The Impact of Night-time Emergency Department Presentation on Upper Gastrointestinal Hemorrhage Outcomes

Alayo, Quazim A.; Oyenuga, Abayomi; Adejumo, Adeyinka Charles; Pottathil, Raveendran; Grewal, Damanpreet; Okafor, Philip N.

doi:10.1097/mcg.0000000000001596

Cited by 2 publications

(1 citation statement)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Night shifts in EDs are associated with poorer outcomes [33][34][35]. Here, we showed that patient arrival in the evening and especially during night shifts were highly predictive…”

Section: Discussionmentioning

confidence: 64%

Trends in Atrial Fibrillation Management—Results from a National Multi-Center Urgent Care Network Registry

Lebovitz,

Estryk,

Zimmerman

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Atrial fibrillation (AF) is a common diagnosis in patients presenting to urgent care centers (UCCs), yet there is scant research regarding treatment in these centers. While some of these patients are managed within UCCs, some are referred for further care in an emergency department (ED). Objectives: We aimed to identify the rate of patients referred to an ED and define predictors for this outcome. We analyzed the rates of AF diagnosis and hospital referral over the years. Finally, we described trends in patient anticoagulation (AC) medication use. Methods: This retrospective study included 5873 visits of patients over age 18 visiting the TEREM UCC network with a diagnosis of AF over 11 years. Multivariate analysis was used to identify predictors for ED referral. Results: In a multivariate model, predictors of referral to an ED included vascular disease (OR 1.88 (95% CI 1.43–2.45), p < 0.001), evening or night shifts (OR 1.31 (95% CI 1.11–1.55), p < 0.001; OR 1.68 (95% CI 1.32–2.15), p < 0.001; respectively), previously diagnosed AF (OR 0.31 (95% CI 0.26–0.37), p < 0.001), prior treatment with AC (OR 0.56 (95% CI 0.46–0.67), p < 0.001), beta blockers (OR 0.63 (95% CI 0.52–0.76), p < 0.001), and antiarrhythmic medication (OR 0.58 (95% CI 0.48–0.69), p < 0.001). Visits diagnosed with AF increased over the years (p = 0.030), while referrals to an ED decreased over the years (p = 0.050). The rate of novel oral anticoagulant prescriptions increased over the years. Conclusions: The rate of referral to an ED from a UCC over the years is declining but remains high. Referrals may be predicted using simple clinical variables. This knowledge may help to reduce the burden of hospitalizations.

show abstract

“…Night shifts in EDs are associated with poorer outcomes [33][34][35]. Here, we showed that patient arrival in the evening and especially during night shifts were highly predictive…”

Section: Discussionmentioning

confidence: 64%