Characteristics and Trends of Emergency Department Visits in the United States (2010–2014)

Hooker, Edmond A.; Mallow, Peter J.; Oglesby, Michelle M.

doi:10.1016/j.jemermed.2018.12.025

Cited by 136 publications

(110 citation statements)

References 10 publications

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“…Acute respiratory infections (ARIs) typically present as acute febrile respiratory illnesses (FRIs) cause approximately 4 million deaths worldwide each year [1]. In addition, ARIs were the second most common reason for emergency department (ED) visits in the United States in 2014 (18.2 per 1000 persons) [2], and chest radiographs (CR) have been the first-line imaging modality for diagnosing or excluding pneumonia [3]. It is very important to diagnose pneumonia in ARI patients because simple upper respiratory infections are usually self-limiting, while pneumonia can potentially lead to respiratory failure and intensive care unit admission without appropriate treatment [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical Validation of a Deep Learning Algorithm for Detection of Pneumonia on Chest Radiographs in Emergency Department Patients with Acute Febrile Respiratory Illness

Kim

et al. 2020

JCM

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Early identification of pneumonia is essential in patients with acute febrile respiratory illness (FRI). We evaluated the performance and added value of a commercial deep learning (DL) algorithm in detecting pneumonia on chest radiographs (CRs) of patients visiting the emergency department (ED) with acute FRI. This single-centre, retrospective study included 377 consecutive patients who visited the ED and the resulting 387 CRs in August 2018–January 2019. The performance of a DL algorithm in detection of pneumonia on CRs was evaluated based on area under the receiver operating characteristics (AUROC) curves, sensitivity, specificity, negative predictive values (NPVs), and positive predictive values (PPVs). Three ED physicians independently reviewed CRs with observer performance test to detect pneumonia, which was re-evaluated with the algorithm eight weeks later. AUROC, sensitivity, and specificity measurements were compared between “DL algorithm” vs. “physicians-only” and between “physicians-only” vs. “physicians aided with the algorithm”. Among 377 patients, 83 (22.0%) had pneumonia. AUROC, sensitivity, specificity, PPV, and NPV of the algorithm for detection of pneumonia on CRs were 0.861, 58.3%, 94.4%, 74.2%, and 89.1%, respectively. For the detection of ‘visible pneumonia on CR’ (60 CRs from 59 patients), AUROC, sensitivity, specificity, PPV, and NPV were 0.940, 81.7%, 94.4%, 74.2%, and 96.3%, respectively. In the observer performance test, the algorithm performed better than the physicians for pneumonia (AUROC, 0.861 vs. 0.788, p = 0.017; specificity, 94.4% vs. 88.7%, p < 0.0001) and visible pneumonia (AUROC, 0.940 vs. 0.871, p = 0.007; sensitivity, 81.7% vs. 73.9%, p = 0.034; specificity, 94.4% vs. 88.7%, p < 0.0001). Detection of pneumonia (sensitivity, 82.2% vs. 53.2%, p = 0.008; specificity, 98.1% vs. 88.7%; p < 0.0001) and ‘visible pneumonia’ (sensitivity, 82.2% vs. 73.9%, p = 0.014; specificity, 98.1% vs. 88.7%, p < 0.0001) significantly improved when the algorithm was used by the physicians. Mean reading time for the physicians decreased from 165 to 101 min with the assistance of the algorithm. Thus, the DL algorithm showed a better diagnosis of pneumonia, particularly visible pneumonia on CR, and improved diagnosis by ED physicians in patients with acute FRI.

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Section: Introductionmentioning

confidence: 99%

Clinical Validation of a Deep Learning Algorithm for Detection of Pneumonia on Chest Radiographs in Emergency Department Patients with Acute Febrile Respiratory Illness

Kim

et al. 2020

JCM

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“…In addition, because of the growth of emergency medicine as a physician specialty, patients see the ED as a source of highquality care. In many countries the number of ED visits is growing faster than the population [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on the emergency department visits: a retrospective analysis in Shanghai, China

Wei

et al. 2020

Preprint

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Background The novel coronavirus diseases (COVID-19) has led to a pandemic and affected people's lives greatly, including their health seeking behavior. We aimed to evaluate the impact of the current COVID-19 pandemic on characteristics and trends of emergency department (ED) visits in Shanghai, China.Methods This was a retrospective observational study using medical record databases from the Shanghai Sixth People's Hospital (East Campus) for years 2016 through 2020. All the patients referred to the ED between January 2016 and June 2020 were retrospectively reviewed. January 1, 2020, was chosen as the cutoff date for the statistical analysis and data of January and February in 2020 was compared with the same period of 2019.Results During the first two months of 2020, there was a 60.9% decline in ED visits when compared with the same period of 2019 (9,904 vs. 25,316, respectively), and the waiting time in ED has been greatly reduced correspondingly (12±4 vs. 66±19 min, p < 0.001); ED visits for acute ischemic stroke (AIS) and acute coronary syndrome(ACS) decreased by 53.9% and 41.2% respectively; proportion of intravenous thrombolysis for AIS has dropped(42.1% vs. 11.4%, p = 0.003), and percutaneous coronary intervention for ACS was similar (70.6% vs. 63.3%, p = 0.668); and onset-to-door time (ODT) of these patients increased significantly (AIS: 217(136-374) vs. 378(260-510)min, ACS: 135(85-195) vs. 226(155-368)min, all p < 0.001).Conclusion The outbreak of COVID-19 pandemic was correlated with a significant decline in the number of ED visits including AIS and ACS patients when compared to the pre-COVID-19 period. ODT of AIS and ACS patients increased significantly. Raising public awareness is necessary to avoid serious healthcare and economic consequences of undiagnosed and untreated stroke and myocardial infarction attack.

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“…Overall number of emergency department visits, including otorhinolaryngology, has increased [1]. Due to population growth, industry and traffic expansion, workload of the otorhinolaryngology emergency department is steadily on the rise.…”

Section: Introductionmentioning

confidence: 99%

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

et al. 2021

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Introduction/Objective. Overall number of emergency department visits, including otorhinolaryngology, has increased. Due to population growth, industry and traffic expansion, workload of the otorhinolaryngology emergency department is steadily on the rise. The objective of this study was to determine most common indications for emergency hospitalization in otorhinolaryngology department in secondary medical center. Also, we examined course of diagnostics and treatment upon admittance, outcome of hospitalization and possible referral to tertiary medical center. Methods. Retrospective study included patients who were urgently hospitalized on the Department of otorhinolaryngology and maxillofacial surgery in Djordje Joanovic General Hospital in Zrenjanin in a two-year period. The data were obtained by processing patients? medical charts. Results. The study included 428 patients who were urgently hospitalized on the Department of otorhinolaryngology of the secondary medical center in two-year period. 245 (57.2%) were male and were 183 (42.8%) female, with average age of 48.5 years. Patients were most frequently hospitalized because of tonsillopharyngitis and its? complications, followed by head and neck trauma. Most of the patients were treated conservatively with medication therapy (72%), and 28% underwent surgical or other invasive intervention. 27 (6.3%) patients were referred to tertiary medical center, which was correlated significantly with number of comorbidities and consultative exams. Conclusion. Otorhinolaryngology inflammatory/infectious diseases are the most frequent indication for urgent hospital admission in secondary medical center. Most of the patients were treated conservatively. Referral to tertiary medical center was significantly correlated to number of comorbidities and consultative exams.

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Characteristics and Trends of Emergency Department Visits in the United States (2010–2014)

Cited by 136 publications

References 10 publications

Clinical Validation of a Deep Learning Algorithm for Detection of Pneumonia on Chest Radiographs in Emergency Department Patients with Acute Febrile Respiratory Illness

Clinical Validation of a Deep Learning Algorithm for Detection of Pneumonia on Chest Radiographs in Emergency Department Patients with Acute Febrile Respiratory Illness

The impact of the COVID-19 pandemic on the emergency department visits: a retrospective analysis in Shanghai, China

Otorhinolaryngology emergency department hospitalizations in a secondary medical center

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