Characteristics of emergency department admissions with congestive heart failure in the United States: a Nationwide cross-sectional study.

BACKGROUND: To understand the characteristics and clinical presentation of patients with Congestive Heart Failure (CHF) visiting the emergency department (ED), and to examine the factors associated with clinical outcomes and medical resource utilization amongst the studied population. METHODS: We analyzed the 2014-2016 ED visit data collected by the National Hospital Ambulatory Medical Care Survey Emergency Department Subfile. We described patients' characteristics and clinical outcomes after ED visits with CHF vs. without CHF. Logistic regression models were used to estimate the association between these characteristics and CHF. RESULTS: ED visits with CHF visits represented 3.9% of annual ED visits (3,647,113 out of 92,899,685). ED patients with CHF were mostly non-Hispanic White (69.9%). Compared with other ED patients, those with CHF were older, including 71.2% that were were older than 60. ED patients with CHF were more likely to be admitted to the hospital (aOR: 2.56; 95% CI: 2.28-2.87) and intensive care unit (ICU) (aOR: 2.19; 95% CI: 1.77-2.71). CONCLUSIONS: This study describes the demographic, socioeconic, and clinical characteristics of patients who present to the ED with CHF through analysis of a comprehensive national survey. These patients require a higher level of emergency care due to their higher chance of admittance to the hospital and ICU.

Emergency department use by patients with end-stage renal disease in the United States.

BACKGROUND: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. METHODS: We analyzed data from 2014 to 2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD and compared these to those of patients without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. RESULTS: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits represented ESRD patients. Males were more likely to be ESRD patients than females (aOR: 1.34; 95% CI: 1.09-1.66). Compare to whites, non-Hispanic Blacks were 2.55 times more likely to have ESRD (aOR: 2.55; 95% CI: 1.97-3.30), and Hispanics were 2.68 times more likely to have ESRD (95% CI: 1.95-3.69). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.70; 95% CI: 2.13-3.41) and intensive care unit (ICU) (aOR: 2.21; 95% CI: 1.45-3.38) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests and get radiology tests. CONCLUSION: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients' higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.