The effect of an observation unit on the rate of ED admission and discharge for pyelonephritis

The American Journal of Emergency Medicine
Jon W SchrockSuki Weller

Abstract

We sought to determine if the opening of an adult emergency department (ED) observation unit (OU) would impact the rate of hospital admission and ED discharges for pyelonephritis. A retrospective cohort study was performed with all adult patients from October 2003 through December 2006 in the ED meeting inclusion criteria for pyelonephritis. Clinical, demographic, and laboratory data were recorded. Primary outcomes were rates of admission, ED discharge, and return ED visits before and after the opening of our OU. We compared admission, discharge, and readmission rates using the chi(2) test. Nine hundred thirty charts were reviewed with 633 included for analysis. Urine cultures were performed on 420 subjects with 71% being positive. The percentage of patients admitted to a hospital inpatient unit from the ED decreased from 36% to 26% (relative risk [RR], 0.73; P = .01) after opening the OU. The percentage of patients discharged home from the ED decreased from 65% to 51% (RR, 0.76; P < .001). Among OU patients, 29% were admitted to the hospital for further inpatient care. Emergency department recidivism was unchanged by opening the OU (RR, 0.86; P = .68). The creation of an OU appears to influence admission decisions of ED physic...Continue Reading

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Citations

Nov 28, 2012·Clinics in Geriatric Medicine·Mark G MoseleyJeffrey M Caterino
Mar 6, 2012·The American Journal of Emergency Medicine·Jeffrey M CaterinoMark G Moseley
Jul 26, 2011·Emergency Medicine Clinics of North America·David R Lane, Sukhjit S Takhar
Feb 4, 2016·Trauma Monthly·Hassan GoodarziKasra Hassanpour
Jul 2, 2015·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Siddhartha SinghJames S Goodwin
Dec 2, 2015·Annals of Emergency Medicine·Saul BleckerStuart D Katz
May 1, 2016·Annals of Intensive Care·João M SilvaLuiz Marcelo Sá Malbouisson
Jan 4, 2018·The New England Journal of Medicine·James R Johnson, Thomas A Russo
Mar 10, 2020·Singapore Medical Journal·Kathleen Swee Min KhooWin Sen Kuan

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