Abstract:
OBJECTIVE:To quantify the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on emergency department volumes and patient presentations and evaluate changes in community mortality for the purpose of characterizing new patterns of emergency care use. PATIENTS AND METHODS:This is an observational cross-sectional study using electronic health records for emergency department visits in an integrated multihospital system with academic and community practices across 4 states for visits between March 17 and April 21, 2019, and February 9 and April 21, 2020. We compared numbers and proportions of common and critical chief symptoms and diagnoses, triage assessments, throughput, disposition, and selected hospital lengths of stay and out-of-hospital deaths. RESULTS:In the period of interest, emergency department visits decreased by nearly 50% (35037 to 18646). Total numbers of patients with myocardial infarctions, stroke, appendicitis, and cholecystitis diagnosed decreased. The percentage of visits for mental health symptoms increased. There was an increase in deaths, driven by out-of-hospital mortality. CONCLUSION:Fewer patients presenting with acute and time-sensitive diagnoses suggests that patients are deferring care. This may be further supported by an increase in out-of-hospital mortality. Understanding which patients are deferring care and why will allow us to develop outreach strategies and ensure that those in need of rapid assessment and treatment will do so, preventing downstream morbidity and mortality.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Walker LE,Heaton HA,Monroe RJ,Reichard RR,Kendall M,Mullan AF,Goyal DGdoi
10.1016/j.mayocp.2020.09.019subject
Has Abstractpub_date
2020-11-01 00:00:00pages
2395-2407issue
11eissn
0025-6196issn
1942-5546pii
S0025-6196(20)31052-1journal_volume
95pub_type
杂志文章abstract:BACKGROUND:The efficacy of fine-needle aspiration (FNA) biopsy and its role in the management of a nodular goiter are clearly established. The accuracy of cytologic diagnosis approaches 95%. FINDINGS:FNA biopsy is a reasonable approach to thyroid nodules; it has decreased costs substantially because it facilitates sel...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61611-5
更新日期:1994-01-01 00:00:00
abstract::In a retrospective analysis, 63 participants in a cardiac rehabilitation-preventive cardiology program were identified as having low blood concentrations (mean, 34 mg/dl) of high-density lipoprotein cholesterol (HDL-C) and a mean total cholesterol level of 223 mg/dl after 3 months of hygienic measures (aerobic exercis...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章
doi:10.1016/s0025-6196(12)60824-6
更新日期:1992-09-01 00:00:00
abstract::A 33-year-old woman with acute idiopathic postganglionic panautonomic neuropathy experienced prompt recovery of all dysautonomic symptoms after receiving high-dose intravenous immunoglobulin therapy. Her recovery was complete within 6 months after onset of disease. This unusually rapid and complete recovery in compari...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/72.4.333
更新日期:1997-04-01 00:00:00
abstract::We measured cardiopulmonary function at rest and during exercise in 15 healthy survivors of neonatal respiratory distress syndrome (RDS) and compared the results with those in 15 normal subjects. The mean birth weight of the RDS group was 1,771 g, and 12 of the 15 patients had required endotracheal intubation. The oxy...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65222-7
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVE:To examine the ability of 4 published osteoporosis risk indices to identify women with low bone density. SUBJECTS AND METHODS:Subjects included postmenopausal women 45 years and older consecutively recruited from US clinics, women from general practice centers in The Netherlands (age range, 50-80 years), wom...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/77.7.629
更新日期:2002-07-01 00:00:00
abstract::Dural arteriovenous malformations of the transverse sinus are relatively well localized to the occipitomastoid regions and occur predominantly in women who are more than 40 years of age. The signs and symptoms, except for pulsatile tinnitus, vary and apparently depend on the presence of impaired venous drainage, which...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1979-10-01 00:00:00
abstract:OBJECTIVE:To examine the association of medical knowledge acquisition with attendance at specific conference types during internal medicine residency. PARTICIPANTS AND METHODS:Attendance at residency core curriculum, morbidity and mortality, and medical grand rounds conferences was tracked for 195 residents who took t...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/83.4.449
更新日期:2008-04-01 00:00:00
abstract::Thirty-five patients with a diagnosis of pure ovarian dysgerminoma underwent assessment at our institution between 1950 and 1984. The median age of these patients was 21 years (range, 8 to 41 years). The surgical pathologic stages of the tumors were as follows: stage IA1 in 18 patients, stage IA2 in 2, stage IB1 in 2,...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62512-9
更新日期:1987-12-01 00:00:00
abstract::Aerobic exercise training has been used as part of the treatment for a variety of chronic disorders, most notably cardiovascular disease. In order to determine the feasibility and utility of regular exercise after renal transplantation, the responses of 10 patients to graded exercise testing were compared before train...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62329-5
更新日期:1987-09-01 00:00:00
abstract::Between December 1980 and April 1986 at our institution, 38 patients with cancer that involved the tracheobronchial tree (a total of 40 carcinomas) completed at least one course of hematoporphyrin derivative phototherapy. A complete response occurred in 13 patients (with 14 carcinomas). Eleven of these carcinomas did ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61520-1
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To assess whether caffeine intake is associated with all-cause and cause-specific mortality. PATIENTS AND METHODS:We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey 1999-2010. Cox proportional hazards models were used to compare the multivariate-adjus...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2017.03.010
更新日期:2017-08-01 00:00:00
abstract::We developed and validated a radioimmunoassay for circulating human parathyroid hormone-related peptide (PTHrP), based on a commercial antiserum to the synthetic 1-34 fragment of PTHrP, 125I-Tyr degrees-PTHrP(1-34) as radioligand, and prior extraction of the native peptide from plasma with C-2 cartridges. We determine...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62163-6
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To determine the effect of adding a trained intensivist on patient care and educational outcomes in a community teaching hospital. MATERIAL AND METHODS:We retrospectively reviewed outcomes for patients admitted to the medical intensive-care unit (MICU) of a 270-bed community teaching hospital between July 19...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/72.5.391
更新日期:1997-05-01 00:00:00
abstract::We describe a woman with an unusual case of thromboembolism of the mesenteric artery in whom multiple thrombi were subsequently found in the aorta and right heart chambers on transesophageal echocardiography. Further evaluation revealed a deficiency of protein C and S plasma proteins, inhibitors of the clotting system...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.3.319
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:To characterize public perception of physicians' conflicts of interest (COIs) across medical and surgical specialties. PATIENTS AND METHODS:A cross-sectional 6-arm randomized survey of a nonprobability sample from Amazon's Mechanical Turk occurred on December 11 to 16, 2018. Survey respondents were randomly...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.07.009
更新日期:2019-12-01 00:00:00
abstract::A series of 58 operations on 56 patients, in whom a branch of the superficial temporal artery was anastomosed to a branch of the middle cerebral artery (STA-MCA bypass or Yasargil procedure), is reviewed. These operations were performed chiefly for occlussions or for inaccessible stenotic lesions of the internal carot...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::Arterial calcification in the coronary arteries frequently indicates concomitant atherosclerotic plaque but can be present in the medial layers with no evidence of plaque. Calcification of the medial layer of arteries is seen most often in the peripheral arteries but also is widely recognized In the coronary arteries....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)61536-X
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To report the clinical responses and mediator-release profiles of an aspirin-sensitive man with systemic mast cell disease during aspirin desensitization. MATERIAL AND METHODS:We quantified the release of six mediators during aspirin desensitization. RESULTS:Although aspirin was administered cautiously with...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.5.481
更新日期:1995-05-01 00:00:00
abstract::Two cases of rare, catastrophic calcium emboli to the coronary arteries immediately after percutaneous mitral balloon valvuloplasty are presented. Preoperative echocardiographic findings may identify patients at risk for this complication. These cases should increase the awareness of calcium emboli and lead to conside...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.7.753
更新日期:2001-07-01 00:00:00
abstract::The frequently encountered disorder of venous thromboembolism (VTE) can cause serious morbidity and even death. Nevertheless, in more than 70% of patients who die of pulmonary embolism (PE), the diagnosis is not considered before death. Thus, clinicians should have a high index of suspicion for VTE, especially in high...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)64664-8
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To determine how all-cause hospitalizations within 12 months preceding an index heart failure (HF) hospitalization affect risk stratification for 30-day all-cause readmission. PATIENTS AND METHODS:Early readmission of inpatients with HF is challenging to predict, yet this outcome is used to compare hospital ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.12.018
更新日期:2014-05-01 00:00:00
abstract::Osteoporosis is a skeletal disorder characterized by compromised bone strength and increased risk of fracture. Properties related to bone strength include rate of bone turnover, bone mineral density, geometry, microarchitecture, and mean degree of mineralization. These properties (with or without bone density) are som...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/80.3.379
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To determine the effect of sumatriptan on migraine-related workplace productivity loss. PATIENTS AND METHODS:In this randomized, double-blind, placebo-controlled, parallel-group trial, adult migraineurs self-injected 6 mg of sumatriptan or matching placebo to treat a moderate or severe migraine within the fi...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.4065/75.8.782
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To assess obesity rates during childhood and young adulthood in patients with attention-deficit/hyperactivity disorder (ADHD) and age- and sex-matched controls derived from a population-based birth cohort because cross-sectional studies suggest an association between ADHD and obesity. PATIENTS AND METHODS:St...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2015.09.017
更新日期:2016-03-01 00:00:00
abstract:UNLABELLED:Cirrhosis and liver cancer, the main causes of liver-related morbidity and mortality, result from defective repair of liver injury. This article summarizes rapidly evolving knowledge about liver myofibroblasts and progenitors, the 2 key cell types that interact to orchestrate effective repair, because deregu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.10.009
更新日期:2014-01-01 00:00:00
abstract::Treatment of seniors with Parkinson disease is within the domain of primary care physicians and internists. A good working knowledge of carbidopa/levodopa principles should allow excellent care of most patients, at least during the early years of the disease. Even later, when levodopa responses become more complicated...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2011.0443
更新日期:2011-12-01 00:00:00
abstract::In this study, our aim was to test the hypothesis that colonic tone is abnormal in patients with irritable bowel syndrome (IBS). We studied eight patients with IBS and eight age-matched asymptomatic control subjects, in whom tone and motility were measured by an electronic barostat and by pneumohydraulic perfusion man...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60796-4
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the contemporary trends in outcomes and resource use associated with transcatheter aortic valve replacement (TAVR) in the United States. METHODS:We identified patients who underwent TAVR between January 1, 2012, and December 31, 2017, in the National Readmission Database. We assessed temporal tre...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2020.05.043
更新日期:2020-12-01 00:00:00
abstract::Vancomycin is a glycopeptide antibiotic that is active against staphylococci, streptococci, and other gram-positive bacteria. It is the drug of choice for the treatment of infections due to methicillin-resistant staphylococci, Corynebacterium jeikeium, and multiply resistant strains of Streptococcus pneumoniae. Vancom...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65799-1
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To assess overall perioperative and anesthetic care-specific patient satisfaction. DESIGN:We mailed questionnaires postoperatively to three groups of surgical patients (those who underwent anesthesia without complications, those who experienced airway management difficulties, and those who had cardiovascular...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/72.1.20
更新日期:1997-01-01 00:00:00