Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.

<h4>Background</h4>The "Emergency Room Evaluation and Recommendations" (ER2) is a clinical tool designed to determine prognosis for the short-term Emergency Department (ED) undesirable outcomes including long length of stay (LOS) in ED and in hospital, as well as the likelihood...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Cyrille P Launay, Kevin Galery, Christine Vilcocq, Marc Afilalo, Olivier Beauchet
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/374eef3b05874b82afa0147afc23fe0a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:374eef3b05874b82afa0147afc23fe0a
record_format	dspace
spelling	oai:doaj.org-article:374eef3b05874b82afa0147afc23fe0a2021-12-02T20:15:05ZRisk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.1932-620310.1371/journal.pone.0249882https://doaj.org/article/374eef3b05874b82afa0147afc23fe0a2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0249882https://doaj.org/toc/1932-6203<h4>Background</h4>The "Emergency Room Evaluation and Recommendations" (ER2) is a clinical tool designed to determine prognosis for the short-term Emergency Department (ED) undesirable outcomes including long length of stay (LOS) in ED and in hospital, as well as the likelihood of hospital admission during an index ED visit. It is also designed to guide appropriate and timely tailor-made geriatric interventions. This study aimed to examine whether ER2 assessment part was: 1) usable by ED healthcare workers (e.g. nurses) and 2) scoring system associated with long LOS in ED and in hospital, as well as hospital admission in older ED users on stretchers.<h4>Methods</h4>Based on an observational, prospective and longitudinal cohort study 1,800 participants visiting the ED of the Jewish General Hospital (Montreal, Quebec, Canada) were recruited between September and December 2017. ER2 assessment determined three risk-levels (i.e., low, medium and high) for short-term ED undesirable outcomes. The rate of ER2 digital form completed, the time to fill ER2 items and obtain ER2 risk-levels, the LOS in ED and in hospital, and hospital admission were used as outcomes.<h4>Results</h4>ER2 was usable by ED nurses in charge of older ED users. High-risk group was associated with both increased ED stay (coefficient of regression β = 3.81 with P≤0.001) and hospital stay (coefficient of regression β = 4.60 with P = 0.002) as well as with hospital admission (HR = 1.32 with P≤0.001) when low ER2 risk level was used as referent level. Kaplan-Meier distributions showed that the three risk groups of participants differed significantly (P = 0.001). Those with high-risk level (P≤0.001) were discharged later from hospital to a non-hospital location compared to those with low risk. There was no significant difference between those classified in low-risk and in medium-risk groups (P = 0.985) and those in medium and high-risk groups (P = 0.096).<h4>Conclusion</h4>The ER2 assessment part is usable in daily practice of ED care and its risk stratifications may be used to predict adverse outcomes including prolonged LOS in ED and in hospital as well as hospital admission.<h4>Trial registration</h4>NCT03964311.Cyrille P LaunayKevin GaleryChristine VilcocqMarc AfilaloOlivier BeauchetPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0249882 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cyrille P Launay Kevin Galery Christine Vilcocq Marc Afilalo Olivier Beauchet Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.
description	<h4>Background</h4>The "Emergency Room Evaluation and Recommendations" (ER2) is a clinical tool designed to determine prognosis for the short-term Emergency Department (ED) undesirable outcomes including long length of stay (LOS) in ED and in hospital, as well as the likelihood of hospital admission during an index ED visit. It is also designed to guide appropriate and timely tailor-made geriatric interventions. This study aimed to examine whether ER2 assessment part was: 1) usable by ED healthcare workers (e.g. nurses) and 2) scoring system associated with long LOS in ED and in hospital, as well as hospital admission in older ED users on stretchers.<h4>Methods</h4>Based on an observational, prospective and longitudinal cohort study 1,800 participants visiting the ED of the Jewish General Hospital (Montreal, Quebec, Canada) were recruited between September and December 2017. ER2 assessment determined three risk-levels (i.e., low, medium and high) for short-term ED undesirable outcomes. The rate of ER2 digital form completed, the time to fill ER2 items and obtain ER2 risk-levels, the LOS in ED and in hospital, and hospital admission were used as outcomes.<h4>Results</h4>ER2 was usable by ED nurses in charge of older ED users. High-risk group was associated with both increased ED stay (coefficient of regression β = 3.81 with P≤0.001) and hospital stay (coefficient of regression β = 4.60 with P = 0.002) as well as with hospital admission (HR = 1.32 with P≤0.001) when low ER2 risk level was used as referent level. Kaplan-Meier distributions showed that the three risk groups of participants differed significantly (P = 0.001). Those with high-risk level (P≤0.001) were discharged later from hospital to a non-hospital location compared to those with low risk. There was no significant difference between those classified in low-risk and in medium-risk groups (P = 0.985) and those in medium and high-risk groups (P = 0.096).<h4>Conclusion</h4>The ER2 assessment part is usable in daily practice of ED care and its risk stratifications may be used to predict adverse outcomes including prolonged LOS in ED and in hospital as well as hospital admission.<h4>Trial registration</h4>NCT03964311.
format	article
author	Cyrille P Launay Kevin Galery Christine Vilcocq Marc Afilalo Olivier Beauchet
author_facet	Cyrille P Launay Kevin Galery Christine Vilcocq Marc Afilalo Olivier Beauchet
author_sort	Cyrille P Launay
title	Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.
title_short	Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.
title_full	Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.
title_fullStr	Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.
title_full_unstemmed	Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.
title_sort	risk for short-term undesirable outcomes in older emergency department users: results of the er2 observational cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/374eef3b05874b82afa0147afc23fe0a
work_keys_str_mv	AT cyrilleplaunay riskforshorttermundesirableoutcomesinolderemergencydepartmentusersresultsoftheer2observationalcohortstudy AT kevingalery riskforshorttermundesirableoutcomesinolderemergencydepartmentusersresultsoftheer2observationalcohortstudy AT christinevilcocq riskforshorttermundesirableoutcomesinolderemergencydepartmentusersresultsoftheer2observationalcohortstudy AT marcafilalo riskforshorttermundesirableoutcomesinolderemergencydepartmentusersresultsoftheer2observationalcohortstudy AT olivierbeauchet riskforshorttermundesirableoutcomesinolderemergencydepartmentusersresultsoftheer2observationalcohortstudy
_version_	1718374575109046272

Risk for short-term undesirable outcomes in older emergency department users: Results of the ER2 observational cohort study.

Ejemplares similares