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Observational Study
Management of dyspepsia-The role of the ED Observation unit to optimize patient outcomes.
- Wei Ping Daniel Chor, Pei Xian Lorraine Yong, Li Lin Lim, Chew Yian Chai, Tiong Beng Sim, and Win Sen Kuan.
- Emergency Medicine Department, National University Hospital, National University Health System, 119074, Singapore. Electronic address: daniel_chor@nuhs.edu.sg.
- Am J Emerg Med. 2018 Oct 1; 36 (10): 1733-1737.
BackgroundDyspepsia is a common complaint that can confer significant burden on one's quality of life and may also be associated with serious underlying conditions. The objective of this study was to determine if patients admitted to the emergency department observation unit (EDOU) for severe or persistent dyspepsia would have cost effective management in terms of investigations performed, length and cost of hospital stay. The secondary objective was to determine if any patient characteristics could predict a need for admission to the inpatient unit.MethodsRetrospective chart reviews of patients admitted to the EDOU under the Dyspepsia protocol between January 2008 and August 2014 were conducted. Baseline demographics, investigations performed, outcomes related to EDOU stay, admission and 30-day re-presentation outcomes were recorded.ResultsA total of 1304 patients were included. Median length of stay was 1day. Cumulative bed-saved days were 38 per month. Two hundred eighteen (16.7%) patients required admission to the inpatient service for further management, while 533 (40.9%) and 313 (24.0%) patients underwent esophagogastroduodenoscopy and hepatobiliary ultrasonography, respectively. No major adverse events were attributed to the EDOU admissions or delays in treatment. No significant clinically relevant factors were associated with a need for admission from the EDOU to the inpatient unit. Median cost of the EDOU admission was approximately one-third that of a similar admission to the inpatient unit.ConclusionThe EDOU is an appropriate setting to facilitate investigations and treatment of patients with dyspepsia with considerable bed-saved days.Copyright © 2018 Elsevier Inc. All rights reserved.
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