Pub Date : 2026-03-25DOI: 10.1016/j.annemergmed.2026.02.007
Marissa Tremoglie-Barkowski, Erin Feeney, Leah Furman, Francis X Guyette, Jason L Sperry, Christine M Leeper
{"title":"Exception From Informed Consent Enrollment in Three Hemorrhagic Shock Trials.","authors":"Marissa Tremoglie-Barkowski, Erin Feeney, Leah Furman, Francis X Guyette, Jason L Sperry, Christine M Leeper","doi":"10.1016/j.annemergmed.2026.02.007","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.02.007","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-24DOI: 10.1016/j.annemergmed.2026.02.010
Justina Mounir Henein, Alina Denham
{"title":"Urgent Care and Emergency Department Visitors: A Latent Class Analysis","authors":"Justina Mounir Henein, Alina Denham","doi":"10.1016/j.annemergmed.2026.02.010","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.02.010","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"9 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-24DOI: 10.1016/j.annemergmed.2026.02.011
Corey Hazekamp, Howard Kim
{"title":"Current Practice Patterns for Treating Alcohol Use Disorder in US Emergency Departments","authors":"Corey Hazekamp, Howard Kim","doi":"10.1016/j.annemergmed.2026.02.011","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.02.011","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"57 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.annemergmed.2026.02.013
Crystal PHEND
{"title":"After a Rough Year for Air Ambulance Accidents, the Field Looks for a Way Forward on Safety","authors":"Crystal PHEND","doi":"10.1016/j.annemergmed.2026.02.013","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.02.013","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"31 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.annemergmed.2025.11.010
Nikita Joshi
{"title":"A Country Doctor's Notebook","authors":"Nikita Joshi","doi":"10.1016/j.annemergmed.2025.11.010","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.11.010","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"16 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.annemergmed.2025.09.039
Nikita Joshi
{"title":"Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital","authors":"Nikita Joshi","doi":"10.1016/j.annemergmed.2025.09.039","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.09.039","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"59 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.annemergmed.2026.01.023
Nicholas W Rizer,Eili Klein,Martin S Copenhaver,Xihan Zhao,Gabor D Kelen,Jeremiah S Hinson
STUDY OBJECTIVETo define the incidence and identify factors associated with early clinical deterioration among patients boarding in the emergency department (ED).METHODSWe conducted a retrospective study of adult ED patients admitted to internal medicine or medicine subspecialty services at a floor level of care who boarded between 4 and 48 hours within a 5-hospital academic health system from January 2018 to June 2024. Early deterioration was any escalation from floor to intermediate or intensive level of care within 48 hours of admission order. Logistic regression models were employed to estimate adjusted odds ratios (aOR). Covariates included boarding time, demographics, comorbidities, vital signs, laboratory values, ED and hospital census, overnight admission, and socioeconomic status.RESULTSAmong 173,168 consecutive encounters meeting enrollment criteria, 6,299 (3.6%) experienced deterioration; 2,823 (45%) occurred while still in the ED. Median boarding time was 12.5 hours (interquartile range [IQR]: 8.2 to 20.7 hours) for those with deterioration versus 10.2 hours (IQR: 6.9 to 18.3) for those without. Boarding duration was associated with deterioration both overall (aOR: 1.17, 95% confidence interval [CI] 1.10 to 1.24) and deterioration occurring in the ED (aOR 1.58, 95% CI 1.46 to 1.71) with a 0.8% and 2.4% increased relative risk for each excess hour of boarding, respectively. Other independent predictors included care at an academic safety-net hospital (aOR 2.41; 95% CI 2.17 to 2.67), overnight admission (aOR 1.29; 95% CI 1.21 to 1.38), and elevated lactate (aOR 1.93; 95% CI 1.72 to 2.17). The 28-day mortality rate was higher in patients experiencing deteriorations (13.0% vs 3.9%, OR 3.66, 95% CI 3.38 to 3.96).CONCLUSIONSEarly clinical deterioration occurs with a meaningful frequency among ED boarders. Boarding duration was independently associated with increased odds of early clinical deterioration, an event known to increase morbidity and mortality. These data underscore the considerable patient safety risks inherent to boarding.
研究目的确定急诊科（ED）住院患者早期临床恶化的发生率和相关因素。方法：我们对2018年1月至2024年6月在5家医院学术卫生系统内住院4至48小时的基层内科或医学亚专科服务的成年ED患者进行了回顾性研究。早期恶化是指在入院后48小时内从基层护理升级到中级或重症护理。采用Logistic回归模型估计校正优势比（aOR）。协变量包括登机时间、人口统计、合并症、生命体征、实验室值、急诊科和医院普查、过夜住院和社会经济地位。结果在符合入组标准的173168例患者中，6299例（3.6%）出现病情恶化；2,823例（45%）发生在仍在急诊室的情况下。病情恶化的患者登机时间中位数为12.5小时（四分位数范围[IQR]: 8.2至20.7小时），而没有病情恶化的患者登机时间中位数为10.2小时（IQR: 6.9至18.3）。登机时间与总体恶化（aOR: 1.17, 95%可信区间[CI] 1.10至1.24）和ED恶化（aOR 1.58, 95% CI 1.46至1.71）相关，每多登机一小时，相对风险分别增加0.8%和2.4%。其他独立预测因素包括在学术安全网医院接受治疗（aOR 2.41; 95% CI 2.17至2.67）、过夜住院（aOR 1.29; 95% CI 1.21至1.38）和乳酸水平升高（aOR 1.93; 95% CI 1.72至2.17）。出现病情恶化的患者28天死亡率更高（13.0% vs 3.9%, OR 3.66, 95% CI 3.38 ~ 3.96）。结论急诊科寄宿生出现早期临床恶化的频率较高。入住时间与早期临床恶化的几率增加独立相关，早期临床恶化已知会增加发病率和死亡率。这些数据强调了登机所固有的相当大的患者安全风险。
{"title":"Early Clinical Deterioration Among Emergency Department Boarders: A Retrospective Analysis.","authors":"Nicholas W Rizer,Eili Klein,Martin S Copenhaver,Xihan Zhao,Gabor D Kelen,Jeremiah S Hinson","doi":"10.1016/j.annemergmed.2026.01.023","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.01.023","url":null,"abstract":"STUDY OBJECTIVETo define the incidence and identify factors associated with early clinical deterioration among patients boarding in the emergency department (ED).METHODSWe conducted a retrospective study of adult ED patients admitted to internal medicine or medicine subspecialty services at a floor level of care who boarded between 4 and 48 hours within a 5-hospital academic health system from January 2018 to June 2024. Early deterioration was any escalation from floor to intermediate or intensive level of care within 48 hours of admission order. Logistic regression models were employed to estimate adjusted odds ratios (aOR). Covariates included boarding time, demographics, comorbidities, vital signs, laboratory values, ED and hospital census, overnight admission, and socioeconomic status.RESULTSAmong 173,168 consecutive encounters meeting enrollment criteria, 6,299 (3.6%) experienced deterioration; 2,823 (45%) occurred while still in the ED. Median boarding time was 12.5 hours (interquartile range [IQR]: 8.2 to 20.7 hours) for those with deterioration versus 10.2 hours (IQR: 6.9 to 18.3) for those without. Boarding duration was associated with deterioration both overall (aOR: 1.17, 95% confidence interval [CI] 1.10 to 1.24) and deterioration occurring in the ED (aOR 1.58, 95% CI 1.46 to 1.71) with a 0.8% and 2.4% increased relative risk for each excess hour of boarding, respectively. Other independent predictors included care at an academic safety-net hospital (aOR 2.41; 95% CI 2.17 to 2.67), overnight admission (aOR 1.29; 95% CI 1.21 to 1.38), and elevated lactate (aOR 1.93; 95% CI 1.72 to 2.17). The 28-day mortality rate was higher in patients experiencing deteriorations (13.0% vs 3.9%, OR 3.66, 95% CI 3.38 to 3.96).CONCLUSIONSEarly clinical deterioration occurs with a meaningful frequency among ED boarders. Boarding duration was independently associated with increased odds of early clinical deterioration, an event known to increase morbidity and mortality. These data underscore the considerable patient safety risks inherent to boarding.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"45 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.annemergmed.2026.02.001
Obadi Obadi,Elizabeth S Bermudez,Brit Long
{"title":"Does the Addition of Subcutaneous Basal Insulin Administration Safely Improve Outcomes of Diabetic Ketoacidosis Compared With Intravenous Insulin Infusion Alone?","authors":"Obadi Obadi,Elizabeth S Bermudez,Brit Long","doi":"10.1016/j.annemergmed.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.02.001","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"146 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.annemergmed.2026.02.014
{"title":"Global Research Highlights","authors":"","doi":"10.1016/j.annemergmed.2026.02.014","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.02.014","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"44 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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