European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Review Meta Analysis
Adverse outcomes in older adults attending emergency department: systematic review and meta-analysis of the Triage Risk Stratification Tool.
The objective of this study was to assess the predictive ability of the Triage Risk Stratification Tool (TRST) in identifying older adults at risk of adverse outcomes [return to emergency department (ED), hospitalization, or a composite outcome] within 30 and 120 days following discharge from ED. A systematic search was conducted to identify studies validating the TRST in older adults aged at least 65 years discharged from ED. The methodological quality of selected studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. ⋯ There was little heterogeneity across studies. In conclusion, the TRST is limited in its ability to discriminate between older adults with or without an adverse outcome following discharge from ED. The low levels of heterogeneity gives us confidence that the pooled estimates reflect the predictive ability of the TRST in clinical practice.
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Randomized Controlled Trial
Developing a decision support system for geriatric patients in prehospital care.
To develop a feasible and safe prehospital decision support system (DSS) for the emergency medical services (EMS), facilitating safe steering of geriatric patients to an optimal level of healthcare. ⋯ Using this prehospital DSS - developed for 11 medical conditions - the Swedish prehospital nurse can safely decide on the level of healthcare to which an elderly patient can be steered.
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Our main aim was to describe the path of patients seen in our emergency department (ED) and either admitted or transferred and to compare the characteristics of patients hospitalized in our hospital with those of transferred patients. Our secondary aim was to compare the receipts linked to patient hospital stays. ⋯ Our results show that patients requiring shorter care are transferred, whereas more severe patients are hospitalized on site. Hospitals will need solutions to optimize their receipts while fulfilling their public missions such as continuity of care.
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To identify the prevalence, predictors and outcomes of patients who leave without being seen (LWBS) in one hospital emergency department (ED). ⋯ Outcomes investigated in this study indicate that room for improvement exists not only for patients who LWBS but all patients presenting to the ED. The most powerful predictors of LWBS were lower urgency triage allocation and evening and night shift presentations. This suggests that service improvements could be targeted during 'out of business hours' for those with less emergent conditions.