Background: This study aimed to determine the tendency of older adults to present to the emergency department with pain complaints during the COVID-19 pandemic compared to the prepandemic period.
Methods: A cross-sectional, retrospective study design was used. Data were collected from the electronic medical records of older people who presented to emergency departments with pain before (March 2019-March 2020) and during the COVID-19 pandemic (April 2020-July 2021). We identified 10 pain diagnosis groups using ICD-10 codes. Patient data were grouped and cleaned using SQL scripts on the Oracle database.
Results: It was determined that 13.3% of 405,404 older people had presented to the emergency department with pain between March 2019 and July 2021. There was a 14.2% decrease in such admissions during the pandemic period. In the study, an increase was observed in the rates of older adults presenting to the emergency department with myalgia and joint pain. In contrast, the rates of those presenting with low back and neck pain, headache, eye pain, dysuria, and acute pain decreased during the pandemic. In the regression analysis, predictors for older adults' presentation to the emergency department with pain included age over 85 years (OR: 1.403), female gender (OR: 1.053), and myalgia (OR: 2.471).
Conclusions: During the COVID-19 pandemic, our study revealed fewer presentations to the emergency department for pain-related complaints. To prevent severe health problems from delayed care, we recommend expanding telemedicine, remote pain management, and home-based care. Further research is needed to examine the long-term effects of increased myalgia and joint pain.
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http://dx.doi.org/10.1016/j.pmn.2024.12.007 | DOI Listing |
Background: Coronary heart disease (CHD) and depression frequently co-occur, significantly impacting patient outcomes. However, comprehensive health status assessment tools for this complex population are lacking. This study aimed to develop and validate an explainable machine learning model to evaluate overall health status in patients with comorbid CHD and depression.
View Article and Find Full Text PDFInteract J Med Res
January 2025
Medical Directorate, Lausanne University Hospital, Lausanne, Switzerland.
Large language models (LLMs) are artificial intelligence tools that have the prospect of profoundly changing how we practice all aspects of medicine. Considering the incredible potential of LLMs in medicine and the interest of many health care stakeholders for implementation into routine practice, it is therefore essential that clinicians be aware of the basic risks associated with the use of these models. Namely, a significant risk associated with the use of LLMs is their potential to create hallucinations.
View Article and Find Full Text PDFClin Infect Dis
January 2025
Department of Epidemiology and Public Health, University of Maryland School of Maryland; Baltimore, MD.
Background: Clinicians often start unnecessarily broad-spectrum empiric Gram-negative antibiotics out of the concern that delaying effective therapy could lead to a worse clinical outcome. This study examined the consequences of delayed initiation of broad-spectrum Gram-negative antibiotics.
Methods: In a retrospective cohort of adult inpatients from 928 US hospitals, we compared clinical outcomes after (1) empiric narrow-spectrum antibiotics escalated to broad-spectrum antibiotics (delayed broad-spectrum therapy, DBT) and (2) empiric broad-spectrum antibiotics continued for at least 5 days (early broad-spectrum therapy, EBT) using Win Ratios.
J Glaucoma
January 2025
Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.
We present a case of Acute Angle-Closure Crisis (AACC) precipitated by primary transient psychogenic polydipsia; we believe that our case is the first of its kind to be reported. A 74-year-old male presented to the emergency department with altered mental status due to acute-onset hyponatremia. Six days after admission, the patient noticed painful loss of vision in his right eye and an ipsilateral headache lasting 10-15 minutes.
View Article and Find Full Text PDFEur Heart J Cardiovasc Imaging
January 2025
Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
Aims: This study evaluates whether multi-chamber myocardial deformation analysis using speckle tracking echocardiography (STE) can enhance validated current staging systems and improve risk stratification for patients with moderate-to-severe aortic stenosis (AS).
Methods And Results: We reanalyzed 2D, Doppler, and STE data obtained from two cohorts: derivation (654 patients, median age: 82 years; 51% men) and validation (237 patients, median age: 77 years; 55% men) with at least moderate AS (aortic valve area<1.5 cm2).
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