Annals of emergency medicine
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Multicenter Study
Patients with rib fractures do not develop delayed pneumonia: a prospective, multicenter cohort study of minor thoracic injury.
Patients admitted to emergency departments (EDs) for minor thoracic injuries are possibly at risk of delayed pneumonia. We aimed to evaluate the incidence of delayed pneumonia post-minor thoracic injury and the associated risk factors. ⋯ This prospective cohort study of nonhospitalized patients with minor thoracic injuries revealed a low incidence of delayed pneumonia. Nonetheless, our results support tailored follow-up for asthmatic or chronic obstructive pulmonary disease patients with rib fracture.
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Multicenter Study
Toward understanding the difference between using patients or encounters in the accounting of emergency department utilization.
Descriptions of emergency department (ED) census often do not differentiate between patients and encounters, and there is no guidance about which unit of analysis is most appropriate. We explore differences between patient- and encounter-level accounting of ED utilization. ⋯ EDs provide care to a relatively static population, with truly new patients composing only a minority of encounters. Although multiple encounters per patient are common, highly frequent use occurs for only a minority of ED patients, and then only for a discrete period. Encounters and patients are not equivalent units of analysis, and policymakers and researchers should determine which is most appropriate for their decisionmaking.
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Multicenter Study
Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study.
Although repeated intubation attempts are believed to contribute to patient morbidity, only limited data characterize the association between the number of emergency department (ED) laryngoscopic attempts and adverse events. We seek to determine whether multiple ED intubation attempts are associated with an increased risk of adverse events. ⋯ In this large Japanese multicenter study of ED patients undergoing intubation, we found that multiple intubation attempts were independently associated with increased adverse events.