Impact of an emergency short stay unit on emergency department performance of poisoned patients
Abstract Objectives This was a before and after study which sought to assess the impact of opening an ED short stay unit (ESSU) on the ED performance of poisoned patients. Methods Data was collected from two groups of adult patients presenting to an ED with a tertiary referral inpatient Toxicology u...
Gespeichert in:
| Veröffentlicht in: | The American journal of emergency medicine 2017-05, Vol.35 (5), p.764-768 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 768 |
|---|---|
| container_issue | 5 |
| container_start_page | 764 |
| container_title | The American journal of emergency medicine |
| container_volume | 35 |
| creator | Downes, Michael A, FACEM Balshaw, James K, BSc Muscat, Tracy M, B Nursing Ritchie, Nicole, B Nursing Isbister, Geoffrey K, MD |
| description | Abstract Objectives This was a before and after study which sought to assess the impact of opening an ED short stay unit (ESSU) on the ED performance of poisoned patients. Methods Data was collected from two groups of adult patients presenting to an ED with a tertiary referral inpatient Toxicology unit from the 2009 and 2012 calendar years, to assess the impact of the ESSU. The toxicology unit clinical database and hospital electronic medical records were interrogated for demographic, clinical and hospital flow details of presentations. The primary outcome was ED length of stay (LOS). Other outcomes included proportion of patients remaining in ED for their admission, 28 day re-presentations and hospital LOS. Results During 2009, 795 patients met inclusion criteria, and during 2012, 762. The median LOS in ED was reduced from 8.5 h (IQR: 4.7–14 h) to 2.7 h (IQR: 1.6–4.6; p < 0.0001). The proportion of patients remaining in ED for their entire hospital stay was reduced from 515/795 (65%) to 56/762 (7.3%) [Absolute difference: 57%; 95% CI: 53 to 62%; p < 0.0001]. Total hospital LOS increased from 14.5 h (IQR: 8.4–21.8 h) to 16.7 h (IQR: 11.5–23; p < 0.0001), but there was a decrease in re-presentations with self-poisoning within 28 days from 6.9% in 2009 to 4.5% in 2012 ( p < 0.038). There was no difference between disposition destination or toxins causing exposure between the two groups. Conclusions The ESSU led to a significant improvement in ED performance of poisoned patients. It also potentially assisted in reducing ED overcrowding. |
| doi_str_mv | 10.1016/j.ajem.2017.01.027 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1863219020</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0735675717300293</els_id><sourcerecordid>1902499356</sourcerecordid><originalsourceid>FETCH-LOGICAL-c483t-7ba3a683458f11b7b81a43945944879092ea0e8d0ded925d71a6e2458c1c782e3</originalsourceid><addsrcrecordid>eNp9kk2L1TAUhoMoznX0D7iQghs3rTlJ2iQgggx-DAy4UNchNz3V1DapSSvcf2_KHT-YhasszvO-JM8JIU-BNkChezk2dsS5YRRkQ6GhTN4jB2g5qxVIuE8OVPK27mQrL8ijnEdKAUQrHpILpoBrDuxAzPW8WLdWcahsqHDG9BWDO1X5W0xrlVd7qrbgy_zfYY-LTeuMYa0WTENMsw0O944l-hwD9tViV1_m-TF5MNgp45Pb85J8eff289WH-ubj--urNze1E4qvtTxabjvFRasGgKM8KrCCa9FqIZTUVDO0FFVPe-w1a3sJtkNWaAdOKob8krw49y4p_tgwr2b22eE02YBxywZUxxloymhBn99Bx7ilUG5ndkBozduuUOxMuRRzTjiYJfnZppMBanb9ZjS7frPrNxRM0V9Cz26rt-OM_Z_Ib98FeHUGsLj46TGZ7Ionh71P6FbTR____td34m7ywTs7fccT5r_vMJkZaj7tH2DfP0hOKdOc_wLMzqpc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1902499356</pqid></control><display><type>article</type><title>Impact of an emergency short stay unit on emergency department performance of poisoned patients</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>ProQuest Central UK/Ireland</source><creator>Downes, Michael A, FACEM ; Balshaw, James K, BSc ; Muscat, Tracy M, B Nursing ; Ritchie, Nicole, B Nursing ; Isbister, Geoffrey K, MD</creator><creatorcontrib>Downes, Michael A, FACEM ; Balshaw, James K, BSc ; Muscat, Tracy M, B Nursing ; Ritchie, Nicole, B Nursing ; Isbister, Geoffrey K, MD</creatorcontrib><description>Abstract Objectives This was a before and after study which sought to assess the impact of opening an ED short stay unit (ESSU) on the ED performance of poisoned patients. Methods Data was collected from two groups of adult patients presenting to an ED with a tertiary referral inpatient Toxicology unit from the 2009 and 2012 calendar years, to assess the impact of the ESSU. The toxicology unit clinical database and hospital electronic medical records were interrogated for demographic, clinical and hospital flow details of presentations. The primary outcome was ED length of stay (LOS). Other outcomes included proportion of patients remaining in ED for their admission, 28 day re-presentations and hospital LOS. Results During 2009, 795 patients met inclusion criteria, and during 2012, 762. The median LOS in ED was reduced from 8.5 h (IQR: 4.7–14 h) to 2.7 h (IQR: 1.6–4.6; p < 0.0001). The proportion of patients remaining in ED for their entire hospital stay was reduced from 515/795 (65%) to 56/762 (7.3%) [Absolute difference: 57%; 95% CI: 53 to 62%; p < 0.0001]. Total hospital LOS increased from 14.5 h (IQR: 8.4–21.8 h) to 16.7 h (IQR: 11.5–23; p < 0.0001), but there was a decrease in re-presentations with self-poisoning within 28 days from 6.9% in 2009 to 4.5% in 2012 ( p < 0.038). There was no difference between disposition destination or toxins causing exposure between the two groups. Conclusions The ESSU led to a significant improvement in ED performance of poisoned patients. It also potentially assisted in reducing ED overcrowding.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2017.01.027</identifier><identifier>PMID: 28139312</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Adults ; Australia - epidemiology ; Blood Chemical Analysis - methods ; Critical care ; Demographics ; ED overcrowding ; Efficiency, Organizational ; Electronic medical records ; Emergency ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital - organization & administration ; Emergency Service, Hospital - statistics & numerical data ; Emergency services ; Female ; Health care ; Hospitals ; Humans ; Length of Stay ; Male ; Middle Aged ; Nursing administration ; Outcome and Process Assessment (Health Care) ; Overcrowding ; Patient Admission ; Patient Selection ; Patients ; Poisoned ; Poisoning ; Poisoning - diagnosis ; Poisoning - epidemiology ; Poisoning - therapy ; Practice Guidelines as Topic ; Referral and Consultation ; Retrospective Studies ; Risk Assessment ; Short stay unit ; Toxicology ; Toxins ; Young Adult</subject><ispartof>The American journal of emergency medicine, 2017-05, Vol.35 (5), p.764-768</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-7ba3a683458f11b7b81a43945944879092ea0e8d0ded925d71a6e2458c1c782e3</citedby><cites>FETCH-LOGICAL-c483t-7ba3a683458f11b7b81a43945944879092ea0e8d0ded925d71a6e2458c1c782e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1902499356?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>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28139312$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Downes, Michael A, FACEM</creatorcontrib><creatorcontrib>Balshaw, James K, BSc</creatorcontrib><creatorcontrib>Muscat, Tracy M, B Nursing</creatorcontrib><creatorcontrib>Ritchie, Nicole, B Nursing</creatorcontrib><creatorcontrib>Isbister, Geoffrey K, MD</creatorcontrib><title>Impact of an emergency short stay unit on emergency department performance of poisoned patients</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Objectives This was a before and after study which sought to assess the impact of opening an ED short stay unit (ESSU) on the ED performance of poisoned patients. Methods Data was collected from two groups of adult patients presenting to an ED with a tertiary referral inpatient Toxicology unit from the 2009 and 2012 calendar years, to assess the impact of the ESSU. The toxicology unit clinical database and hospital electronic medical records were interrogated for demographic, clinical and hospital flow details of presentations. The primary outcome was ED length of stay (LOS). Other outcomes included proportion of patients remaining in ED for their admission, 28 day re-presentations and hospital LOS. Results During 2009, 795 patients met inclusion criteria, and during 2012, 762. The median LOS in ED was reduced from 8.5 h (IQR: 4.7–14 h) to 2.7 h (IQR: 1.6–4.6; p < 0.0001). The proportion of patients remaining in ED for their entire hospital stay was reduced from 515/795 (65%) to 56/762 (7.3%) [Absolute difference: 57%; 95% CI: 53 to 62%; p < 0.0001]. Total hospital LOS increased from 14.5 h (IQR: 8.4–21.8 h) to 16.7 h (IQR: 11.5–23; p < 0.0001), but there was a decrease in re-presentations with self-poisoning within 28 days from 6.9% in 2009 to 4.5% in 2012 ( p < 0.038). There was no difference between disposition destination or toxins causing exposure between the two groups. Conclusions The ESSU led to a significant improvement in ED performance of poisoned patients. It also potentially assisted in reducing ED overcrowding.</description><subject>Adult</subject><subject>Adults</subject><subject>Australia - epidemiology</subject><subject>Blood Chemical Analysis - methods</subject><subject>Critical care</subject><subject>Demographics</subject><subject>ED overcrowding</subject><subject>Efficiency, Organizational</subject><subject>Electronic medical records</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital - organization & administration</subject><subject>Emergency Service, Hospital - statistics & numerical data</subject><subject>Emergency services</subject><subject>Female</subject><subject>Health care</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nursing administration</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Overcrowding</subject><subject>Patient Admission</subject><subject>Patient Selection</subject><subject>Patients</subject><subject>Poisoned</subject><subject>Poisoning</subject><subject>Poisoning - diagnosis</subject><subject>Poisoning - epidemiology</subject><subject>Poisoning - therapy</subject><subject>Practice Guidelines as Topic</subject><subject>Referral and Consultation</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Short stay unit</subject><subject>Toxicology</subject><subject>Toxins</subject><subject>Young Adult</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</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>eNp9kk2L1TAUhoMoznX0D7iQghs3rTlJ2iQgggx-DAy4UNchNz3V1DapSSvcf2_KHT-YhasszvO-JM8JIU-BNkChezk2dsS5YRRkQ6GhTN4jB2g5qxVIuE8OVPK27mQrL8ijnEdKAUQrHpILpoBrDuxAzPW8WLdWcahsqHDG9BWDO1X5W0xrlVd7qrbgy_zfYY-LTeuMYa0WTENMsw0O944l-hwD9tViV1_m-TF5MNgp45Pb85J8eff289WH-ubj--urNze1E4qvtTxabjvFRasGgKM8KrCCa9FqIZTUVDO0FFVPe-w1a3sJtkNWaAdOKob8krw49y4p_tgwr2b22eE02YBxywZUxxloymhBn99Bx7ilUG5ndkBozduuUOxMuRRzTjiYJfnZppMBanb9ZjS7frPrNxRM0V9Cz26rt-OM_Z_Ib98FeHUGsLj46TGZ7Ionh71P6FbTR____td34m7ywTs7fccT5r_vMJkZaj7tH2DfP0hOKdOc_wLMzqpc</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Downes, Michael A, FACEM</creator><creator>Balshaw, James K, BSc</creator><creator>Muscat, Tracy M, B Nursing</creator><creator>Ritchie, Nicole, B Nursing</creator><creator>Isbister, Geoffrey K, 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>20170501</creationdate><title>Impact of an emergency short stay unit on emergency department performance of poisoned patients</title><author>Downes, Michael A, FACEM ; Balshaw, James K, BSc ; Muscat, Tracy M, B Nursing ; Ritchie, Nicole, B Nursing ; Isbister, Geoffrey K, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-7ba3a683458f11b7b81a43945944879092ea0e8d0ded925d71a6e2458c1c782e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Australia - epidemiology</topic><topic>Blood Chemical Analysis - methods</topic><topic>Critical care</topic><topic>Demographics</topic><topic>ED overcrowding</topic><topic>Efficiency, Organizational</topic><topic>Electronic medical records</topic><topic>Emergency</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Emergency Service, Hospital - organization & administration</topic><topic>Emergency Service, Hospital - statistics & numerical data</topic><topic>Emergency services</topic><topic>Female</topic><topic>Health care</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nursing administration</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Overcrowding</topic><topic>Patient Admission</topic><topic>Patient Selection</topic><topic>Patients</topic><topic>Poisoned</topic><topic>Poisoning</topic><topic>Poisoning - diagnosis</topic><topic>Poisoning - epidemiology</topic><topic>Poisoning - therapy</topic><topic>Practice Guidelines as Topic</topic><topic>Referral and Consultation</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Short stay unit</topic><topic>Toxicology</topic><topic>Toxins</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Downes, Michael A, FACEM</creatorcontrib><creatorcontrib>Balshaw, James K, BSc</creatorcontrib><creatorcontrib>Muscat, Tracy M, B Nursing</creatorcontrib><creatorcontrib>Ritchie, Nicole, B Nursing</creatorcontrib><creatorcontrib>Isbister, Geoffrey K, 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>Downes, Michael A, FACEM</au><au>Balshaw, James K, BSc</au><au>Muscat, Tracy M, B Nursing</au><au>Ritchie, Nicole, B Nursing</au><au>Isbister, Geoffrey K, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of an emergency short stay unit on emergency department performance of poisoned patients</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>35</volume><issue>5</issue><spage>764</spage><epage>768</epage><pages>764-768</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Abstract Objectives This was a before and after study which sought to assess the impact of opening an ED short stay unit (ESSU) on the ED performance of poisoned patients. Methods Data was collected from two groups of adult patients presenting to an ED with a tertiary referral inpatient Toxicology unit from the 2009 and 2012 calendar years, to assess the impact of the ESSU. The toxicology unit clinical database and hospital electronic medical records were interrogated for demographic, clinical and hospital flow details of presentations. The primary outcome was ED length of stay (LOS). Other outcomes included proportion of patients remaining in ED for their admission, 28 day re-presentations and hospital LOS. Results During 2009, 795 patients met inclusion criteria, and during 2012, 762. The median LOS in ED was reduced from 8.5 h (IQR: 4.7–14 h) to 2.7 h (IQR: 1.6–4.6; p < 0.0001). The proportion of patients remaining in ED for their entire hospital stay was reduced from 515/795 (65%) to 56/762 (7.3%) [Absolute difference: 57%; 95% CI: 53 to 62%; p < 0.0001]. Total hospital LOS increased from 14.5 h (IQR: 8.4–21.8 h) to 16.7 h (IQR: 11.5–23; p < 0.0001), but there was a decrease in re-presentations with self-poisoning within 28 days from 6.9% in 2009 to 4.5% in 2012 ( p < 0.038). There was no difference between disposition destination or toxins causing exposure between the two groups. Conclusions The ESSU led to a significant improvement in ED performance of poisoned patients. It also potentially assisted in reducing ED overcrowding.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28139312</pmid><doi>10.1016/j.ajem.2017.01.027</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0735-6757 |
| ispartof | The American journal of emergency medicine, 2017-05, Vol.35 (5), p.764-768 |
| issn | 0735-6757 1532-8171 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1863219020 |
| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
| subjects | Adult Adults Australia - epidemiology Blood Chemical Analysis - methods Critical care Demographics ED overcrowding Efficiency, Organizational Electronic medical records Emergency Emergency medical care Emergency medical services Emergency Service, Hospital - organization & administration Emergency Service, Hospital - statistics & numerical data Emergency services Female Health care Hospitals Humans Length of Stay Male Middle Aged Nursing administration Outcome and Process Assessment (Health Care) Overcrowding Patient Admission Patient Selection Patients Poisoned Poisoning Poisoning - diagnosis Poisoning - epidemiology Poisoning - therapy Practice Guidelines as Topic Referral and Consultation Retrospective Studies Risk Assessment Short stay unit Toxicology Toxins Young Adult |
| title | Impact of an emergency short stay unit on emergency department performance of poisoned patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T00%3A20%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20an%20emergency%20short%20stay%20unit%20on%20emergency%20department%20performance%20of%20poisoned%20patients&rft.jtitle=The%20American%20journal%20of%20emergency%20medicine&rft.au=Downes,%20Michael%20A,%20FACEM&rft.date=2017-05-01&rft.volume=35&rft.issue=5&rft.spage=764&rft.epage=768&rft.pages=764-768&rft.issn=0735-6757&rft.eissn=1532-8171&rft_id=info:doi/10.1016/j.ajem.2017.01.027&rft_dat=%3Cproquest_cross%3E1902499356%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1902499356&rft_id=info:pmid/28139312&rft_els_id=1_s2_0_S0735675717300293&rfr_iscdi=true |