Rates of ED visits and of intubations for congestive heart failure declined from 1996 to 2008
Abstract Objective Many advances have been made recently in the treatment of congestive heart failure (CHF). We hypothesize that this should have resulted in fewer CHF patients presenting to the emergency department (ED) and fewer being intubated. Design Retrospective cohort. Setting consecutive pat...
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| Veröffentlicht in: | The American journal of emergency medicine 2013-12, Vol.31 (12), p.1677-1680 |
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| container_title | The American journal of emergency medicine |
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| creator | Allegra, John R., MD, PhD Eskin, Barnet, MD, PhD Campeas, Sarah, DO Wreschner, Bonnie McGuire, MD |
| description | Abstract Objective Many advances have been made recently in the treatment of congestive heart failure (CHF). We hypothesize that this should have resulted in fewer CHF patients presenting to the emergency department (ED) and fewer being intubated. Design Retrospective cohort. Setting consecutive patients seen by ED physicians in 4 suburban hospitals in New Jersey and New York from 1996 to 2008. Objective Protocol: We classified patients as having CHF based on International Classification of Diseases, Ninth Revision , codes. For each year of the study, we determined CHF visit rates (as a percentage of total ED visits) and calculated the percentage of CHF patients intubated. We used the Student t test, calculated 95% confidence intervals (CIs), and performed regression analyses. Results Of the 2,374,428 ED visits, 32,036 (1.3%) were for CHF. The mean age of the CHF patients was 76 ± 14 years, and 57% were female. Congestive heart failure visits declined from 1.6% of all ED visits in 1996 to 1.2% in 2008, a 26% relative decrease (95% CI: 21%-30%, P < .001, correlation coefficient R2 = 0.94, P < .001). Of the CHF patients, 778 (2.4%) were intubated. Intubation rates declined from 3.6% in 1996 to 1.7% in 2008, a 53% (95% CI: 31%-68%, P < .001, R2 = 0.83, P < .001) relative decrease. Conclusion The rates of annual ED visits for CHF and intubation rates declined from 1996 to 2008. These decreases are most likely due to better CHF treatments. |
| doi_str_mv | 10.1016/j.ajem.2013.09.003 |
| format | Article |
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We hypothesize that this should have resulted in fewer CHF patients presenting to the emergency department (ED) and fewer being intubated. Design Retrospective cohort. Setting consecutive patients seen by ED physicians in 4 suburban hospitals in New Jersey and New York from 1996 to 2008. Objective Protocol: We classified patients as having CHF based on International Classification of Diseases, Ninth Revision , codes. For each year of the study, we determined CHF visit rates (as a percentage of total ED visits) and calculated the percentage of CHF patients intubated. We used the Student t test, calculated 95% confidence intervals (CIs), and performed regression analyses. Results Of the 2,374,428 ED visits, 32,036 (1.3%) were for CHF. The mean age of the CHF patients was 76 ± 14 years, and 57% were female. Congestive heart failure visits declined from 1.6% of all ED visits in 1996 to 1.2% in 2008, a 26% relative decrease (95% CI: 21%-30%, P < .001, correlation coefficient R2 = 0.94, P < .001). Of the CHF patients, 778 (2.4%) were intubated. Intubation rates declined from 3.6% in 1996 to 1.7% in 2008, a 53% (95% CI: 31%-68%, P < .001, R2 = 0.83, P < .001) relative decrease. Conclusion The rates of annual ED visits for CHF and intubation rates declined from 1996 to 2008. These decreases are most likely due to better CHF treatments.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2013.09.003</identifier><identifier>PMID: 24135461</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Aged ; Aged, 80 and over ; Codes ; Cohort Studies ; Confidence intervals ; Correlation coefficient ; Disease Progression ; Emergency ; Emergency medical care ; Emergency Service, Hospital - trends ; Emergency Service, Hospital - utilization ; Female ; Heart failure ; Heart Failure - therapy ; Hospitalization ; Hospitals ; Humans ; Intubation ; Intubation, Intratracheal - trends ; Intubation, Intratracheal - utilization ; Male ; Middle Aged ; New Jersey ; New York ; Physicians ; Population ; Retrospective Studies ; Suburban areas ; Trends ; Women</subject><ispartof>The American journal of emergency medicine, 2013-12, Vol.31 (12), p.1677-1680</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>2013.</rights><rights>Copyright Elsevier Limited 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-118a3e365f89b4abd1cbb5a07b48117a52ced42f21e9ed9c74b936855c0d31633</citedby><cites>FETCH-LOGICAL-c439t-118a3e365f89b4abd1cbb5a07b48117a52ced42f21e9ed9c74b936855c0d31633</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1464956658?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24135461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Allegra, John R., MD, PhD</creatorcontrib><creatorcontrib>Eskin, Barnet, MD, PhD</creatorcontrib><creatorcontrib>Campeas, Sarah, DO</creatorcontrib><creatorcontrib>Wreschner, Bonnie McGuire, MD</creatorcontrib><title>Rates of ED visits and of intubations for congestive heart failure declined from 1996 to 2008</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Objective Many advances have been made recently in the treatment of congestive heart failure (CHF). We hypothesize that this should have resulted in fewer CHF patients presenting to the emergency department (ED) and fewer being intubated. Design Retrospective cohort. Setting consecutive patients seen by ED physicians in 4 suburban hospitals in New Jersey and New York from 1996 to 2008. Objective Protocol: We classified patients as having CHF based on International Classification of Diseases, Ninth Revision , codes. For each year of the study, we determined CHF visit rates (as a percentage of total ED visits) and calculated the percentage of CHF patients intubated. We used the Student t test, calculated 95% confidence intervals (CIs), and performed regression analyses. Results Of the 2,374,428 ED visits, 32,036 (1.3%) were for CHF. The mean age of the CHF patients was 76 ± 14 years, and 57% were female. Congestive heart failure visits declined from 1.6% of all ED visits in 1996 to 1.2% in 2008, a 26% relative decrease (95% CI: 21%-30%, P < .001, correlation coefficient R2 = 0.94, P < .001). Of the CHF patients, 778 (2.4%) were intubated. Intubation rates declined from 3.6% in 1996 to 1.7% in 2008, a 53% (95% CI: 31%-68%, P < .001, R2 = 0.83, P < .001) relative decrease. Conclusion The rates of annual ED visits for CHF and intubation rates declined from 1996 to 2008. These decreases are most likely due to better CHF treatments.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Codes</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Correlation coefficient</subject><subject>Disease Progression</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - trends</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - therapy</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intubation</subject><subject>Intubation, Intratracheal - trends</subject><subject>Intubation, Intratracheal - utilization</subject><subject>Male</subject><subject>Middle Aged</subject><subject>New Jersey</subject><subject>New York</subject><subject>Physicians</subject><subject>Population</subject><subject>Retrospective Studies</subject><subject>Suburban areas</subject><subject>Trends</subject><subject>Women</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU2L1TAUhoMozp3RP-BCAm7ctObkqw2IIOOMCgOCH0sJaXqqqb3NTNJemH9vyh0VZuEqEJ735ZznEPIMWA0M9KuxdiPua85A1MzUjIkHZAdK8KqFBh6SHWuEqnSjmhNymvPIGIBU8jE54RKEkhp25Ptnt2CmcaAX7-gh5LBk6uZ--wjzsnZuCXHOdIiJ-jj_wLyEA9Kf6NJCBxemNSHt0U9hxp4OKe4pGKPpEilnrH1CHg1uyvj07j0j3y4vvp5_qK4-vf94_vaq8lKYpQJonUCh1dCaTrquB991yrGmky1A4xT32Es-cECDvfGN7IzQrVKe9QK0EGfk5bH3OsWbtQxp9yF7nCY3Y1yzBalVq7kypqAv7qFjXNNcptsoaZQuaKH4kfIp5pxwsNcp7F26tcDsJt-OdpNvN_mWGVvkl9Dzu-q122P_N_LHdgFeHwEsLg4Bk80-4FyWCwn9YvsY_t__5l588x68m37hLeZ_e9jMLbNftvNv1wfBmGpaJn4DmmCngg</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Allegra, John R., MD, PhD</creator><creator>Eskin, Barnet, MD, PhD</creator><creator>Campeas, Sarah, DO</creator><creator>Wreschner, Bonnie McGuire, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Rates of ED visits and of intubations for congestive heart failure declined from 1996 to 2008</title><author>Allegra, John R., MD, PhD ; Eskin, Barnet, MD, PhD ; Campeas, Sarah, DO ; Wreschner, Bonnie McGuire, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-118a3e365f89b4abd1cbb5a07b48117a52ced42f21e9ed9c74b936855c0d31633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Codes</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Correlation coefficient</topic><topic>Disease Progression</topic><topic>Emergency</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital - trends</topic><topic>Emergency Service, Hospital - utilization</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - therapy</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intubation</topic><topic>Intubation, Intratracheal - trends</topic><topic>Intubation, Intratracheal - utilization</topic><topic>Male</topic><topic>Middle Aged</topic><topic>New Jersey</topic><topic>New York</topic><topic>Physicians</topic><topic>Population</topic><topic>Retrospective Studies</topic><topic>Suburban areas</topic><topic>Trends</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Allegra, John R., MD, PhD</creatorcontrib><creatorcontrib>Eskin, Barnet, MD, PhD</creatorcontrib><creatorcontrib>Campeas, Sarah, DO</creatorcontrib><creatorcontrib>Wreschner, Bonnie McGuire, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Allegra, John R., MD, PhD</au><au>Eskin, Barnet, MD, PhD</au><au>Campeas, Sarah, DO</au><au>Wreschner, Bonnie McGuire, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rates of ED visits and of intubations for congestive heart failure declined from 1996 to 2008</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>31</volume><issue>12</issue><spage>1677</spage><epage>1680</epage><pages>1677-1680</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Abstract Objective Many advances have been made recently in the treatment of congestive heart failure (CHF). We hypothesize that this should have resulted in fewer CHF patients presenting to the emergency department (ED) and fewer being intubated. Design Retrospective cohort. Setting consecutive patients seen by ED physicians in 4 suburban hospitals in New Jersey and New York from 1996 to 2008. Objective Protocol: We classified patients as having CHF based on International Classification of Diseases, Ninth Revision , codes. For each year of the study, we determined CHF visit rates (as a percentage of total ED visits) and calculated the percentage of CHF patients intubated. We used the Student t test, calculated 95% confidence intervals (CIs), and performed regression analyses. Results Of the 2,374,428 ED visits, 32,036 (1.3%) were for CHF. The mean age of the CHF patients was 76 ± 14 years, and 57% were female. Congestive heart failure visits declined from 1.6% of all ED visits in 1996 to 1.2% in 2008, a 26% relative decrease (95% CI: 21%-30%, P < .001, correlation coefficient R2 = 0.94, P < .001). Of the CHF patients, 778 (2.4%) were intubated. Intubation rates declined from 3.6% in 1996 to 1.7% in 2008, a 53% (95% CI: 31%-68%, P < .001, R2 = 0.83, P < .001) relative decrease. Conclusion The rates of annual ED visits for CHF and intubation rates declined from 1996 to 2008. These decreases are most likely due to better CHF treatments.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24135461</pmid><doi>10.1016/j.ajem.2013.09.003</doi><tpages>4</tpages></addata></record> |
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| subjects | Age Aged Aged, 80 and over Codes Cohort Studies Confidence intervals Correlation coefficient Disease Progression Emergency Emergency medical care Emergency Service, Hospital - trends Emergency Service, Hospital - utilization Female Heart failure Heart Failure - therapy Hospitalization Hospitals Humans Intubation Intubation, Intratracheal - trends Intubation, Intratracheal - utilization Male Middle Aged New Jersey New York Physicians Population Retrospective Studies Suburban areas Trends Women |
| title | Rates of ED visits and of intubations for congestive heart failure declined from 1996 to 2008 |
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