Evidence map›Paper›PMID 34876025›Full record

ArticleBMC emergency medicine2021

Evaluating the transitions in care for children presenting with acute asthma to emergency departments: a retrospective cohort study.

Kimberly R Kroetch, Brian H Rowe, Rhonda J Rosychuk

Abstract read
In one paragraph

Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Kimberly R KroetchDepartment of Mathematics and Statistics, Faculty of Arts and Science, MacEwan University, Edmonton, Alberta, T5J 4S2, Canada.
Brian H RoweDepartment of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, T6G 2R7, Canada.
Rhonda J RosychukDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Rm 3-524, Edmonton Clinic Health Academy, 11405 87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada. rhonda.rosychuk@ualberta.ca.ORCID 0000-0001-8019-5466

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute asthma is a common presentation to emergency departments (EDs) worldwide and, due to overcrowding, delays in treatment often occur. This study deconstructs the total ED length of stay into stages and estimates covariate effects on transition times for children presenting with asthma.

methodsWe extracted ED presentations in 2019 made by children in Alberta, Canada for acute asthma. We used multivariable Cox regressions in a multistate model to model transition times among the stages of start, physician initial assessment (PIA), disposition decision, and ED departure.

resultsData from 6598 patients on 8270 ED presentations were extracted. The individual PIA time was longer (i.e., HR < 1) when time to the crowding metric (hourly PIA) was above 1 h (HR = 0.32; 95% CI:0.30,0.34), for tertiary (HR = 0.65; 95% CI:0.61,0.70) and urban EDs (HR = 0.77; 95% CI:0.70,0.84), for younger patients (HR = 0.99 per year; 95% CI:0.99,1.00), and for patients triaged less urgent/non-urgent (HR = 0.89; 95% CI:0.84,0.95). It was shorter for patients arriving by ambulance (HR = 1.22; 95% CI:1.04,1.42). Times from PIA to disposition decision were longer for tertiary (HR = 0.47; 95% CI:0.44,0.51) and urban (HR = 0.69; 95% CI:0.63,0.75) EDs, for patients triaged as resuscitation/emergent (HR = 0.51; 95% CI:0.48,0.54), and for patients arriving by ambulance (HR = 0.78; 95% CI:0.70,0.87). Times from disposition decision to ED departure were longer for patients who were admitted (HR = 0.16; 95% CI:0.13,0.20) or transferred (HR = 0.42; 95% CI:0.35,0.50), and for tertiary EDs (HR = 0.93; 95% CI:0.92,0.94).

conclusionsAll transition times were impacted by ED presentation characteristics. The sole key patient characteristic was age and it only impacted time to PIA. ED crowding demonstrated strong effects of time to PIA but not for the transition times involving disposition decision and ED departure stages.

Indexed as

AsthmaEmergency Service, HospitalAlbertaCrowdingHumansLength of StayRetrospective StudiesAdministrative dataAsthmaEmergency departmentMultistate modelsPediatrics

Identifiers

PMID34876025
PMCPMC8650289

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.