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• W2892195945 abstract "To prospectively describe the diagnoses and treatment of older emergency department (ED) patients presenting with dyspnea and to determine the patient characteristics which predict each of pneumonia, chronic obstructive pulmonary disease (COPD) and heart failure (HF). This is a prospective, observational cohort study of older adult (aged ≥65 years of age) who present with a chief complaint consistent with dyspnea or 2 respiratory rates greater than 20 within 4 hours of presentation. Exclusion criteria included: inability to obtain consent, active cancer, organ transplant on immunosuppression, trauma activation, incarceration or suicidal. Patients who were altered or had cognitive impairment were included. Sample size of 89 was based on a previous studies. Patients were enrolled at 2 EDs, 1 academic and 1 community, from 7am to 11pm, 7 days a week. Blood samples were collected for measurement of current (brain naturitic peptide, troponin and procalcitonin) and novel antimicrobial peptides that may help diagnose infectious causes of dyspnea (human beta defensin 1 and 2 (HBD-1, -2), human neutrophil peptides 1-3 (HNP1-3) and cathelididin (LL-37)). The diagnosis and treatment of dyspneic older adult ED patients will be described with proportion and 95% confidence intervals. ED diagnosis agreement with expert “gold standard” panel review will be compared to an a priori standard of 50% using a 1-sided Chi-square test. Finally, unadjusted univariate associations between each of the 3 diagnoses individually and patient demographics, medical history, diagnostic study results and presentation using univariate logistic regression. Enrollment is progressing with 335 patients screened, 122 eligible for enrollment and 71 enrolled as of May. Average age was similar across screened (74.1 years), eligible (74.4) and enrolled patients (72.6). The majority of patients were eligible by chief complaint only (88%). Our goal is to complete enrollment by July 1, 2018 with completion of chart review for gold standard diagnosis by experts and blood sample analysis by September 1, 2018 and initial data analysis completion by the meeting of the American College of Emergency Physicians (ACEP) in October 2018. Dyspnea is a common, high morbidity illness in older adult ED patients. We will provide the results of the first prospective study of dyspneic undifferentiated older adult patients in the ED." @default.
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• W2892195945 date "2018-10-01" @default.
• W2892195945 modified "2023-09-26" @default.
• W2892195945 title "140EMF Older Adult Emergency Department Patients With Dyspnea: Epidemiology and Improved Diagnostic Strategies" @default.
• W2892195945 doi "https://doi.org/10.1016/j.annemergmed.2018.08.145" @default.
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