Acute complications associated with new-onset atrial fibrillation

Friedman, Harold Z.; Goldberg, S; Bonema, John D.; Cragg, David R.; Hauser, Andrew M.

doi:10.1016/0002-9149(91)90059-t

Cited by 15 publications

(3 citation statements)

References 5 publications

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“…For example, the introduction of a short observation period improved the diagnosis of myocardial infarction, reducing the number of unidentified heart attacks in adults with chest pain [1]. As far as atrial fibrillation and tachycardia are concerned, a brief observation period increased safety for patients about discharge from the ED [2,3].…”

Section: Introductionmentioning

confidence: 99%

Utility of a pediatric observation unit for the management of children admitted to the emergency department

et al. 2021

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Background Observation Units (OU), as part of emergency department (ED), are areas reserved for short-term treatment or observation of patients with selected diagnoses to determine the need for hospitalization or home referral. Methods In this retrospective cohort study, we analyzed similarities and differences of children admitted to the pediatric ED of the Fondazione Policlinico Universitario A. Gemelli IRCCS hospital in the first 2 years of OU activity, analyzing general patient characteristics, access modalities, diagnosis, triage, laboratory and instrumental examinations, specialist visits, outcome of OU admission and average time spent in OU. Furthermore, we compared total numbers and type of hospitalization of the first 2 years of OU activity with those of previous 2 years. Results The most frequent diagnoses were abdominal pain, minor head injury without loss of consciousness, vomiting, epilepsy and acute bronchiolitis. The most performed laboratory examinations were blood count. The most commonly performed instrumental examination was abdominal ultrasound. Neurological counseling was the most commonly requested. Average time spent in OU was 13 h in 2016 and 14.1 h in 2017. Most OU admissions did not last longer than 24 h (90.5% in 2016 and 89.5% in 2017). In the years 2014–2015, 13.4% of pediatric patients accessing the ED were hospitalized, versus 9.9% the years 2016–2017 reducing pediatric hospital admissions by 3.6% (p < 0.001). Conclusions This study demonstrate that OU is a valid alternative to ordinary wards for specific pathologies. In accordance with the literature, our study showed that, in the first 2 years of the OU activity, admissions to hospital ward decreased compared with the previous 2 years with an increase of complex patients.

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Section: Introductionmentioning

confidence: 99%

Utility of a pediatric observation unit for the management of children admitted to the emergency department

et al. 2021

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“…However, if a sustained rapid rate is allowed to persist for hours, tachycardia-induced left ventricular dysfunction can result. The need for swift, appropriate action by the emergency physician is highlighted by the fact that up to 18% of patients with AFF develop potentially life-threatening complications, such as congestive heart failure, hypotension, ventricular ectopy, respiratory failure, angina, and myocardial infarction (6,7).…”

Section: Introductionmentioning

confidence: 99%

Diltiazem vs. Metoprolol in the Management of Atrial Fibrillation or Flutter with Rapid Ventricular Rate in the Emergency Department

Fromm

Suau

Cohen

et al. 2015

The Journal of Emergency Medicine

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“…Eighty-eight of the remaining 216 patients (41%) admitted to Harbor-UCLA Medical Center were admitted to an intensive care unit. Patients were hospitalized at Harbor-UCLA Medical Center for a mean of 7 2 5 days (median 6 days; IQR 3-9 days). One hundred twelve of the admitted patients (52%) converted to normal sinus rhythm during their stays.…”

Section: Resultsmentioning

confidence: 99%

New–onset Atrial Fibrillation: When Is Admission Medically Justified?

Mulcahy

Coates

Henneman

et al. 1996

Academic Emergency Medicine

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Objective: To determine 1) the percentage of patients with new-onset atrial fibrillation for whom admission is medically justified and 2) whether those patients for whom hospitalization is medically justified can be reliably identified in the ED.Methods: A retrospective, descriptive cohort analysis was performed using consecutive adult patients with new-onset atrial fibrillation seen in an urban, county hospital ED from 1987 through 1992. Admissions were categorized as medically justified if patients were hypotensive (systolic blood pressure <90 mm Hg), had a diagnosis other than new-onset atrial fibrillation that warranted admission, or had a significant complication during the ED stay or during the subsequent hospitalization. The need for admission was considered to have been apparent during the ED evaluation if the patient fulfilled the above criteria for a medically justified admission while in the ED.Results: Admission was medically justified for 143 of the 216 patients (66%; 95% CI 60-71%) admitted to our institution. For those patients whose admissions were medically justified, the most common concurrent conditions were congestive heart failure and chest pain suggestive of myocardial ischemia. The need for admission was apparent during the ED evaluation for 140 of the 143 patients (98%; 95% CI 94-100%) whose admissions were categorized as medically justified. Conclusion:Approximately one third of patients with new-onset atrial fibrillation may not require admission to the hospital. Most patients (98%) for whom admission is medically justified can be reliably identified during the ED evaluation.

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Acute complications associated with new-onset atrial fibrillation

Cited by 15 publications

References 5 publications

Utility of a pediatric observation unit for the management of children admitted to the emergency department

Utility of a pediatric observation unit for the management of children admitted to the emergency department

Diltiazem vs. Metoprolol in the Management of Atrial Fibrillation or Flutter with Rapid Ventricular Rate in the Emergency Department

New–onset Atrial Fibrillation: When Is Admission Medically Justified?

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