Risk Factors for Traumatic Intracranial Hemorrhage in Older Adults Sustaining a Head Injury in Ground-Level Falls: A Systematic Review and Meta-analysis.

Study Objective: Ground-level falls have become the leading cause of head injury in older adults. However, the risk factors for traumatic intracranial hemorrhage (ICH) in this population remain unclear. We aimed to identify risk factors for traumatic ICH in older patients who sustained a ground-level fall-related head injury presenting in the emergency department.

Emergency Department Use Prior to Cancer Diagnosis and Mortality.

Importance: The emergency department (ED) is a common yet understudied route to cancer diagnosis. It has been reported that over 1 in 3 patients in Ontario, Canada, used the ED prior to cancer diagnosis.

Objective: To examine the association between ED use in the 90 days prior to cancer diagnosis and subsequent mortality.

Validation of the ToDay, a simplified diagnostic algorithm for deep vein thrombosis.

Background: The current deep vein thrombosis (DVT) diagnostic algorithms are rarely followed in clinical practice due to complexity and time constraints. Simplified alternatives are needed to enhance adherence while maintaining diagnostic accuracy. The ToDay algorithm was developed to address these concerns by combining physician implicit assessment of DVT likelihood with D-dimer testing.

External validation of the DAYS score for suspected deep vein thrombosis.

Background: Diagnosing deep vein thrombosis (DVT) involves clinical assessment, D-dimer testing, and imaging. The DAYS score, a novel 2-item prediction tool combined with D-dimer, demonstrated promising performance but required external validation.

Objectives: This study aimed to validate 2 DVT prediction scores: the DAYS score and a newly developed DVT score.

Predictors of emergency physician adherence to standardized pulmonary embolism testing.

Objectives: An evidence-based pathway for pulmonary embolism testing was implemented in two academic emergency departments as part of a prospective management study (the PEGeD study). This study aimed to identify factors associated with emergency physicians not following (deviating from) the PEGeD pulmonary embolism testing pathway.

Methods: This was a health records review of cases from the PEGeD study which enrolled emergency patients with suspected pulmonary embolism.

Adjust-Unlikely pulmonary embolism testing using telephone recruitment: a pilot study to assess the feasibility of evaluating its safety and efficiency.

Background: Studies on pulmonary embolism (PE) rule-out strategies traditionally recruited patients in the ED. This method is increasingly impractical given excessive pressures experienced in EDs. Attempting to reach patients after leaving the ED may be more feasible.

Is pulmonary embolism a chronic disease?

Pulmonary embolism (PE) is often regarded as an acute disorder, yet emerging evidence underscores its chronic trajectory. Many survivors endure long-term complications, including recurrent thrombosis, persistent dyspnoea and psychosocial challenges. These sequelae impair functional capacity and quality of life long after the initial event.

An assessment of evidence to inform best practice for the communication of acute venous thromboembolism diagnosis: a scoping review.

Background: Physician communication with patients is a key aspect of excellent care. Scant evidence exists to inform best practice for physician communication in patients diagnosed with pulmonary embolism and deep vein thrombosis, collectively referred to as venous thromboembolism (VTE).

Objectives: The aim of this study was to summarize the existing literature on best practices for communication between healthcare providers and patients newly diagnosed with VTE.

Anticoagulation for patients discharged from the emergency department with venous thromboembolism.

Objective: Direct oral anticoagulants (DOACs) are increasingly being used over low molecular weight heparin (LMWH) and vitamin K antagonists for the treatment of venous thromboembolism (VTE). The objective of this study was to examine predictors of anticoagulant type (DOAC vs. LMWH) prescribed at discharge from the emergency department (ED) among patients diagnosed with VTE in the ED.

Evaluation of Head Injury in the Emergency Department.

This review summarizes the latest evidence in the evaluation of older adults presenting to the emergency department following head injury. The incidence of traumatic intracranial bleeding in older adults is rising. It is associated with significant morbidity and mortality.

Treatment of Critical Bleeds in Patients With Immune Thrombocytopenia: A Systematic Review.

Objectives: Evidence-based protocols for managing bleeding emergencies in patients with immune thrombocytopenia (ITP) are lacking. We conducted a systematic review of treatments for critical bleeding in patients with ITP.

Methods: We included all study designs and extracted data in aggregate or individually for patients who received one or more interventions and for whom any of the following outcomes were reported: platelet count response, bleeding, disability, or death.

Multidisciplinary Expert Guidance for the Management of Severe Bleeding on Oral Anticoagulation: An Algorithm for Practicing Clinicians.

Bleeding complications associated with oral anticoagulant (OAC) frequently lead to emergency department visits and hospitalization. Short-term all-cause mortality after severe bleeding is substantial ranging from approximately 10% for gastrointestinal bleeding (the most frequent single site) to approximately 50% for intracranial bleeding. A protocol for multidisciplinary approach to bleeding is needed to (i) ensure rapid identification of patients at risk of adverse outcomes, (ii) optimize delivery of supportive measures, (iii) treat the source of bleeding, and (iv) administer anticoagulant reversal or hemostatic therapies judiciously for patients most likely to benefit.

Emergency department use before cancer diagnosis in Ontario, Canada: a population-based study.

Background: Although suspicions of cancer may be raised in patients who visit the emergency department, little is known about emergency department use before a cancer diagnosis. We sought to describe emergency department use among patients in Ontario within the 90 days before confirmed cancer diagnosis and to evaluate factors associated with this emergency department use.

Methods: We conducted a retrospective, population-based study of patients aged 18 years or older who had a confirmed cancer diagnosis in Ontario from 2014 to 2021 using linked administrative databases.

Pathways to cancer care after a suspected cancer diagnosis in the emergency department: a survey of emergency physicians across Ontario.

Introduction: Little is known about how patients are managed after a suspected cancer diagnosis through the emergency department. The objective of this study was to examine the ED management, specifically referral practices, for ten suspected cancer diagnoses by emergency physicians across Ontario and to explore variability in management by cancer-type and centre.

Methods: An electronic survey was distributed to emergency physicians across Ontario, asking about referral practices for patients who could be discharged from the ED with one of ten suspected cancer diagnoses.

Which adults aged 65 and older are at low-risk for cervical spine injuries after low-level falls?

Objectives: The population is aging and falls are a common reason for emergency department visits. Appropriate imaging in this population is important. The objectives of this study were to estimate the prevalence of cervical spine injury and identify factors associated with cervical spine injuries in adults ≥ 65 years after low-level falls.