860 results on '"Storrow, Alan B."'
Search Results
2. Defining the r factor for post-trauma resilience and its neural predictors
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van Rooij, Sanne J. H., Santos, Justin L., Hinojosa, Cecilia A., Ely, Timothy D., Harnett, Nathaniel G., Murty, Vishnu P., Lebois, Lauren A. M., Jovanovic, Tanja, House, Stacey L., Bruce, Steven E., Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Jr., Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sanchez, Leon D., Joormann, Jutta, Pizzagalli, Diego A., Sheridan, John F., Harte, Steven E., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Ressler, Kerry J., and Stevens, Jennifer S.
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- 2024
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3. Disentangling sex differences in PTSD risk factors
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Haering, Stephanie, Seligowski, Antonia V., Linnstaedt, Sarah D., Michopoulos, Vasiliki, House, Stacey L., Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Germine, Laura T., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Jr, Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Gentile, Nina T., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sanchez, Leon D., Bruce, Steven E., Harte, Steven E., McLean, Samuel A., Kessler, Ronald C., Koenen, Karestan C., Powers, Abigail, and Stevens, Jennifer S.
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- 2024
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4. Internal capsule microstructure mediates the relationship between childhood maltreatment and PTSD following adulthood trauma exposure
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Wong, Samantha A., Lebois, Lauren A. M., Ely, Timothy D., van Rooij, Sanne J. H., Bruce, Steven E., Murty, Vishnu P., Jovanovic, Tanja, House, Stacey L., Beaudoin, Francesca L., An, Xinming, Zeng, Donglin, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Jr., Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Kurz, Michael C., Swor, Robert A., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sergot, Paulina, Sanchez, Leon D., Miller, Mark W., Pietrzak, Robert H., Joormann, Jutta, Barch, Deanna M., Pizzagalli, Diego A., Harte, Steven E., Elliott, James M., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Ressler, Kerry J., Stevens, Jennifer S., and Harnett, Nathaniel G.
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- 2023
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5. Outcomes of the National Heart, Lung, and Blood Institute K12 program in emergency care research: 7‐year follow‐up
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Morris, Cynthia D, Cook, Jennifer NB, Lin, Amber, Scott, Jane D, Kuppermann, Nathan, Callaway, Clifton W, Yealy, Donald M, Lowe, Robert A, Richardson, Lynne D, Kimmel, Stephen, Holmes, James F, Collins, Sean, Becker, Lance B, Storrow, Alan B, Newgard, Harrison J, Baren, Jill, and Newgard, Craig D
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Awards and Prizes ,Biomedical Research ,Cohort Studies ,Emergency Medical Services ,Female ,Follow-Up Studies ,Humans ,Male ,National Heart ,Lung ,and Blood Institute (U.S.) ,National Institutes of Health (U.S.) ,United States ,Public Health and Health Services ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
BackgroundLong-term follow-up for clinician-scientist training programs is sparse. We describe the outcomes of clinician-scientist scholars in the National Heart Lung and Blood Institute (NHLBI) K12 program in emergency care research up to 8.7 years after matriculation in the program.MethodsThis was a cohort study of faculty clinician-scientist scholars enrolled in a NHLBI K12 research training program at 6 sites across the US, with median follow-up 7.7 years (range 5.7-8.7 years) from the date of matriculation. Scholars completed electronic surveys in 2017 and 2019, with the 2019 survey collecting information for their current work setting, percent time for research, and grant funding from all sources. We used NIH RePorter and online resources to verify federal grants through March 2021. The primary outcome was a funded career development award (CDA) or research project grant (RPG) where the scholar was principal investigator. We included funding from all federal sources and national foundations.ResultsThere were 43 scholars, including 16 (37%) women. Over the follow-up period, 32 (74%) received an individual CDA or RPG, with a median of 36 months (range 9-83 months) after entering the program. Of the 43 scholars, 23 (54%) received a CDA and 22 (51%) received an RPG, 7 (16%) of which were R01s. Of the 23 scholars who received a CDA, 13 (56%) subsequently had an RPG funded. Time to CDA or RPG did not differ by sex (women vs. men log-rank test p = 0.27) or specialty training (emergency medicine versus other specialties, p = 0.59).ConclusionsAfter 7 years of follow-up for this NHLBI K12 emergency care research training program, three quarters of clinician-scientist scholars had obtained CDA or RPG funding, with no notable differences by sex or clinical training.
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- 2022
6. Author Correction: Defining the r factor for post-trauma resilience and its neural predictors
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van Rooij, Sanne J. H., Santos, Justin L., Hinojosa, Cecilia A., Ely, Timothy D., Harnett, Nathaniel G., Murty, Vishnu P., Lebois, Lauren A. M., Jovanovic, Tanja, House, Stacey L., Bruce, Steven E., Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Jr., Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sanchez, Leon D., Joormann, Jutta, Pizzagalli, Diego A., Sheridan, John F., Harte, Steven E., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Ressler, Kerry J., and Stevens, Jennifer S.
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- 2024
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7. Derivation and external validation of a portable method to identify patients with pulmonary embolism from radiology reports: The READ-PE algorithm
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Christensen, Matthew A., Stubblefield, William B., Wang, Grace, Altheimer, Alyssa, Ouadah, Sarah J., Birrenkott, Drew A., Peters, Gregory A., Prucnal, Christiana, Harshbarger, Savanah, Chang, Kyle, Storrow, Alan B., Ward, Michael J., Collins, Sean P., Kabrhel, Christopher, and Wrenn, Jesse O.
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- 2024
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8. Probing the neurocardiac circuit in trauma and posttraumatic stress
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Seligowski, Antonia V., Harnett, Nathaniel G., Ellis, Robyn A., Grasser, Lana R., Hanif, Mubeena, Wiltshire, Charis, Ely, Timothy D., Lebois, Lauren A.M., van Rooij, Sanne J.H., House, Stacey L., Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Paul I., Jr., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sergot, Paulina, Sanchez, Leon D., Bruce, Steven E., Harte, Steven E., Koenen, Karestan C., Kessler, Ronald C., McLean, Samuel A., Ressler, Kerry J., Stevens, Jennifer S., and Jovanovic, Tanja
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- 2024
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9. Sex Differences in Response Inhibition–Related Neural Predictors of Posttraumatic Stress Disorder in Civilians With Recent Trauma
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Borst, Bibian, Jovanovic, Tanja, House, Stacey L., Bruce, Steven E., Harnett, Nathaniel G., Roeckner, Alyssa R., Ely, Timothy D., Lebois, Lauren A.M., Young, Dmitri, Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Paul I., Jr., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Datner, Elizabeth M., Pearson, Claire, Peak, David A., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sergot, Paulina, Sanchez, Leon D., Harte, Steven E., Koenen, Karestan C., Kessler, Ronald C., McLean, Samuel A., Ressler, Kerry J., Stevens, Jennifer S., and van Rooij, Sanne J.H.
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- 2024
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10. Structural inequities contribute to racial/ethnic differences in neurophysiological tone, but not threat reactivity, after trauma exposure
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Harnett, Nathaniel G., Fani, Negar, Carter, Sierra, Sanchez, Leon D., Rowland, Grace E., Davie, William M., Guzman, Camilo, Lebois, Lauren A. M., Ely, Timothy D., van Rooij, Sanne J. H., Seligowski, Antonia V., Winters, Sterling, Grasser, Lana R., Musey, Jr., Paul I., Seamon, Mark J., House, Stacey L., Beaudoin, Francesca L., An, Xinming, Zeng, Donglin, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Hudak, Lauren A., Pascual, Jose L., Harris, Erica, Chang, Anna M., Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., Bruce, Steven E., Miller, Mark W., Pietrzak, Robert H., Joormann, Jutta, Barch, Deanna M., Pizzagalli, Diego A., Harte, Steven E., Elliott, James M., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Jovanovic, Tanja, Stevens, Jennifer S., and Ressler, Kerry J.
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- 2023
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11. Intensive longitudinal assessment following index trauma to predict development of PTSD using machine learning
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Horwitz, Adam, McCarthy, Kaitlyn, House, Stacey L., Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey Jr., Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Pearson, Claire, Peak, David A., Domeier, Robert M., Rathlev, Niels K., Sergot, Paulina, Sanchez, Leon D., Bruce, Steven E., Joormann, Jutta, Harte, Steven E., Koenen, Karestan C., McLean, Samuel A., and Sen, Srijan
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- 2024
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12. Association between microbiome and the development of adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure
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Zeamer, Abigail L., Salive, Marie-Claire, An, Xinming, Beaudoin, Francesca L., House, Stacey L., Stevens, Jennifer S., Zeng, Donglin, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Rauch, Scott L., Storrow, Alan B., Lewandowski, Christopher, Musey, Jr, Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Swor, Robert A., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sergot, Paulina, Sanchez, Leon D., Bruce, Steven E., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Bucci, Vanni, and Haran, John P.
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- 2023
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13. Use of serial smartphone-based assessments to characterize diverse neuropsychiatric symptom trajectories in a large trauma survivor cohort
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Beaudoin, Francesca L., An, Xinming, Basu, Archana, Ji, Yinyao, Liu, Mochuan, Kessler, Ronald C., Doughtery, Robert F., Zeng, Donglin, Bollen, Kenneth A., House, Stacey L., Stevens, Jennifer S., Neylan, Thomas C., Clifford, Gari D., Jovanovic, Tanja, Linnstaedt, Sarah D., Germine, Laura T., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Jr., Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Kurz, Michael C., Swor, Robert A., Murty, Vishnu P., McGrath, Meghan E., Hudak, Lauren A., Pascual, Jose L., Datner, Elizabeth M., Chang, Anna M., Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., Neil, Brian J. O’, Sergot, Paulina, Sanchez, Leon D., Bruce, Steven E., Baker, Justin T., Joormann, Jutta, Miller, Mark W., Pietrzak, Robert H., Barch, Deanna M., Pizzagalli, Diego A., Sheridan, John F., Smoller, Jordan W., Harte, Steven E., Elliott, James M., Koenen, Karestan C., Ressler, Kerry J., and McLean, Samuel A.
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- 2023
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14. Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study
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Rowland, Grace E., Roeckner, Alyssa, Ely, Timothy D., Lebois, Lauren A.M., van Rooij, Sanne J.H., Bruce, Steven E., Jovanovic, Tanja, House, Stacey L., Beaudoin, Francesca L., An, Xinming, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Paul I., Jr., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Kurz, Michael C., Gentile, Nina T., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Pearson, Claire, Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., Sergot, Paulina, Sanchez, Leon D., Miller, Mark W., Pietrzak, Robert H., Joormann, Jutta, Pizzagalli, Diego A., Sheridan, John F., Smoller, Jordan W., Harte, Steven E., Elliott, James M., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Ressler, Kerry J., Stevens, Jennifer S., and Harnett, Nathaniel G.
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- 2023
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15. The Accuracy of Interqual Criteria in Determining the Observation versus Inpatient Status in Older Adults with Syncope
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Chang, Anna Marie, Hollander, Judd E, Su, Erica, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Aging ,Aged ,Aged ,80 and over ,Cohort Studies ,Female ,Humans ,Inpatients ,Length of Stay ,Male ,Middle Aged ,Syncope ,case management ,geriatrics ,InterQual ,syncope ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
BackgroundMcKesson's InterQual criteria are widely used in hospitals to determine if patients should be classified as observation or inpatient status, but the accuracy of the criteria is unknown.ObjectiveWe sought to determine whether InterQual criteria accurately predicted length of stay (LOS) in older patients with syncope.MethodsWe conducted a secondary analysis of a cohort study of adults ≥60 years of age who had syncope. We calculated InterQual criteria and classified the patient as observation or inpatient status. Outcomes were whether LOS were less than or greater than 2 midnights.ResultsWe analyzed 2361 patients; 1227 (52.0%) patients were male and 1945 (82.8%) were white, with a mean age of 73.2 ± 9.0 years. The median LOS was 32.6 h (interquartile range 24.2-71.8). The sensitivity of InterQual criteria for LOS was 60.8% (95% confidence interval 57.9-63.6%) and the specificity was 47.8% (95% confidence interval 45.0-50.5%).ConclusionsIn older adults with syncope, those who met InterQual criteria for inpatient status had longer LOS compared with those who did not; however, the accuracy of the criteria to predict length of stay over 2 days is poor, with a sensitivity of 60% and a specificity of 48%. Future research should identify criteria to improve LOS prediction.
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- 2020
16. Myocardial Infarction Can Be Safely Excluded by High‐sensitivity Troponin I Testing 3 Hours After Emergency Department Presentation
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Peacock, W Frank, Christenson, Robert, Diercks, Deborah B, Fromm, Christian, Headden, Gary F, Hogan, Christopher J, Kulstad, Erik B, LoVecchio, Frank, Nowak, Richard M, Schrock, Jon W, Singer, Adam J, Storrow, Alan B, Straseski, Joely, Wu, Alan HB, and Zelinski, Daniel P
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Cardiovascular ,Prevention ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Acute Coronary Syndrome ,Adult ,Biomarkers ,Emergency Service ,Hospital ,Female ,Humans ,Male ,Middle Aged ,Myocardial Infarction ,Troponin I ,Troponin T ,Public Health and Health Services ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
BackgroundThe accuracy and speed by which acute myocardial infarction (AMI) is excluded are an important determinant of emergency department (ED) length of stay and resource utilization. While high-sensitivity troponin I (hsTnI) >99th percentile (upper reference level [URL]) represents a "rule-in" cutpoint, our purpose was to evaluate the ability of the Beckman Coulter hsTnI assay, using various level-of-quantification (LoQ) cutpoints, to rule out AMI within 3 hours of ED presentation in suspected acute coronary syndrome (ACS) patients.MethodsThis multicenter evaluation enrolled adults with >5 minutes of ACS symptoms and an electrocardiogram obtained per standard care. Exclusions were ST-segment elevation or chronic hemodialysis. After informed consent was obtained, blood samples were collected in heparin at ED admission (baseline), ≥1 to 3, ≥3 to 6, and ≥6 to 9 hours postadmission. Samples were processed and stored at -20°C within 1 hour and were tested at three independent clinical laboratories on an immunoassay system (DxI 800, Beckman Coulter). Analytic cutpoints were the URL of 17.9 ng/L and two LoQ cutpoints, defined as the 10 and 20% coefficient of variation (5.6 and 2.3 ng/L, respectively). A criterion standard MI diagnosis was adjudicated by an independent endpoint committee, blinded to hsTnI, and using the universal definition of MI.ResultsOf 1,049 patients meeting the entry criteria, and with baseline and 1- to 3-hour hsTnI results, 117 (11.2%) had an adjudicated final diagnosis of AMI. AMI patients were typically older, with more cardiovascular risk factors. Median (IQR) presentation time was 4 (1.6-16.0) hours after symptom onset, although AMI patients presented ~0.5 hour earlier than non-AMI. Enrollment and first blood draw occurred at a mean of ~1 hour after arrival. To evaluate the assay's rule-out performance, patients with any hsTnI > URL were considered high risk and were excluded. The remaining population (n = 829) was divided into four LoQ relative categories: both hsTnI LoQ (Lo-Hi cohort); first > LoQ and second LoQ (Hi-Hi cohort). In patients with any hsTnI result 3 hours after the onset of suspected ACS symptoms, with at least two Beckman Coulter Access hsTnI LoQ had inadequate sensitivity and NPV.
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- 2020
17. Risk Stratification of Older Adults Who Present to the Emergency Department With Syncope: The FAINT Score
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Probst, Marc A, Gibson, Thomas, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,Cardiovascular ,Neurosciences ,Heart Disease ,Clinical Research ,Emergency Care ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Good Health and Well Being ,Aged ,Area Under Curve ,Cardiovascular Diseases ,Emergency Service ,Hospital ,Female ,Health Status Indicators ,Humans ,Male ,Practice Guidelines as Topic ,Prospective Studies ,Risk Assessment ,Syncope ,United States ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
Study objectiveOlder adults with syncope are commonly treated in the emergency department (ED). We seek to derive a novel risk-stratification tool to predict 30-day serious cardiac outcomes.MethodsWe performed a prospective, observational study of older adults (≥60 years) with unexplained syncope or near syncope who presented to 11 EDs in the United States. Patients with a serious diagnosis identified in the ED were excluded. We collected clinical and laboratory data on all patients. Our primary outcome was 30-day all-cause mortality or serious cardiac outcome.ResultsWe enrolled 3,177 older adults with unexplained syncope or near syncope between April 2013 and September 2016. Mean age was 73 years (SD 9.0 years). The incidence of the primary outcome was 5.7% (95% confidence interval [CI] 4.9% to 6.5%). Using Bayesian logistic regression, we derived the FAINT score: history of heart failure, history of cardiac arrhythmia, initial abnormal ECG result, elevated pro B-type natriuretic peptide, and elevated high-sensitivity troponin T. A FAINT score of 0 versus greater than or equal to 1 had sensitivity of 96.7% (95% CI 92.9% to 98.8%) and specificity 22.2% (95% CI 20.7% to 23.8%), respectively. The FAINT score tended to be more accurate than unstructured physician judgment: area under the curve 0.704 (95% CI 0.669 to 0.739) versus 0.630 (95% CI 0.589 to 0.670).ConclusionAmong older adults with syncope or near syncope of potential cardiac cause, a FAINT score of zero had a reasonably high sensitivity for excluding death and serious cardiac outcomes at 30 days. If externally validated, this tool could improve resource use for this common condition.
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- 2020
18. Orthostatic vital signs do not predict 30 day serious outcomes in older emergency department patients with syncope: A multicenter observational study
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White, Jennifer L, Hollander, Judd E, Chang, Anna Marie, Nishijima, Daniel K, Lin, Amber L, Su, Erica, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Nicks, Bret A, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Clinical Research ,Cardiovascular ,Heart Disease ,Emergency Care ,Aged ,Aged ,80 and over ,Case-Control Studies ,Electrocardiography ,Emergency Service ,Hospital ,Female ,Heart Diseases ,Humans ,Male ,Middle Aged ,Physical Examination ,Prospective Studies ,Syncope ,Vital Signs ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
BackgroundSyncope is a common chief complaint among older adults in the Emergency Department (ED), and orthostatic vital signs are often a part of their evaluation. We assessed whether abnormal orthostatic vital signs in the ED are associated with composite 30-day serious outcomes in older adults presenting with syncope.MethodsWe performed a secondary analysis of a prospective, observational study at 11 EDs in adults ≥ 60 years who presented with syncope or near syncope. We excluded patients lost to follow up. We used the standard definition of abnormal orthostatic vital signs or subjective symptoms of lightheadedness upon standing to define orthostasis. We determined the rate of composite 30-day serious outcomes, including those during the index ED visit, such as cardiac arrhythmias, myocardial infarction, cardiac intervention, new diagnosis of structural heart disease, stroke, pulmonary embolism, aortic dissection, subarachnoid hemorrhage, cardiopulmonary resuscitation, hemorrhage/anemia requiring transfusion, with major traumatic injury from fall, recurrent syncope, and death) between the groups with normal and abnormal orthostatic vital signs.ResultsThe study cohort included 1974 patients, of whom 51.2% were male and 725 patients (37.7%) had abnormal orthostatic vital signs. Comparing those with abnormal to those with normal orthostatic vital signs, we did not find a difference in composite 30-serious outcomes (111/725 (15.3%) vs 184/1249 (14.7%); unadjusted odds ratio, 1.05 [95%CI, 0.81-1.35], p = 0.73). After adjustment for gender, coronary artery disease, congestive heart failure (CHF), history of arrhythmia, dyspnea, hypotension, any abnormal ECG, physician risk assessment, medication classes and disposition, there was no association with composite 30-serious outcomes (adjusted odds ratio, 0.82 [95%CI, 0.62-1.09], p = 0.18).ConclusionsIn a cohort of older adult patients presenting with syncope who were able to have orthostatic vital signs evaluated, abnormal orthostatic vital signs did not independently predict composite 30-day serious outcomes.
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- 2019
19. Derivation and Validation of a Brief Emergency Department-Based Prediction Tool for Posttraumatic Stress After Motor Vehicle Collision
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Jones, Christopher W., An, Xinming, Ji, Yinyao, Liu, Mochuan, Zeng, Donglin, House, Stacey L., Beaudoin, Francesca L., Stevens, Jennifer S., Neylan, Thomas C., Clifford, Gari D., Jovanovic, Tanja, Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Paul I., Jr., Hendry, Phyllis L., Sheikh, Sophia, Punches, Brittany E., Lyons, Michael S., Kurz, Michael C., Swor, Robert A., McGrath, Meghan E., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Datner, Elizabeth M., Harris, Erica, Chang, Anna M., Pearson, Claire, Peak, David A., Merchant, Roland C., Domeier, Robert M., Rathlev, Niels K., O'Neil, Brian J., Sergot, Paulina, Sanchez, Leon D., Bruce, Steven E., Miller, Mark W., Pietrzak, Robert H., Joormann, Jutta, Barch, Deanna M., Pizzagalli, Diego A., Sheridan, John F., Smoller, Jordan W., Harte, Steven E., Elliott, James M., Koenen, Karestan C., Ressler, Kerry J., Kessler, Ronald C., and McLean, Samuel A.
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- 2023
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20. Medication Discussions With Patients With Cardiovascular Disease in the Emergency Department: An Opportunity for Emergency Nurses to Engage Patients to Support Medication Reconciliation
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Stolldorf, Deonni P., Jones, Abby B., Miller, Karen F., Paz, Hadassah H., Mumma, Bryn E., Danesh, Valerie C., Collins, Sean P., Dietrich, Mary S., and Storrow, Alan B.
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- 2023
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21. Sex-dependent differences in vulnerability to early risk factors for posttraumatic stress disorder: results from the AURORA study
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Haering, Stephanie, primary, Seligowski, Antonia V., additional, Linnstaedt, Sarah D., additional, Michopoulos, Vasiliki, additional, House, Stacey L., additional, Beaudoin, Francesca L., additional, An, Xinming, additional, Neylan, Thomas C., additional, Clifford, Gari D., additional, Germine, Laura T., additional, Rauch, Scott L., additional, Haran, John P., additional, Storrow, Alan B., additional, Lewandowski, Christopher, additional, Musey, Paul I., additional, Hendry, Phyllis L., additional, Sheikh, Sophia, additional, Jones, Christopher W., additional, Punches, Brittany E., additional, Swor, Robert A., additional, Gentile, Nina T., additional, Hudak, Lauren A., additional, Pascual, Jose L., additional, Seamon, Mark J., additional, Pearson, Claire, additional, Peak, David A., additional, Merchant, Roland C., additional, Domeier, Robert M., additional, Rathlev, Niels K., additional, O'Neil, Brian J., additional, Sanchez, Leon D., additional, Bruce, Steven E., additional, Harte, Steven E., additional, McLean, Samuel A., additional, Kessler, Ronald C., additional, Koenen, Karestan C., additional, Stevens, Jennifer S., additional, and Powers, Abigail, additional
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- 2024
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22. Current Emergency Department Disposition of Patients With Acute Heart Failure: An Opportunity for Improvement
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Sax, DANA R., MARK, DUSTIN G., RANA, JAMAL S., REED, MARY E., LINDENFELD, JOANN, STEVENSON, LYNNE W., STORROW, ALAN B., BUTLER, JAVED, PANG, PETER S., and COLLINS, SEAN P.
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- 2022
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23. Performance of the American Heart Association/American College of Cardiology/Heart Rhythm Society versus European Society of Cardiology guideline criteria for hospital admission of patients with syncope
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Widmer, Velina, Leu, Kathrin, Reichlin, Tobias, Shrestha, Samyut, Freese, Michael, Krisai, Philipp, Belkin, Maria, Kawecki, Damian, Morawiec, Beata, Muzyk, Piotr, Nowalany-Kozielska, Ewa, Geigy, Nicolas, Martinez-Nadal, Gemma, Fuenzalida Inostroza, Carolina Isabel, Mandrión, José Bustamante, Poepping, Imke, Greenslade, Jaimi, Hawkins, Tracey, Rentsch, Katharina, Mitrovic, Sandra, von Eckardstein, Arnold, Buser, Andreas, Osswald, Stefan, Walter, Joan, Adler, David H., Bastani, Aveh, Baugh, Christopher W., Caterino, Jeffrey M., Diercks, Deborah B., Hollander, Judd E., Nicks, Bret A., Nishijima, Daniel K., Shah, Manish N., Stiffler, Kirk A., Wilber, Scott T., Storrow, Alan B., du Fay de Lavallaz, Jeanne, Zimmermann, Tobias, Badertscher, Patrick, Lopez-Ayala, Pedro, Nestelberger, Thomas, Miró, Òscar, Salgado, Emilio, Zaytseva, Xenia, Gafner, Michele Sara, Christ, Michael, Cullen, Louise, Than, Martin, Martin-Sanchez, F. Javier, Di Somma, Salvatore, Peacock, W. Frank, Keller, Dagmar I., Costabel, Juan Pablo, Sigal, Alan, Puelacher, Christian, Wussler, Desiree, Koechlin, Luca, Strebel, Ivo, Schuler, Sereina, Manka, Robert, Bilici, Murat, Lohrmann, Jens, Kühne, Michael, Breidthardt, Tobias, Clark, Carol L., Probst, Marc, Gibson, Thomas A., Weiss, Robert E., Sun, Benjamin C., and Mueller, Christian
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- 2022
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24. Clinical Benefit of Hospitalization for Older Adults With Unexplained Syncope: A Propensity-Matched Analysis
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Probst, Marc A, Su, Erica, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Aging ,Clinical Research ,Aged ,Aged ,80 and over ,Emergency Service ,Hospital ,Female ,Hospitalization ,Humans ,Incidence ,Male ,Medically Unexplained Symptoms ,Middle Aged ,Patient Discharge ,Propensity Score ,Prospective Studies ,Risk Assessment ,Syncope ,United States ,Clinical Sciences ,Emergency & Critical Care Medicine - Abstract
Study objectiveMany adults with syncope are hospitalized solely for observation and testing. We seek to determine whether hospitalization versus outpatient management for older adults with unexplained syncope is associated with a reduction in postdisposition serious adverse events at 30 days.MethodsWe performed a propensity score analysis using data from a prospective, observational study of older adults with unexplained syncope or near syncope who presented to 11 emergency departments (EDs) in the United States. We enrolled adults (≥60 years) who presented with syncope or near syncope. We excluded patients with a serious diagnosis identified in the ED. Clinical and laboratory data were collected on all patients. The primary outcome was rate of post-ED serious adverse events at 30 days.ResultsWe enrolled 2,492 older adults with syncope and no serious ED diagnosis from April 2013 to September 2016. Mean age was 73 years (SD 8.9 years), and 51% were women. The incidence of serious adverse events within 30 days after the index visit was 7.4% for hospitalized patients and 3.19% for discharged patients, representing an unadjusted difference of 4.2% (95% confidence interval 2.38% to 6.02%). After propensity score matching on risk of hospitalization, there was no statistically significant difference in serious adverse events at 30 days between the hospitalized group (4.89%) and the discharged group (2.82%) (risk difference 2.07%; 95% confidence interval -0.24% to 4.38%).ConclusionIn our propensity-matched sample of older adults with unexplained syncope, for those with clinical characteristics similar to that of the discharged cohort, hospitalization was not associated with improvement in 30-day serious adverse event rates.
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- 2019
25. Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes
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Chang, Anna Marie, Hollander, Judd E, Su, Erica, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Biomedical and Clinical Sciences ,Clinical Sciences ,Cardiovascular ,Clinical Research ,Aging ,Heart Disease ,Aged ,Aged ,80 and over ,Cardiovascular Diseases ,Case-Control Studies ,Emergency Service ,Hospital ,Female ,Humans ,Male ,Middle Aged ,Prospective Studies ,Recurrence ,Risk Assessment ,Risk Factors ,Syncope ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
Almost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode.MethodsThis study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60 years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of 30-day serious outcome. The secondary outcome was 30-day serious cardiac arrhythmia. In multivariate analysis, we assessed whether prior syncope was an independent predictor of 30-day serious events.ResultsThe study cohort included 3580 patients: 1281 (35.8%) had prior syncope and 2299 (64.2%) were presenting with first episode of syncope. 498 (13.9%) patients had 1 prior episode while 771 (21.5%) had >1 prior episode. Those with recurrent syncope were more likely to have congestive heart failure, coronary artery disease, previous diagnosis of arrhythmia, and an abnormal ECG. Overall, 657 (18.4%) of the cohort had a serious outcome by 30 days after index ED visit. In multivariate analysis, we found no significant difference in risk of events (adjusted odds ratio 1.09; 95% confidence interval 0.90-1.31; p = 0.387).ConclusionIn older adults with syncope, a prior history of syncope within the year does not increase the risk for serious 30-day events.
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- 2019
26. Do High‐sensitivity Troponin and Natriuretic Peptide Predict Death or Serious Cardiac Outcomes After Syncope?
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Clark, Carol L, Gibson, Thomas A, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Cardiovascular ,Emergency Care ,Heart Disease ,Prevention ,Clinical Research ,Adult ,Aged ,Biomarkers ,Case-Control Studies ,Emergency Service ,Hospital ,Female ,Humans ,Male ,Middle Aged ,Natriuretic Peptide ,Brain ,Peptide Fragments ,Prospective Studies ,Syncope ,Troponin T ,Clinical Sciences ,Public Health and Health Services ,Emergency & Critical Care Medicine - Abstract
OBJECTIVES:An estimated 1.2 million annual emergency department (ED) visits for syncope/near syncope occur in the United States. Cardiac biomarkers are frequently obtained during the ED evaluation, but the prognostic value of index high-sensitivity troponin (hscTnT) and natriuretic peptide (NT-proBNP) are unclear. The objective of this study was to determine if hscTnT and NT-proBNP drawn in the ED are independently associated with 30-day death/serious cardiac outcomes in adult patients presenting with syncope. METHODS:A prespecified secondary analysis of a prospective, observational trial enrolling participants ≥ age 60 presenting with syncope, at 11 United States hospitals, was conducted between April 2013 and September 2016. Exclusions included seizure, stroke, transient ischemic attack, trauma, intoxication, hypoglycemia, persistent confusion, mechanical/electrical invention, prior enrollment, or predicted poor follow-up. Within 3 hours of consent, hscTnT and NT-proBNP were collected and later analyzed centrally using Roche Elecsys Gen 5 STAT and 2010 Cobas, respectively. Primary outcome was combined 30-day all-cause mortality and serious cardiac events. Adjusting for illness severity, using multivariate logistic regression analysis, variations between primary outcome and biomarkers were estimated, adjusting absolute risk associated with ranges of biomarkers using Bayesian Markov Chain Monte Carlo methods. RESULTS:The cohort included 3,392 patients; 367 (10.8%) experienced the primary outcome. Adjusted absolute risk for the primary outcome increased with hscTnT and NT-proBNP levels. HscTnT levels ≤ 5 ng/L were associated with a 4% (95% confidence interval [CI] = 3%-5%) outcome risk, and hscTnT > 50 ng/L, a 29% (95% CI = 26%-33%) risk. NT-proBNP levels ≤ 125 ng/L were associated with a 4% (95% CI = 4%-5%) risk, and NT-proBNP > 2,000 ng/L a 29% (95% CI = 25%-32%) risk. Likelihood ratios and predictive values demonstrated similar results. Sensitivity analyses excluding ED index serious outcomes demonstrated similar findings. CONCLUSIONS:hscTnT and NT-proBNP are independent predictors of 30-day death and serious outcomes in older ED patients presenting with syncope.
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- 2019
27. Comparison of 30-Day Serious Adverse Clinical Events for Elderly Patients Presenting to the Emergency Department With Near-Syncope Versus Syncope
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Bastani, Aveh, Su, Erica, Adler, David H, Baugh, Christopher, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Malveau, Susan E, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, Yagapen, Annick N, Weiss, Robert E, and Sun, Benjamin C
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Cardiovascular ,Lung ,Aging ,Clinical Research ,Heart Disease ,Emergency Care ,Aged ,Aged ,80 and over ,Case-Control Studies ,Emergency Service ,Hospital ,Female ,Humans ,Male ,Middle Aged ,Prospective Studies ,Risk Assessment ,Syncope ,Clinical Sciences ,Emergency & Critical Care Medicine - Abstract
Study objectiveControversy remains in regard to the risk of adverse events for patients presenting with syncope compared with near-syncope. The purpose of our study is to describe the difference in outcomes between these groups in a large multicenter cohort of older emergency department (ED) patients.MethodsFrom April 28, 2013, to September 21, 2016, we conducted a prospective, observational study across 11 EDs in adults (≥60 years) with syncope or near-syncope. A standardized data extraction tool was used to collect information during their index visit and at 30-day follow-up. Our primary outcome was the incidence of 30-day death or serious clinical events. Data were analyzed with descriptive statistics and multivariate logistic regression analysis adjusting for relevant demographic or historical variables.ResultsA total of 3,581 patients (mean age 72.8 years; 51.6% men) were enrolled in the study. There were 1,380 patients (39%) presenting with near-syncope and 2,201 (61%) presenting with syncope. Baseline characteristics revealed a greater incidence of congestive heart failure, coronary artery disease, previous arrhythmia, nonwhite race, and presenting dyspnea in the near-syncope compared with syncope cohort. There were no differences in the primary outcome between the groups (near-syncope 18.7% versus syncope 18.2%). A multivariate logistic regression analysis identified no difference in 30-day serious outcomes for patients with near-syncope (odds ratio 0.94; 95% confidence interval 0.78 to 1.14) compared with syncope.ConclusionNear-syncope confers risk to patients similar to that of syncope for the composite outcome of 30-day death or serious clinical event.
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- 2019
28. The First National Institutes of Health Institutional Training Program in Emergency Care Research: Productivity and Outcomes
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Newgard, Craig D, Morris, Cynthia D, Smith, Lindsey, Cook, Jennifer NB, Yealy, Donald M, Collins, Sean, Holmes, James F, Kuppermann, Nathan, Richardson, Lynne D, Kimmel, Stephen, Becker, Lance B, Scott, Jane D, Lowe, Robert A, Callaway, Clifton W, Gowen, L Kris, Baren, Jill, Storrow, Alan B, Vasilevsky, Nicole, White, Marijane, and Zell, Adrienne
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Biomedical and Clinical Sciences ,Clinical Sciences ,Health Services ,Clinical Research ,Good Health and Well Being ,Adult ,Age Distribution ,Emergency Medicine ,Female ,Humans ,Male ,Middle Aged ,National Institutes of Health (U.S.) ,Program Evaluation ,Surveys and Questionnaires ,United States ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
Study objectiveWe assess the productivity, outcomes, and experiences of participants in the National Institutes of Health/National Heart, Lung, and Blood Institute-funded K12 institutional research training programs in emergency care research.MethodsWe used a mixed-methods study design to evaluate the 6 K12 programs, including 2 surveys, participant interviews, scholar publications, grant submissions, and funded grants. The training program lasted from July 1, 2011, through June 30, 2017. We tracked scholars for a minimum of 3 years and up to 5 years, beginning with date of entry into the program. We interviewed program participants by telephone using open-ended prompts.ResultsThere were 94 participants, including 43 faculty scholars, 13 principal investigators, 30 non-principal investigator primary mentors, and 8 program administrators. The survey had a 74% overall response rate, including 95% of scholars. On entry to the program, scholars were aged a median of 37 years (interquartile range [IQR] 34 to 40 years), with 16 women (37%), and represented 11 disciplines. Of the 43 scholars, 40 (93%) submitted a career development award or research project grant during or after the program; 26 (60%) have secured independent funding as of August 1, 2017. Starting with date of entry into the program, the median time to grant submission was 19 months (IQR 11 to 27 months) and time to funding was 33 months (IQR 27 to 39 months). Cumulative median publications per scholar increased from 7 (IQR 4 to 15.5) at program entry to 21 (IQR 11 to 33.5) in the first post-K12 year. We conducted 57 semistructured interviews and identified 7 primary themes.ConclusionThis training program produced 43 interdisciplinary investigators in emergency care research, with demonstrated productivity in grant funding and publications.
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- 2018
29. Predictors of Clinically Significant Echocardiography Findings in Older Adults with Syncope: A Secondary Analysis
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Probst, Marc A, Gibson, Thomas A, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Nishijima, Daniel K, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Cardiovascular ,Clinical Research ,Aging ,Heart Disease ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Aged ,Echocardiography ,Emergency Service ,Hospital ,Female ,Humans ,Male ,Middle Aged ,Predictive Value of Tests ,Prospective Studies ,Risk Assessment ,Sensitivity and Specificity ,Syncope ,Clinical Sciences ,General & Internal Medicine - Abstract
BackgroundSyncope is a common reason for visiting the emergency department (ED) and is associated with significant healthcare resource utilization.ObjectiveTo develop a risk-stratification tool for clinically significant findings on echocardiography among older adults presenting to the ED with syncope or nearsyncope.DesignProspective, observational cohort study from April 2013 to September 2016.SettingEleven EDs in the United States.PatientsWe enrolled adults (=60 years) who presented to the ED with syncope or near-syncope who underwent transthoracic echocardiography (TTE).MeasurementsThe primary outcome was a clinically significant finding on TTE. Clinical, electrocardiogram, and laboratory variables were also collected. Multivariable logistic regression analysis was used to identify predictors of significant findings on echocardiography.ResultsA total of 3,686 patients were enrolled. Of these, 995 (27%) received echocardiography, and 215 (22%) had a significant finding on echocardiography. Regression analysis identified five predictors of significant finding: (1) history of congestive heart failure, (2) history of coronary artery disease, (3) abnormal electrocardiogram, (4) high-sensitivity troponin-T >14 pg/mL, and 5) N-terminal pro B-type natriuretic peptide >125 pg/mL. These five variables make up the ROMEO (Risk Of Major Echocardiography findings in Older adults with syncope) criteria. The sensitivity of a ROMEO score of zero for excluding significant findings on echocardiography was 99.5% (95% CI: 97.4%-99.9%) with a specificity of 15.4% (95% CI: 13.0%-18.1%).ConclusionsIf validated, this risk-stratification tool could help clinicians determine which syncope patients are at very low risk of having clinically significant findings on echocardiography.RegistrationClinicalTrials.gov Identifier NCT01802398.
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- 2018
30. Structural covariance of the ventral visual stream predicts posttraumatic intrusion and nightmare symptoms: a multivariate data fusion analysis
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Harnett, Nathaniel G., Finegold, Katherine E., Lebois, Lauren A. M., van Rooij, Sanne J. H., Ely, Timothy D., Murty, Vishnu P., Jovanovic, Tanja, Bruce, Steven E., House, Stacey L., Beaudoin, Francesca L., An, Xinming, Zeng, Donglin, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Haran, John P., Storrow, Alan B., Lewandowski, Christopher, Musey, Paul I., Hendry, Phyllis L., Sheikh, Sophia, Jones, Christopher W., Punches, Brittany E., Kurz, Michael C., Swor, Robert A., Hudak, Lauren A., Pascual, Jose L., Seamon, Mark J., Harris, Erica, Chang, Anna M., Pearson, Claire, Peak, David A., Domeier, Robert M., Rathlev, Niels K., O’Neil, Brian J., Sergot, Paulina, Sanchez, Leon D., Miller, Mark W., Pietrzak, Robert H., Joormann, Jutta, Barch, Deanna M., Pizzagalli, Diego A., Sheridan, John F., Harte, Steven E., Elliott, James M., Kessler, Ronald C., Koenen, Karestan C., McLean, Samuel A., Nickerson, Lisa D., Ressler, Kerry J., and Stevens, Jennifer S.
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- 2022
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31. Outcomes of Patients With Syncope and Suspected Dementia
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Holden, Timothy R, Shah, Manish N, Gibson, Tommy A, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Nishijima, Daniel K, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Clinical Research ,Patient Safety ,Emergency Care ,Aging ,Dementia ,Acquired Cognitive Impairment ,Brain Disorders ,Clinical Sciences ,Public Health and Health Services ,Emergency & Critical Care Medicine - Abstract
ObjectivesSyncope and near-syncope are common in patients with dementia and a leading cause of emergency department (ED) evaluation and subsequent hospitalization. The objective of this study was to describe the clinical trajectory and short-term outcomes of patients who presented to the ED with syncope or near-syncope and were assessed by their ED provider to have dementia.MethodsThis multisite prospective cohort study included patients 60 years of age or older who presented to the ED with syncope or near-syncope between 2013 and 2016. We analyzed a subcohort of 279 patients who were identified by the treating ED provider to have baseline dementia. We collected comprehensive patient-level, utilization, and outcomes data through interviews, provider surveys, and chart abstraction. Outcome measures included serious conditions related to syncope and death.ResultsOverall, 221 patients (79%) were hospitalized with a median length of stay of 2.1 days. A total of 46 patients (16%) were diagnosed with a serious condition in the ED. Of the 179 hospitalized patients who did not have a serious condition identified in the ED, 14 (7.8%) were subsequently diagnosed with a serious condition during the hospitalization, and an additional 12 patients (6.7%) were diagnosed postdischarge within 30 days of the index ED visit. There were seven deaths (2.5%) overall, none of which were cardiac-related. No patients who were discharged from the ED died or had a serious condition in the subsequent 30 days.ConclusionsPatients with perceived dementia who presented to the ED with syncope or near-syncope were frequently hospitalized. The diagnosis of a serious condition was uncommon if not identified during the initial ED assessment. Given the known iatrogenic risks of hospitalization for patients with dementia, future investigation of the impact of goals of care discussions on reducing potentially preventable, futile, or unwanted hospitalizations while improving goal-concordant care is warranted.
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- 2018
32. Measuring outcome differences associated with STEMI screening and diagnostic performance: a multicentred retrospective cohort study protocol.
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Yiadom, Maame Yaa AB, Mumma, Bryn E, Baugh, Christopher W, Patterson, Brian W, Mills, Angela M, Salazar, Gilberto, Tanski, Mary, Jenkins, Cathy A, Vogus, Timothy J, Miller, Karen F, Jackson, Brittney E, Lehmann, Christoph U, Dorner, Stephen C, West, Jennifer L, Wang, Thomas J, Collins, Sean P, Dittus, Robert S, Bernard, Gordon R, Storrow, Alan B, and Liu, Dandan
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Humans ,Electrocardiography ,Risk Factors ,Retrospective Studies ,Research Design ,Time Factors ,Emergency Service ,Hospital ,Emergency Medical Services ,Female ,Male ,Multicenter Studies as Topic ,Angioplasty ,Balloon ,Coronary ,Time-to-Treatment ,ST Elevation Myocardial Infarction ,Outcome Assessment ,Health Care ,Emergency Service ,Hospital ,Outcome Assessment ,Angioplasty ,Balloon ,Coronary ,Clinical Sciences ,Public Health and Health Services ,Other Medical and Health Sciences - Abstract
IntroductionAdvances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known.MethodsWe present the methods for a retrospective multicentre cohort study anticipated to include 1220 patients across seven EDs to (1) evaluate the relationship between timely screening and diagnosis with treatment and postintervention clinical outcomes; (2) introduce novel measures for cross-facility performance comparisons of screening and diagnostic care team performance including: door-to-screening, door-to-diagnosis and door-to-catheterisation laboratory arrival times and (3) describe the use of electronic health record data in tandem with an existing disease registry.Ethics and disseminationThe completion of this study will provide critical feedback on the quality of screening and diagnostic performance within the contemporary STEMI care pathway that can be used to (1) improve emergency care delivery for patients with STEMI presenting to the ED, (2) present novel metrics for the comparison of screening and diagnostic care and (3) inform the development of screening and diagnostic support tools that could be translated to other care environments. We will disseminate our results via publication and quality performance data sharing with each site. Institutional ethics review approval was received prior to study initiation.
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- 2018
33. ECG Predictors of Cardiac Arrhythmias in Older Adults With Syncope
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Nishijima, Daniel K, Lin, Amber L, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Biomedical and Clinical Sciences ,Clinical Sciences ,Cardiovascular ,Clinical Research ,Emergency Care ,Heart Disease ,Aged ,Aged ,80 and over ,Electrocardiography ,Emergency Service ,Hospital ,Female ,Follow-Up Studies ,Humans ,Incidence ,Male ,Middle Aged ,Prognosis ,Prospective Studies ,Risk Assessment ,Risk Factors ,Survival Rate ,Syncope ,United States ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
Study objectiveCardiac arrhythmia is a life-threatening condition in older adults who present to the emergency department (ED) with syncope. Previous work suggests the initial ED ECG can predict arrhythmia risk; however, specific ECG predictors have been variably specified. Our objective is to identify specific ECG abnormalities predictive of 30-day serious cardiac arrhythmias in older adults presenting to the ED with syncope.MethodsWe conducted a prospective, observational study at 11 EDs in adults aged 60 years or older who presented with syncope or near syncope. We excluded patients with a serious cardiac arrhythmia diagnosed during the ED evaluation from the primary analysis. The outcome was occurrence of 30-day serous cardiac arrhythmia. The exposure variables were predefined ECG abnormalities. Independent predictors were identified through multivariate logistic regression. The sensitivities and specificities of any predefined ECG abnormality and any ECG abnormality identified on adjusted analysis to predict 30-day serious cardiac arrhythmia were also calculated.ResultsAfter exclusion of 197 patients (5.5%; 95% confidence interval [CI] 4.7% to 6.2%) with serious cardiac arrhythmias in the ED, the study cohort included 3,416 patients. Of these, 104 patients (3.0%; 95% CI 2.5% to 3.7%) had a serious cardiac arrhythmia within 30 days from the index ED visit (median time to diagnosis 2 days [interquartile range 1 to 5 days]). The presence of nonsinus rhythm, multiple premature ventricular conductions, short PR interval, first-degree atrioventricular block, complete left bundle branch block, and Q wave/T wave/ST-segment abnormalities consistent with acute or chronic ischemia on the initial ED ECG increased the risk for a 30-day serious cardiac arrhythmia. This combination of ECG abnormalities had a similar sensitivity in predicting 30-day serious cardiac arrhythmia compared with any ECG abnormality (76.9% [95% CI 67.6% to 84.6%] versus 77.9% [95% CI 68.7% to 85.4%]) and was more specific (55.1% [95% CI 53.4% to 56.8%] versus 46.6% [95% CI 44.9% to 48.3%]).ConclusionIn older ED adults with syncope, approximately 3% receive a diagnosis of a serious cardiac arrhythmia not recognized on initial ED evaluation. The presence of specific abnormalities on the initial ED ECG increased the risk for 30-day serious cardiac arrhythmias.
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- 2018
34. Post-traumatic stress and future substance use outcomes: leveraging antecedent factors to stratify risk
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Garrison-Desany, Henri M., primary, Meyers, Jacquelyn L., additional, Linnstaedt, Sarah D., additional, House, Stacey L., additional, Beaudoin, Francesca L., additional, An, Xinming, additional, Zeng, Donglin, additional, Neylan, Thomas C., additional, Clifford, Gari D., additional, Jovanovic, Tanja, additional, Germine, Laura T., additional, Bollen, Kenneth A., additional, Rauch, Scott L., additional, Haran, John P., additional, Storrow, Alan B., additional, Lewandowski, Christopher, additional, Musey, Paul I., additional, Hendry, Phyllis L., additional, Sheikh, Sophia, additional, Jones, Christopher W., additional, Punches, Brittany E., additional, Swor, Robert A., additional, Gentile, Nina T., additional, Hudak, Lauren A., additional, Pascual, Jose L., additional, Seamon, Mark J., additional, Harris, Erica, additional, Pearson, Claire, additional, Peak, David A., additional, Domeier, Robert M., additional, Rathlev, Niels K., additional, O’Neil, Brian J., additional, Sergot, Paulina, additional, Sanchez, Leon D., additional, Bruce, Steven E., additional, Joormann, Jutta, additional, Harte, Steven E., additional, McLean, Samuel A., additional, Koenen, Karestan C., additional, and Denckla, Christy A., additional
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- 2024
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35. Sex differences in response inhibition-related neural predictors of PTSD in recent trauma-exposed civilians
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Borst, Bibian, primary, Jovanovic, Tanja, additional, House, Stacey L., additional, Bruce, Steven E., additional, Harnett, Nathaniel G., additional, Roeckner, Alyssa R., additional, Ely, Timothy D., additional, Lebois, Lauren A.M., additional, Young, Dmitri, additional, Beaudoin, Francesca L., additional, An, Xinming, additional, Neylan, Thomas C., additional, Clifford, Gari D., additional, Linnstaedt, Sarah D., additional, Germine, Laura T., additional, Bollen, Kenneth A., additional, Rauch, Scott L., additional, Haran, John P., additional, Storrow, Alan B., additional, Lewandowski, Christopher, additional, Musey, Paul I., additional, Hendry, Phyllis L., additional, Sheikh, Sophia, additional, Jones, Christopher W., additional, Punches, Brittany E., additional, Hudak, Lauren A., additional, Pascual, Jose L., additional, Seamon, Mark J., additional, Datner, Elizabeth M., additional, Pearson, Claire, additional, Peak, David A., additional, Domeier, Robert M., additional, Rathlev, Niels K., additional, O'Neil, Brian J., additional, Sergot, Paulina, additional, Sanchez, Leon D., additional, Harte, Steven E., additional, Koenen, Karestan C., additional, Kessler, Ronald C., additional, McLean, Samuel A., additional, Ressler, Kerry J., additional, Stevens, Jennifer S., additional, and van Rooij, Sanne J.H., additional
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- 2024
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36. Socio-demographic and trauma-related predictors of PTSD within 8 weeks of a motor vehicle collision in the AURORA study
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Kessler, Ronald C., Ressler, Kerry J., House, Stacey L., Beaudoin, Francesca L., An, Xinming, Stevens, Jennifer S., Zeng, Donglin, Neylan, Thomas C., Linnstaedt, Sarah D., Germine, Laura T., Musey, Jr., Paul I., Hendry, Phyllis L., Sheikh, Sophia, Storrow, Alan B., Jones, Christopher W., Punches, Brittany E., Datner, Elizabeth M., Mohiuddin, Kamran, Gentile, Nina T., McGrath, Meghan E., van Rooij, Sanne J., Hudak, Lauren A., Haran, John P., Peak, David A., Domeier, Robert M., Pearson, Claire, Sanchez, Leon D., Rathlev, Niels K., Peacock, William F., Bruce, Steven E., Miller, Mark W., Joormann, Jutta, Barch, Deanna M., Pizzagalli, Diego A., Sheridan, John F., Smoller, Jordan W., Pace, Thaddeus W. W., Harte, Steven E., Elliott, James M., Harnett, Nathaniel G., Lebois, Lauren A. M., Hwang, Irving, Sampson, Nancy A., Koenen, Karestan C., and McLean, Samuel A.
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- 2021
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37. Minimizing Attrition for Multisite Emergency Care Research
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Nicks, Bret A, Shah, Manish N, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Malveau, Susan E, Nishijima, Daniel K, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, Yagapen, Annick N, and Sun, Benjamin C
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Health Services ,Health and social care services research ,8.1 Organisation and delivery of services ,Aftercare ,Aged ,Data Collection ,Emergency Medical Services ,Health Services Research ,Humans ,Male ,Medical Records ,Middle Aged ,Multicenter Studies as Topic ,Patient Dropouts ,Patient Selection ,Prospective Studies ,Public Health and Health Services ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
Loss to follow-up of enrolled patients (a.k.a. attrition) is a major threat to study validity and power. Minimizing attrition can be challenging even under ideal research conditions, including the presence of adequate funding, experienced study personnel, and a refined research infrastructure. Emergency care research is shifting toward enrollment through multisite networks, but there have been limited descriptions of approaches to minimize attrition for these multicenter emergency care studies. This concept paper describes a stepwise approach to minimize attrition, using a case example of a multisite emergency department prospective cohort of over 3,000 patients that has achieved a 30-day direct phone follow-up attrition rate of
- Published
- 2017
38. Prognostic neuroimaging biomarkers of trauma-related psychopathology: resting-state fMRI shortly after trauma predicts future PTSD and depression symptoms in the AURORA study
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Harnett, Nathaniel G., van Rooij, Sanne J. H., Ely, Timothy D., Lebois, Lauren A. M., Murty, Vishnu P., Jovanovic, Tanja, Hill, Sarah B., Dumornay, Nathalie M., Merker, Julia B., Bruce, Steve E., House, Stacey L., Beaudoin, Francesca L., An, Xinming, Zeng, Donglin, Neylan, Thomas C., Clifford, Gari D., Linnstaedt, Sarah D., Germine, Laura T., Bollen, Kenneth A., Rauch, Scott L., Lewandowski, Christopher, Hendry, Phyllis L., Sheikh, Sophia, Storrow, Alan B., Musey, Jr., Paul I., Haran, John P., Jones, Christopher W., Punches, Brittany E., Swor, Robert A., McGrath, Meghan E., Pascual, Jose L., Seamon, Mark J., Mohiuddin, Kamran, Chang, Anna M., Pearson, Claire, Peak, David A., Domeier, Robert M., Rathlev, Niels K., Sanchez, Leon D., Pietrzak, Robert H., Joormann, Jutta, Barch, Deanna M., Pizzagalli, Diego A., Sheridan, John F., Harte, Steven E., Elliott, James M., Kessler, Ronald C., Koenen, Karestan C., Mclean, Samuel, Ressler, Kerry J., and Stevens, Jennifer S.
- Published
- 2021
- Full Text
- View/download PDF
39. Reliability of Clinical Assessments in Older Adults With Syncope or Near Syncope
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Nishijima, Daniel K, Laurie, Amber L, Weiss, Robert E, Yagapen, Annick N, Malveau, Susan E, Adler, David H, Bastani, Aveh, Baugh, Christopher W, Caterino, Jeffrey M, Clark, Carol L, Diercks, Deborah B, Hollander, Judd E, Nicks, Bret A, Shah, Manish N, Stiffler, Kirk A, Storrow, Alan B, Wilber, Scott T, and Sun, Benjamin C
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Biomedical and Clinical Sciences ,Clinical Sciences ,Patient Safety ,Cardiovascular ,Health Services ,Clinical Research ,Aged ,Aged ,80 and over ,Cross-Sectional Studies ,Emergency Service ,Hospital ,Female ,Hospitalization ,Humans ,Male ,Medical History Taking ,Middle Aged ,Observer Variation ,Physical Examination ,Reproducibility of Results ,Risk Factors ,Syncope ,Public Health and Health Services ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
ObjectivesClinical prediction models for risk stratification of older adults with syncope or near syncope may improve resource utilization and management. Predictors considered for inclusion into such models must be reliable. Our primary objective was to evaluate the inter-rater agreement of historical, physical examination, and electrocardiogram (ECG) findings in older adults undergoing emergency department (ED) evaluation for syncope or near syncope. Our secondary objective was to assess the level of agreement between clinicians on the patient's overall risk for death or serious cardiac outcomes.MethodsWe conducted a cross-sectional study at 11 EDs in adults 60 years of age or older who presented with unexplained syncope or near syncope. We excluded patients with a presumptive cause of syncope (e.g., seizure) or if they were unable or unwilling to follow-up. Evaluations of the patient's past medical history and current medication use were completed by treating provider and trained research associate pairs. Evaluations of the patient's physical examination and ECG interpretation were completed by attending/resident, attending/advanced practice provider, or attending/attending pairs. All evaluations were blinded to the responses from the other rater. We calculated the percent agreement and kappa statistic for binary variables. Inter-rater agreement was considered acceptable if the kappa statistic was 0.6 or higher.ResultsWe obtained paired observations from 255 patients; mean (±SD) age was 73 (±9) years, 137 (54%) were male, and 204 (80%) were admitted to the hospital. Acceptable agreement was achieved in 18 of the 21 (86%) past medical history and current medication findings, none of the 10 physical examination variables, and three of the 13 (23%) ECG interpretation variables. There was moderate agreement (Spearman correlation coefficient, r = 0.40) between clinicians on the patient's probability of 30-day death or serious cardiac outcome, although as the probability increased, there was less agreement.ConclusionsAcceptable agreement between raters was more commonly achieved with historical rather than physical examination or ECG interpretation variables. Clinicians had moderate agreement in assessing the patient's overall risk for a serious outcome at 30 days. Future development of clinical prediction models in older adults with syncope should account for variability of assessments between raters and consider the use of objective clinical variables.
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- 2016
40. Developing Safe Harbors to Address Malpractice Liability and Wasteful Health Care Spending
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Blumstein, James F., primary, McMichael, Benjamin J., additional, and Storrow, Alan B., additional
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- 2023
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41. Reward neurocircuitry predicts longitudinal changes in alcohol use following trauma exposure
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Hinojosa, Cecilia, primary, van Rooij, Sanne J.H., additional, Fani, Negar, additional, Ellis, Robyn A., additional, Harnett, Nathaniel G., additional, Lebois, Lauren, additional, Ely, Timothy D, additional, Jovanovic, Tanja, additional, Murty, Vishnu P., additional, House, Stacey L., additional, Beaudoin, Francesca, additional, An, Xinming, additional, Neylan, Thomas C., additional, Clifford, Gari D, additional, Linnstaedt, Sarah D., additional, Germine, Laura T., additional, Rauch, Scott L., additional, Haran, John P., additional, Storrow, Alan B., additional, Lewandowski, Christopher, additional, Musey, Paul I., additional, Hendry, Phyllis L., additional, Sheikh, Sophia, additional, Jones, Christopher W., additional, Punches, Brittany E., additional, Hudak, Lauren A., additional, Pascual, Jose L., additional, Seamon, Mark S., additional, Harris, Erica, additional, Pearson, Claire, additional, Peak, David A., additional, Merchant, Roland C., additional, Domeier, Robert M., additional, Rathlev, Niels K., additional, O'Neil, Brian J., additional, Sergot, Paulina, additional, Bruce, Steven E., additional, Pizzagalli, Diego A., additional, Sheridan, John F., additional, Harte, Steven E., additional, Koenen, Karestan C., additional, Kessler, Ronald C, additional, McLean, Samuel A., additional, Ressler, Kerry J., additional, and Stevens, Jennifer, additional
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- 2023
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42. When plasticity becomes pathological: Sequential decreases in basolateral amygdala response to threat cues predict failure to recover from PTSD
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Roeckner, Alyssa, primary, Lin, Esther R.-H, additional, Hinrichs, Rebecca, additional, Harnett, Nathaniel G, additional, Lebois, Lauren, additional, van Rooij, Sanne J H, additional, Ely, Timothy D, additional, Jovanovic, Tanja, additional, Murty, Vishnu P., additional, Bruce, Steven E., additional, House, Stacey L., additional, Beaudoin, Francesca, additional, An, Xinming, additional, Neylan, Thomas C., additional, Clifford, Gari D., additional, Linnstaedt, Sarah D., additional, Germine, Laura T., additional, Rauch, Scott L., additional, Haran, John P., additional, Storrow, Alan B., additional, Lewandowski, Christopher, additional, Musey, Paul I., additional, Hendry, Phyllis L., additional, Sheikh, Sophia, additional, Jones, Christopher W., additional, Punches, Brittany E., additional, Swor, Robert A., additional, Hudak, Lauren A., additional, Pascual, Jose L., additional, Seamon, Mark S., additional, Datner, Elizabeth M., additional, Pearson, Claire, additional, Peak, David A., additional, Merchant, Roland C., additional, Domeier, Robert M., additional, Rathlev, Niels K., additional, O'Neil, Brian J., additional, Sergot, Paulina, additional, Sanchez, Leon D., additional, Joormann, Jutta, additional, Sheridan, John F., additional, Harte, Steven E., additional, Koenen, Karestan C., additional, Kessler, Ronald C, additional, McLean, Samuel A., additional, Ressler, Kerry J., additional, and Stevens, Jennifer, additional
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- 2023
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43. Disentangling sex differences in PTSD risk factors: a systematic overview and multiple mediation analysis in the AURORA study
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Haering, Stephanie, primary, Seligowski, Antonia V., additional, Linnstaedt, Sarah D., additional, Michopoulos, Vasiliki, additional, House, Stacey L., additional, Beaudoin, Francesca, additional, An, Xinming, additional, Neylan, Thomas C., additional, Clifford, Gari D., additional, Germine, Laura T., additional, Rauch, Scott L., additional, Haran, John P., additional, Storrow, Alan B., additional, Lewandowski, Christopher, additional, Musey, Paul I., additional, Hendry, Phyllis L., additional, Sheikh, Sophia, additional, Jones, Christopher W., additional, Punches, Brittany E., additional, Swor, Robert A., additional, Gentile, Nina T., additional, Hudak, Lauren A., additional, Pascual, Jose L., additional, Seamon, Mark S., additional, Pearson, Claire, additional, Peak, David A., additional, Merchant, Roland C., additional, Domeier, Robert M., additional, Rathlev, Niels K., additional, O'Neil, Brian J., additional, Sanchez, Leon D., additional, Bruce, Steven E., additional, Harte, Steven E., additional, McLean, Samuel A., additional, Kessler, Ronald C, additional, Koenen, Karestan C., additional, Powers, Abigail, additional, and Stevens, Jennifer, additional
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- 2023
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44. An emergency care research course for healthcare career preparation
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Miller, Karen F., Das, Rishub K., Majors, Ciera D., Paz, Hadassah H., Robinson, Ayana N., Hamilton, Veronica F., Jackson, Brittney E., Collins, Sean P., and Storrow, Alan B.
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- 2021
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45. 2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure: A Report of the American College of Cardiology Solution Set Oversight Committee
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Hollenberg, Steven M., Warner Stevenson, Lynne, Ahmad, Tariq, Amin, Vaibhav J., Bozkurt, Biykem, Butler, Javed, Davis, Leslie L., Drazner, Mark H., Kirkpatrick, James N., Peterson, Pamela N., Reed, Brent N., Roy, Christopher L., and Storrow, Alan B.
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- 2019
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46. Early Management of Patients With Acute Heart Failure: State of the Art and Future Directions. A Consensus Document From the Society for Academic Emergency Medicine/Heart Failure Society of America Acute Heart Failure Working Group
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Collins, Sean, Storrow, Alan B, Albert, Nancy M, Butler, Javed, Ezekowitz, Justin, Felker, G Michael, Fermann, Gregory J, Fonarow, Gregg C, Givertz, Michael M, Hiestand, Brian, Hollander, Judd E, Lanfear, David E, Levy, Phillip D, Pang, Peter S, Peacock, W Frank, Sawyer, Douglas B, Teerlink, John R, Lenihan, Daniel J, and Group, SAEM HFSA Acute Heart Failure Working
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Emergency Care ,Clinical Research ,Health Services ,Aging ,Cardiovascular ,Heart Disease ,Acute Disease ,Consensus ,Disease Management ,Emergency Medicine ,Forecasting ,Heart Failure ,Humans ,Randomized Controlled Trials as Topic ,Societies ,Medical ,Time Factors ,United States ,Acute heart failure ,emergency medicine ,early management ,SAEM/HFSA Acute Heart Failure Working Group ,Cardiorespiratory Medicine and Haematology ,Nursing ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures.
- Published
- 2015
47. Early management of patients with acute heart failure: state of the art and future directions--a consensus document from the SAEM/HFSA acute heart failure working group.
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Collins, Sean P, Storrow, Alan B, Levy, Phillip D, Albert, Nancy, Butler, Javed, Ezekowitz, Justin A, Felker, G Michael, Fermann, Gregory J, Fonarow, Gregg C, Givertz, Michael M, Hiestand, Brian, Hollander, Judd E, Lanfear, David E, Pang, Peter S, Peacock, W Frank, Sawyer, Douglas B, Teerlink, John R, and Lenihan, Daniel J
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Humans ,Acute Disease ,Radiography ,Thoracic ,Electrocardiography ,Physical Examination ,Patient Discharge ,Risk Assessment ,Consensus ,Emergency Service ,Hospital ,Disease Management ,Clinical Trials as Topic ,Heart Failure ,Biomarkers ,Health Services ,Heart Disease ,Emergency Care ,Clinical Research ,Cardiovascular ,Clinical Sciences ,Public Health and Health Services ,Emergency & Critical Care Medicine - Abstract
Heart failure (HF) afflicts nearly 6 million Americans, resulting in 1 million emergency department (ED) visits and over 1 million annual hospital discharges. The majority of inpatient admissions originate in the ED; thus, it is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics, and alternatives to hospitalization. This article discusses contemporary ED management as well as the necessary next steps for ED-based acute HF research.
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- 2015
48. Accelerating Biomarker Discovery Through Electronic Health Records, Automated Biobanking, and Proteomics
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Wells, Quinn S., Gupta, Deepak K., Smith, J. Gustav, Collins, Sean P., Storrow, Alan B., Ferguson, Jane, Smith, Maya Landenhed, Pulley, Jill M., Collier, Sarah, Wang, Xiaoming, Roden, Dan M., Gerszten, Robert E., and Wang, Thomas J.
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- 2019
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49. Improvement in Kansas City Cardiomyopathy Questionnaire Scores After a Self-Care Intervention in Patients With Acute Heart Failure Discharged From the Emergency Department
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Stubblefield, William B., Jenkins, Cathy A., Liu, Dandan, Storrow, Alan B., Spertus, John A., Pang, Peter S., Levy, Phillip D., Butler, Javed, Chang, Anna Marie, Char, Douglas, Diercks, Deborah B., Fermann, Gregory J., Han, Jin H., Hiestand, Brian C., Hogan, Christopher J., Khan, Yosef, Lee, Sangil, Lindenfeld, JoAnn M., McNaughton, Candace D., Miller, Karen, Peacock, W. Frank, Schrock, Jon W., Self, Wesley H., Singer, Adam J., Sterling, Sarah A., and Collins, Sean P.
- Published
- 2021
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50. Validation of the Confusion Assessment Method for the Intensive Care Unit in Older Emergency Department Patients
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Han, Jin H, Wilson, Amanda, Graves, Amy J, Shintani, Ayumi, Schnelle, John F, Dittus, Robert S, Powers, James S, Vernon, John, Storrow, Alan B, and Ely, E Wesley
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Health Services ,Mental Health ,Clinical Research ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Confusion ,Delirium ,Emergency Service ,Hospital ,Female ,Humans ,Intensive Care Units ,Likelihood Functions ,Logistic Models ,Male ,Observer Variation ,Prospective Studies ,Psychiatric Status Rating Scales ,Reproducibility of Results ,Sensitivity and Specificity ,Public Health and Health Services ,Emergency & Critical Care Medicine ,Clinical sciences - Abstract
ObjectivesIn the emergency department (ED), health care providers miss delirium approximately 75% of the time, because they do not routinely screen for this syndrome. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is a brief (
- Published
- 2014
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