Abstract:
STUDY OBJECTIVE:We determine the association between use of specific cephalosporins and macrolides and hospital length of stay in patients with sickle cell disease (SCD) who are admitted with acute chest syndrome, and determine treatment risk factors for acute chest syndrome-related 30-day readmission. METHODS:Patients admitted to 48 US hospitals within the Pediatric Health Information System between January 2008 and December 2016 with associated International Classification of Diseases, Ninth Revision (ICD-9) or ICD-10 diagnoses of SCD and acute chest syndrome were included. Primary outcomes were hospital length of stay and acute chest syndrome-related and all-cause 30-day readmission. Data were analyzed with t tests, ANOVA, and bivariable and multivariable linear and logistic regressions. RESULTS:In 21,126 visits (representing 8,856 patients), median age was 11.2 years (interquartile range 6.1 to 16.5 years), 53.5% were male patients, and 77.2% had hemoglobin SS genotype. Median length of stay was 4 days (interquartile range 2 to 6 days; mean 4.76 days [SD 4.62 days]). Ceftriaxone alone (length of stay 4.75 days [SD 4.66 days]; P<.001) or the combination of ceftriaxone and azithromycin (length of stay 4.84 days [SD 4.74 days]; P<.001) was associated with the shortest length of stay and a reduced risk of acute chest syndrome-related readmission (ceftriaxone odds ratio [OR] 0.31; 95% confidence interval [CI] 0.27 to 0.35; ceftriaxone+azithromycin OR 0.20; 95% CI 0.17 to 0.24). Albuterol (OR 0.97; 95% CI 0.96 to 0.98) and RBC transfusion (OR 0.60; 95% CI 0.43 to 0.83) were also associated with decreased rates of acute chest syndrome-related 30-day readmission. All-cause 30-day readmission rate was 16.7% (95% CI 16.2% to 17.3%). CONCLUSION:Guideline-compliant therapy for acute chest syndrome could preferentially include ceftriaxone and azithromycin. All-cause 30-day readmission for acute chest syndrome is lower than that reported for all-cause readmissions for SCD and more consistent with rates of readmission for pneumonia in the general population.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Badaki-Makun O,Casella JF,Tackett S,Tao X,Chamberlain JMdoi
10.1016/j.annemergmed.2020.08.011subject
Has Abstractpub_date
2020-09-01 00:00:00pages
S37-S45issue
3Seissn
0196-0644issn
1097-6760pii
S0196-0644(20)30656-9journal_volume
76pub_type
杂志文章abstract:STUDY OBJECTIVE:To determine whether N-acetylcysteine (NAC reduces methemoglobin. METHODS:We carried out an in vitro laboratory experiment in which five healthy adult volunteers donated blood. Each sample was divided equally among three test tubes. Tube 1 served as a negative control. Sodium nitrite .18 mol/L with dex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70112-9
更新日期:1996-11-01 00:00:00
abstract::Little is known about the efficacy of CPR in the setting of hypothermia-induced cardiac arrest. We measured organ blood flow produced by conventional closed-chest CPR in eight swine following normothermic KCl-induced cardiac arrest and in seven swine surface-cooled until cardiac arrest occurred. Radiomicrospheres were...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80173-1
更新日期:1986-04-01 00:00:00
abstract:STUDY OBJECTIVE:The necessity for rapid administration of intravenous thrombolysis in patients with acute ischemic stroke may lead to treatment of patients with conditions mimicking stroke. We analyze stroke patients treated with intravenous thrombolysis in our center to characterize cases classified as stroke mimics. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.09.011
更新日期:2012-01-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years). METHODS:A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, O...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2017.01.029
更新日期:2017-09-01 00:00:00
abstract::The Bahamas is an archipelago of 700 islands with the majority of the population concentrated on just 2 islands: New Providence and Grand Bahama. Most emergency medical services are provided by Princess Margaret Hospital and Rand Memorial Hospital located respectively on those 2 islands. A detailed description of the ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.118865
更新日期:2001-12-01 00:00:00
abstract::To evaluate the heat burden in parked cars, a study was done to measure inside car temperatures in different situations. A large car and a small car were parked in direct sunlight and in shade. In direct sun, the highest temperatures recorded in the small and large cars were 78 C and 65 C, respectively. The highest te...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80097-8
更新日期:1982-05-01 00:00:00
abstract:STUDY OBJECTIVE:Atrial flutter is a common arrhythmia seen in the emergency department (ED), yet there is little research describing its management and outcomes. We analyze the success and safety of treatment of ED patients with atrial flutter. METHODS:This was a retrospective cohort study obtained by searching the ED...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.09.027
更新日期:2011-06-01 00:00:00
abstract::While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown re...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80067-0
更新日期:1984-11-01 00:00:00
abstract:STUDY OBJECTIVE:We determine the validity of self-reported prescription filling among emergency department (ED) patients. METHODS:We analyzed a subgroup of 1,026 patients enrolled in a randomized controlled trial who were prescribed at least 1 medication at ED discharge, were covered by Medicaid insurance, and complet...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2013.01.026
更新日期:2013-09-01 00:00:00
abstract::In more than 15 years of paramedic operation, fewer than 15 prehospital studies have been undertaken on the pharmacologic intervention by paramedics. Many of these studies suffer from inadequate sample size or deficient study design. There is no evidence that any medication given by the prehospital care provider is be...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(89)80113-1
更新日期:1989-02-01 00:00:00
abstract::We present the case of a 27-year-old man who sustained a minor head injury and presented with complaints of headache and vomiting. The diagnosis of vertex epidural hematoma is discussed. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70145-8
更新日期:1994-08-01 00:00:00
abstract:STUDY OBJECTIVE:We perform a videographic analysis of external laryngeal manipulation (ELM) by novice intubators using a direct laryngoscopic imaging system and a validated means of assessing laryngeal view (percentage of glottic opening [POGO] score). METHODS:Nine first-year emergency medicine residents performed a t...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.125716
更新日期:2002-07-01 00:00:00
abstract::In an effort to assess the reliability of patient history in excluding pregnancy, we studied the correlation between specific historical factors and the presence of a positive qualitative serum beta-human chorionic gonadotropin assay. Two hundred eight patients were studied, and information was collected prospectively...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80310-5
更新日期:1989-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the relationship between spinal injuries and helmet use in motorcycle trauma. DESIGN:Retrospective case series. SETTING:Twenty-eight hospitals in four midwestern states--Illinois, Iowa, Nebraska and Wisconsin--representing urban, suburban, and rural settings. PATIENTS AND OTHER PARTICIPA...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/s0196-0644(94)70317-5
更新日期:1994-04-01 00:00:00
abstract::Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(88)80360-3
更新日期:1988-12-01 00:00:00
abstract::The management of HIV disease has evolved into a complicated and sophisticated subspecialty in recent years. Fourteen drugs, in various combinations, are being used in increasingly complex treatment regimens. The side effects of some of these drugs, as well as certain drug-drug interactions may mimic signs and symptom...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(99)70341-0
更新日期:1999-05-01 00:00:00
abstract::Acute ischemic stroke is the third leading cause of death in the United States and the leading cause of adult disability. The direct and indirect costs of stroke care exceed $51 billion annually. In 1996, the US Food and Drug Administration approved the first treatment for acute ischemic stroke, intravenous tissue pla...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1067/mem.2001.111573
更新日期:2001-02-01 00:00:00
abstract:STUDY OBJECTIVES:To confirm the ability of the esophageal detector device (EDD) to indicate positioning of endotracheal tubes (ETTs) in patients intubated under emergency conditions and to compare the performance of the EDD with that of end-tidal carbon dioxide (ETCO2). METHODS:This single-subject study comprising a p...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(96)70162-2
更新日期:1996-05-01 00:00:00
abstract::Recent developments, such as the bombings of the World Trade Center in 1993 and the Alfred P. Murrah Federal Building in Oklahoma City in 1995, the sarin attacks in Tokyo and Matsumoto, Japan, and US Embassy bombings in Kenya and Tanzania in 1998, have heightened fears of terrorist attacks. Future terrorist activities...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70228-3
更新日期:1999-08-01 00:00:00
abstract::Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The present...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80019-8
更新日期:1989-07-01 00:00:00
abstract::After Hurricane Katrina hit the Gulf Coast on August 29, 2005, thousands of ill and injured evacuees were transported to Houston, TX. Houston's regional disaster plan was quickly implemented, leading to the activation of the Regional Hospital Preparedness Council's Catastrophic Medical Operations Center and the rapid ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2008.10.014
更新日期:2009-04-01 00:00:00
abstract::This report describes a case of acquired eventration of a hemidiaphragm after insertion of a chest tube for treatment of an iatrogenic pneumothorax. Partial withdrawal of the chest tube resulted in immediate return of the hemidiaphragm to its original position. This is believed to be the first report of the resolution...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(95)70275-x
更新日期:1995-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the clinical characteristics of endotracheal intubation in the French emergency prehospital medical system and compare these data with those of other systems. METHODS:This study was performed in lle de France (Paris Region) in mobile ICUs staffed by physicians. This prospective, descriptiv...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70175-1
更新日期:1998-10-01 00:00:00
abstract:STUDY OBJECTIVE:Traumatic eye injuries are common emergency department presentations worldwide, and diagnosis may be delayed because of concurrent injuries and lack of guidelines in regard to the utility of clinical examination, computed tomography (CT), and point-of-care ultrasonography. In this study, we compare poin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.02.001
更新日期:2019-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effects of early fluid resuscitation on the rate, volume, and duration of hemorrhage using a sheep model of uncontrolled pulmonary vascular hemorrhage. METHODS:Sixteen adult sheep were anesthetized and fitted with catheters to measure systemic and pulmonary artery pressures. A branch o...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70352-4
更新日期:1997-03-01 00:00:00
abstract:STUDY OBJECTIVES:To compare diagnostic strategies for the emergency assessment of patients with suspected acute thoracic aortic dissection and to measure the effect of delays related to the availability of these tests on the selection of the most appropriate one. METHODS:We carried out a decision analysis representing...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70026-4
更新日期:1996-09-01 00:00:00
abstract:STUDY OBJECTIVE:We explore what emergency physicians with access to health information exchange have to say about it and strive to better understand the factors affecting their use of it. METHODS:A qualitative study using grounded theory principles was conducted in 4 urban emergency departments that had health informa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2013.09.024
更新日期:2014-03-01 00:00:00
abstract::Patients evaluated by paramedics but not transported to the hospital account for 50% to 90% of emergency medical services lawsuits. We reviewed 2,698 consecutive paramedic run reports to examine documentation in these cases. Documentation criteria for prehospital patient release were history, physical examination, vit...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82187-0
更新日期:1990-05-01 00:00:00
abstract::Gastrointestinal obstruction is a rare complication of multiple-dose administration of activated charcoal. Previous reports deal only with obstruction after ingestion of drugs that impair gastrointestinal motility. This patient developed a small-bowel obstruction associated with the administration of multiple doses of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70170-9
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:We determine the feasibility and yield of universal opt-out HIV screening among adolescents and adults in a southeastern emergency department (ED) serving a semiurban-semirural population. METHODS:Individuals aged 13 to 64 years who visited the ED during specified hours received the OraQuick rapid HIV test (...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.03.026
更新日期:2011-07-01 00:00:00