Emergency department tachypnea predicts transfer to a higher level of care in the first 24 hours after ED admission

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Heather FarleyWilliam S Weintraub

Abstract

The authors hypothesized that vital sign abnormalities detected in the emergency department (ED) can be used to forecast clinical deterioration occurring within 24 hours of hospital admission. This was a retrospective case-control study performed after implementation of a hospitalwide rapid response team (RRT) system. Inclusion criteria for study patients consisted of age > or = 18 years, admission to the general floor though the ED, and RRT activation and subsequent transfer to a higher level of care in the first 24 hours. Control patients were > or =18 years, were admitted to the floor though the ED, never required RRT or transfer to a higher level of care, and were matched to cases by risk of mortality. Multilevel logistic regression was used to model the odds of an adverse outcome as a function of race and sex, respiratory rate (RR), heart rate (HR), and systolic (sBP) and diastolic blood pressure (dBP) at time of transfer from the ED. A total of 74 cases and 246 controls were used. RR (odds ratio [OR] = 2.79 per 10-point change, 95% confidence interval [CI] = 1.41 to 5.51) and to a lesser extent dBP (OR = 0.81, 95% CI = 0.67 to 0.97) contributed significantly to the odds of intensive care unit (ICU) or intermediate care tr...Continue Reading

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Citations

Apr 11, 2014·PloS One·Daniel Pilsgaard HenriksenAnnmarie Touborg Lassen
May 13, 2014·Australasian Emergency Nursing Journal : AENJ·Jennifer HoskingNatisha Sands
Apr 5, 2016·Critical Care Research and Practice·Maria Schollin-BorgJoakim Johansson
Jul 27, 2012·Scandinavian Journal of Infectious Diseases·Lars GustavssonJohan Westin
Jun 1, 2016·The American Journal of Emergency Medicine·Cassidy M DahnJames A Feldman
Jan 31, 2017·The American Journal of Emergency Medicine·Joshua J SolanoShamai A Grossman
Sep 30, 2016·Journal of Clinical Nursing·Katherine LambeJulie Considine
Feb 3, 2016·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Julie ConsidineJudy Currey
Sep 10, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Shawna D BellewM Fernanda Bellolio
Sep 17, 2019·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Marta Cancella de AbreuPierre Hausfater
Jul 19, 2017·Journal of Intensive Care·Gabriel WardiRebecca E Sell
Sep 20, 2017·Journal of Clinical Nursing·Erika GrayJulie Considine
May 28, 2019·The Western Journal of Emergency Medicine·Nicole R HodgsonStephen J Traub
Mar 21, 2020·Journal of Clinical Monitoring and Computing·George GlassMatthew T Clark
Jan 30, 2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Steve B ChukwulebeAnthony J Dean
Jul 6, 2021·Journal of General and Family Medicine·Shoko SoenoTadahiro Goto

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