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Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments

OBJECTIVES: Frequent attendance for nonemergency problems to emergency departments (EDs) contributes to ED overcrowding, resulting in medical care delays, increased medical errors, and social and economic burdens. Most studies regarding frequent attenders of EDs examine general patients without clas...

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Autores principales: Chuang, Chen-Ju, Wu, Yi-Fang, Wu, Kai-Hsiang, Chen, Yi-Chuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036124/
https://www.ncbi.nlm.nih.gov/pubmed/32104605
http://dx.doi.org/10.1155/2020/8289275
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author Chuang, Chen-Ju
Wu, Yi-Fang
Wu, Kai-Hsiang
Chen, Yi-Chuan
author_facet Chuang, Chen-Ju
Wu, Yi-Fang
Wu, Kai-Hsiang
Chen, Yi-Chuan
author_sort Chuang, Chen-Ju
collection PubMed
description OBJECTIVES: Frequent attendance for nonemergency problems to emergency departments (EDs) contributes to ED overcrowding, resulting in medical care delays, increased medical errors, and social and economic burdens. Most studies regarding frequent attenders of EDs examine general patients without classifying certain subgroups. This study aimed to investigate patients with liver cirrhosis who present repeatedly to the ED. METHODS: This was a retrospective, observational cohort study of adult patients with a history of liver cirrhosis presenting to the ED from January 2011 to December 2015. We included patients with cirrhosis whose first ED visit occurred during the study period. We went far back for 20 years and excluded patients with any ED visits (including both cirrhosis and noncirrhosis-related ones) before the study period. We categorized frequent attenders as patients with more than 4 ED visits within 12 months after the first ED visit; infrequent attenders were those who did not meet this criterion. RESULTS: A total of 3513 patients with cirrhosis were included in this retrospective cohort study. Compared with the infrequent attenders, frequent attenders had a higher rate of presentations due to hepatic encephalopathy (15.2% vs 13.7%, P < 0.001) and ascites (10% vs 4%, P < 0.001) and ascites (10% vs 4%, P < 0.001) and ascites (10% vs 4%, CONCLUSIONS: Hepatic encephalopathy and ascites account for more ED visits in frequent than in infrequent attenders. Our findings provide information for those planning outpatient support for patients with cirrhosis. Further research is warranted.
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spelling pubmed-70361242020-02-26 Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments Chuang, Chen-Ju Wu, Yi-Fang Wu, Kai-Hsiang Chen, Yi-Chuan Emerg Med Int Research Article OBJECTIVES: Frequent attendance for nonemergency problems to emergency departments (EDs) contributes to ED overcrowding, resulting in medical care delays, increased medical errors, and social and economic burdens. Most studies regarding frequent attenders of EDs examine general patients without classifying certain subgroups. This study aimed to investigate patients with liver cirrhosis who present repeatedly to the ED. METHODS: This was a retrospective, observational cohort study of adult patients with a history of liver cirrhosis presenting to the ED from January 2011 to December 2015. We included patients with cirrhosis whose first ED visit occurred during the study period. We went far back for 20 years and excluded patients with any ED visits (including both cirrhosis and noncirrhosis-related ones) before the study period. We categorized frequent attenders as patients with more than 4 ED visits within 12 months after the first ED visit; infrequent attenders were those who did not meet this criterion. RESULTS: A total of 3513 patients with cirrhosis were included in this retrospective cohort study. Compared with the infrequent attenders, frequent attenders had a higher rate of presentations due to hepatic encephalopathy (15.2% vs 13.7%, P < 0.001) and ascites (10% vs 4%, P < 0.001) and ascites (10% vs 4%, P < 0.001) and ascites (10% vs 4%, CONCLUSIONS: Hepatic encephalopathy and ascites account for more ED visits in frequent than in infrequent attenders. Our findings provide information for those planning outpatient support for patients with cirrhosis. Further research is warranted. Hindawi 2020-02-11 /pmc/articles/PMC7036124/ /pubmed/32104605 http://dx.doi.org/10.1155/2020/8289275 Text en Copyright © 2020 Chen-Ju Chuang et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chuang, Chen-Ju
Wu, Yi-Fang
Wu, Kai-Hsiang
Chen, Yi-Chuan
Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments
title Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments
title_full Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments
title_fullStr Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments
title_full_unstemmed Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments
title_short Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments
title_sort patients with liver cirrhosis as frequent attenders of emergency departments
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036124/
https://www.ncbi.nlm.nih.gov/pubmed/32104605
http://dx.doi.org/10.1155/2020/8289275
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