimed to identify the reasons for unnecessary visits to the ED within 30 days of discharge from a medical hospitalist unit.
Methods: We performed a retrospective review of patients discharged in 2018 from a medical unit of tertiary teaching hospital in Korea. The authors discussed in-depth and determined whether or not an ED visit was unnecessary, and further classified the causes of unnecessary visits into three categories.
Results: The mean age of the patients was 62.9 years (range, 15-99 years), and among the 1,343 patients discharged from the unit, 720 (53.6%) were men. Overall, 215 patients (16.0%) visited the ED within 30 days after discharge; among them, 16.3% were readmitted. Of the 215 cases of ED visits within 30 days after discharge, 57 (26.5%) were considered unnecessary. Of these, 30 (52.6%) were categorized as having failed care transition, 15 (26.3%) had unestablished care plans for predictable issues, and 12 (21.1%) had insufficient patient education.
Conclusion: A substantial number of short-term ED visits by discharged multimorbid or older medical patients were considered unnecessary. Discharging patients with a thorough discharge plan is essential to avoid unnecessary ED visits.
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http://dx.doi.org/10.4235/agmr.21.0075 | DOI Listing |
Int Med Case Rep J
January 2025
Department of Neurology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, People's Republic of China.
Background: Coexistence of autoimmune encephalitis (AE) with multiple autoantibodies is of particular concern because overlying antibodies may cause variation of clinical manifestations. Coexistence of anti-glutamic acid decarboxylase (GAD) and anti-Gamma-aminobutyric acid-α-receptor (GABAAR) antibodies in AE was rare.
Case Presentation: A 44-year-old female patient presented to our hospital due to cognitive decline for 4 years, seizures, slowed speech and depression for 2 months.
Cureus
December 2024
Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, SAU.
Para-pneumonic effusion in children is often associated with bacterial infections; however, dual viral infections, including respiratory syncytial virus (RSV) and COVID-19, can also lead to severe respiratory complications, as demonstrated in this case. This case report presents the clinical course of a pediatric patient with both RSV and COVID-19 infections, leading to para-pneumonic effusion. A three-year-old girl with a history of asthma and prior febrile convulsions presented to the Emergency Department with fever, cough, vomiting, and fatigue.
View Article and Find Full Text PDFCureus
December 2024
Emergency and Critical Care Medicine, Iizuka City Hospital, Iizuka, JPN.
Urinary tract infections (UTIs) caused by urease-producing bacteria are known to cause hyperammonemia; however, non-urease-producing bacteria can also cause it. This report describes a case of an 87-year-old woman who developed hyperammonemia and impaired consciousness resulting from a UTI caused by the non-urease-producing bacterium, (). On admission, the patient presented with urinary retention, hyperammonemia (281 μg/dL), and alkaline urine (pH 8.
View Article and Find Full Text PDFCureus
December 2024
Ernest Mario School of Pharmacy, Rutgers University, Piscataway, USA.
Objective: Patients with major depressive disorder (MDD) often face poor health outcomes. Additionally, patients with multiple hospitalizations tend to have worse predicted disease prognosis. Antidepressant medications remain a first-line treatment option for MDD, but data evaluating the effects of different antidepressants on psychiatric readmission rates is lacking.
View Article and Find Full Text PDFFed Pract
September 2024
Veterans Affairs Greater Los Angeles Healthcare System, California.
Background: Current evidence demonstrates that a significant proportion of prescriptions for antibiotics that originate from the emergency department (ED) are inappropriate. Urinary tract infections (UTIs) are a frequent indication for prescribing an antibiotic in the ED. The Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) piloted a pharmacistled ED aftercare program to promote appropriate antimicrobial management of outpatient UTIs.
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