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EROC 2011 Abstract Proceedings – March 4, 2011 Dept. of Emergency Medicine, Good Samaritan Hospital Medical Center, West Islip, NY Title: Is the Use of Multiple Medications an Independent Predictor of Length of Stay and Probability of Admission? Authors: Shannon Weinstein DO, Ronald Dvorkin MD, David Levy DO, David Yens, PhD Good Samaritan Hospital Medical Center, Department of Emergency Medicine, West Islip, NY Objectives: It is required that all patients presenting to the Emergency Department (ED) be asked to provide their current medications and that this list be updated or reconciled when the patient is discharged. Since this information is now readily available, we sought to determine whether there is an association between the number of medications provided to the ED staff and the length of stay (LOS) in the ED and probability of hospital admission. Methods: We conducted a retrospective cohort study (chart review) of all ED patients seen in the adult ED over a 93 day period. The primary outcome measurements were the length of stay and probability of admission as a function of the number of medications recorded at arrival. Other variables such as age, sex, and triage category were also measured. Results: Of the 15,398 charts reviewed, 27.7% of patients were admitted and the overall average LOS was 309.7 minutes for all patients and 226.7 minutes for discharged patients. The probability of admission increased by 1.69% (95% Confidence Interval [CI] 1.51% -1.87%) for each additional medication the patient reported. There was a correlation between the length of stay for discharged patients and the number of medications recorded. Each additional medication was associated with a 3.8 minute longer LOS (95% CI 2.8 minutes to 4.8 minutes). Conclusions: The number of medications a patient reported at arrival is a predictor of length of stay and probability of admission, and may be useful in constructing models of ED throughput. 16
EROC 2011 Abstract Proceedings – March 4, 2011 Dept. of Family Practice, Long Beach Medical Center, Long Beach, NY Title: Stressful Life Events and Symptomatic Nephrolithiasis: A Retrospective Chart Review Pilot Study Authors: Patrick D. Frisella, D.O. 1 , Min-Kyung Jung, PhD 2 , Shaun Wagner, D.O. 1 , Alina Frolova, D.O. 1 , Brooke Schneider, D.O. 1 , Steven Harris, M.D. 1 1 Department of Medical Education, Long Beach Medical Center, Long Beach, New York. 2 Office of Research, New York College of Osteopathic Medicine, Old Westbury, New York Introduction: Nephrolithiasis affects 12% of the US population. There are many risk factors attributed to the formation of symptomatic renal stones which include a history of recurrent urinary tract infection, Roux-en-Y gastric bypass surgery, gout, inflammatory bowel disease and medications. Formation of symptomatic nephrolithiasis has been shown to take 93 days. Stressful life events have been associated with symptomatic disease but with limited evidence in the literature. We investigated the impact of stressful life events with respect to age and gender in relation to symptomatic nephrolithiasis. Methods: A retrospective chart review was conducted of 250 outpatient urologist visits, which included an extensive social history of stressful life events. An inclusion criteria was designed to select charts with a documented first episode of symptomatic nephrolithiasis confirmed by Ultrasound or CT scan, social history that included +/- stressful life events three to six months prior to symptoms and excluded those with history of multiple nephrolithiasis or chronic disease that predisposed to nephrolithiasis. 70 charts were selected and grouped according to positive stressful life events (PSLE) and negative stressful life events (NSLE), gender and age. Life events were then scored using Holmes-Rahe stress inventory scale. Statistics performed using ANOVA and logistic regression analysis. Results: The PSLE group had an earlier median and average age of onset versus the NSLE group (44.0 vs. 50.5, CI 95% 40.0-48.0 vs. 45.9-55.1 and 42.4 vs. 48.8 p-value = 0.043, respectively). Younger patients (≤ 41 years of age) appear to have a threefold greater risk of having a major life event associated with nephrolithiasis than older patients (p-value = 0.033; OR = 3.27; CI 1.10 to 9.71). Conclusion: This study demonstrated that stressful life events were associated with an earlier onset of symptomatic nephrolithiasis, warranting further investigation on the direct relationship of stress and disease. 17
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