Podcast #235: ER Discharge and Mortality

Podcast #235: ER Discharge and Mortality

Author: Pete Bakes, M.D.

Educational Pearls

  • One of the roles of the ER provider is to discharge patients only after life-threatening conditions have been ruled out. However, some patients that are discharged from the ED die within days of their discharge. One recent study sought to investigate the factors and diagnoses associated with death within 7 days of discharge.
  • This study was a retrospective study in 10 million medicare recipients that presented to the ER over 10 years. They excluded palliative, hospice and SNF patients.
  • 0.12% of these patients died within 7 days of ER discharge. Signs and symptoms such as altered mental status, general malaise and fatigue, and nonspecific dyspnea had relative risks of 3-5 for death following discharge.
  • Think carefully before discharge in patients with the signs/symptoms above.

References: Obermeyer Ziad, Cohn Brent, Wilson Michael, JenaAnupam B, Cutler David M. Early death after discharge from emergency departments: analysis of national US insurance claims data BMJ 2017;356 :j239

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Podcast #234: CIN AEM Study

Podcast #234: CIN AEM Study

Author: Dylan Luyten, M.D. Educational Pearls Around 30% of patients in the ER receive CT imaging, and the sensitivity of CT imaging may be improved with IV contrast. However, contrast is often withh...

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Podcast #233: Carfentanil

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Podcast #232: HAPE

Podcast #232: HAPE

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Podcast #231: Esophageal Tearing

Podcast #231: Esophageal Tearing

Author: Jared Scott, M.D. Educational Pearls Boerhaave syndrome (aka effort rupture of the esophagus) accounts for 10% of esophageal ruptures and is usually caused by strain during vomiting episodes....

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Podcast #230: Concussive Treatment

Podcast #230: Concussive Treatment

Author: Aaron Lessen, M.D. Educational Pearls 2 studies this past year looked at pediatric and adolescent patients following a concussion. They found people who returned to activity sooner did better...

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Podcast #229: Andrew Jackson

Podcast #229: Andrew Jackson

Author: Sam Killian, M.D. Educational Pearls Andrew Jackson was the 7th president of the USA. He served 2 terms from 1829-1837. He had had many medical issues during his presidency. He was said to be...

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Podcast #228: BB Guns

Podcast #228: BB Guns

Author: Jared Scott, M.D. Educational Pearls BB gun eye injuries are most common in August and September. They most often happen to males aged 16-17 year old. Around 10% of the BB eye injuries lead t...

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