A5046200315- Emergency and Acute Care Studies
- Cardiac Arrest and Resuscitation
- Trauma and Emergency Care Studies
- Healthcare Policy and Management
- Telemedicine and Telehealth Implementation
- Childhood Cancer Survivors' Quality of Life
- Sepsis Diagnosis and Treatment
- Venous Thromboembolism Diagnosis and Management
- Airway Management and Intubation Techniques
- Palliative Care and End-of-Life Issues
- Intensive Care Unit Cognitive Disorders
- COVID-19 and Mental Health
- Chronic Disease Management Strategies
- Nausea and vomiting management
- COVID-19 and healthcare impacts
- Ultrasound in Clinical Applications
- Innovations in Medical Education
- Anesthesia and Pain Management
- Hip and Femur Fractures
- Clinical Reasoning and Diagnostic Skills
- Healthcare Systems and Technology
- Cancer survivorship and care
- Cardiac Arrhythmias and Treatments
- Frailty in Older Adults
- Restraint-Related Deaths
Leiden University Medical Center
2008-2022
Leiden University
2018
University of Freiburg
2006
Objectives To study predictors of emergency department (ED) revisits and the association between ED 90‐day functional decline or mortality. Design Multicenter cohort study. Setting One academic two regional Dutch hospitals. Participants Older adults discharged from (N=1,093). Measurements At baseline, data on demographic characteristics, illness severity, geriatric parameters (cognition, capacity) were collected. All participants prospectively followed for an unplanned revisit within 30 days...
Patients with advanced cancer commonly visit the emergency department (ED) during last 3 months of life. Identification these patients and their palliative care needs help initiating appropriate according to patients' wishes. Our objective was provide insight into ED visits at end life.Adult solid tumours who died < after were included (2011-2014). Patients, visits, follow-up described. Factors associated approaching death assessed using Cox proportional hazards models.Four hundred twenty...
<b>Tele-monitoring during the COVID-19 pandemic is recognised as a safe strategy to monitor patients at home. This first controlled study that demonstrates effectiveness of home monitoring reduce hospital admissions 28-day follow-up.</b>https://bit.ly/39vvngH
Emergency department (ED) overcrowding is a potential threat for patient safety. We searched independent determinants of prolonged ED length stay (LOS) with the aim to identify factors which can be targeted reduce LOS, may help in preventing overcrowding. This prospective cohort study included consecutive patients Dutch tertiary care centre. Multivariable logistic regression analysis was used LOS > 4 h, including characteristics (demographics, referral type, acuity, (number of) presenting...
Objective The aim of this study was to develop models that predict hospital admission ED patients younger and older than 70 compare their performance. Methods Prediction were derived in a retrospective observational all patients≥18 years old visiting the university during first 6 months 2012. Patients stratified into two age groups (<70 ≥70 old). Multivariable logistic regression analysis used identify predictors among factors available immediately after patient arrival ED. Validation...
Survival to hospital discharge after out-of-hospital cardiac arrest (OHCA) varies widely. This study describes short-term survival OHCA in a region with an extensive care path and follow-up of 1 year.Consecutive patients ≥16 years admitted the emergency department between April 2011 December 2012 were included. In July 2014 took place. Socio-demographic data, characteristics interventions described associations determined.Two hundred forty-two included (73 % male, median age 65 years). 76...
Background In Dutch ambulance practice, failure or inability to intubate patients with altered oxygenation and/or ventilation leaves bag-valve mask as the only alternative, which is undesirable for patient outcome. A novel Laryngeal Mask Airway Supreme (LMA-S) device may be a suitable alternative. Aim To evaluate effectiveness and suitability of LMA-S emergency medical services in daily out-of-hospital practice. Methods After period theoretical practical training paramedics use LMA-S,...
Patients with hematological malignancies (HM) have more unpredictable disease trajectories compared to patients advanced solid tumors (STs) and miss opportunities for a palliative care approach. They often undergo intensive disease-directed treatments until the end of life frequent emergency department (ED) visits in-hospital deaths. Insight into end-of-life quality can support arranging appropriate according patients' wishes.Mortality follow-back study compare HM ST who died <3 months after...
Background: The surprise question (SQ), "Would I be surprised if this patient died within one year?", is a simple instrument to identify patients with palliative care needs. SQ-performance has not been evaluated in advanced cancer visiting the emergency department (ED). Objective: To evaluate SQ's test characteristics and predictive value ED. Design: Observational cohort study. Setting: Patients >18 years phase ED of an academic medical center. Methods: Attending physicians answered SQ (not...
High intra-operative oxygen concentration reportedly reduces postoperative nausea and vomiting (PONV), but recent data are conflicting. Therefore, we tested whether the effectiveness of supplemental depends on endpoint (nausea vs. vomiting), observation interval (early late) or surgical field (abdominal non-abdominal). We randomly assigned 560 adult patients undergoing various elective procedures with a PONV risk at least 40% to 80% (supplemental) 30% (control). Potential confounding factors...
to investigate whether cognitive impairment, measured early after Emergency Department (ED) arrival and irrespective of its cause, is independently associated with functional decline or mortality 3 12 months in older ED patients.a prospective multi-centre cohort study all Acutely Presenting Older Patients visiting the (APOP study) three hospitals Netherlands.2,130 patients, ≥70 years.data on demographics, disease severity geriatric characteristics were collected during first hour visit....
Abstract Background The increasing demand for acute care and restructuring of hospitals resulting in emergency department (ED) closures fewer inpatient beds are reasons to improve ED efficiency. approach towards the patient process varies among doctors. objective this study was determine variations flow physicians (EP’s) internists at Leiden University Medical Centre (LUMC), Netherlands. Methods An observational instrument developed during a pilot LUMC ED, following observations activities...
To evaluate the impact of implemented procedures for out-of-hospital cardiac arrests (OHCAs) by determining patient outcome defined as percentage return spontaneous circulation at arrival emergency department, and 3-month 1-year-survival rates.Observational study.Primary medical care consisting Advanced Life Support is given ambulance nurses secondary hospitals within mid-western part Netherlands covering 750 000 inhabitants.433 500 consecutive patients with OHCA were included in study over...
Older people frequently attend the emergency department (ED) and have a high risk of poor outcome as compared to their younger counterparts. Our aim was study routinely collected clinical parameters predictors 90-day mortality in older patients attending our ED. We conducted retrospective follow-up at Leiden University Medical Center (The Netherlands) among aged 70 years or ED 2012. Predictors were age, gender, time way arrival, presenting complaint, consulting medical specialty, vital...
Objective Consultations occur frequently in the emergency department (ED) of tertiary care centres and pose a threat for patient safety as they contribute to ED lengths stay (LOS) overcrowding. The aim this study was investigate reasons appropriateness consultations, relative impact specialty characteristics on probability consultation, because could help improve efficiency care. Methods This prospective cohort included patients presenting Dutch centre setting where physicians mostly treat...
A combination of unexplained peripheral neuropathy, hypoparathyroidism, and the inability to cope with metabolic stress could point a rare inborn error metabolism, such as mitochondrial trifunctional protein (MTP) deficiency.Here, we describe 20-year-old woman who was known since childhood axonal motor sensory polyneuropathy unknown origin. She presented progressive dyspnoea, increased muscle weakness, preceded by 6 days fever, vomiting, diarrhoea. Laboratory testing showed rhabdomyolysis,...
Background/Objectives Cognitive impairment is a frequent problem among older patients attending the Emergency Department (ED) and can be result of pre-existing cognitive impairment, delirium, or neurologic disorders. Another cause also acute disturbance brain perfusion oxygenation, which may reversed by optimal resuscitation. This study aimed to assess relationship between vital signs, as measure hemodynamic changes, in ED patients. Design Prospective cohort Setting ED's two tertiary care...
Emergency airway management can be particularly challenging in patients entrapped crashed cars because of limited access. The aim this study was to analyse the feasibility four different devices various standardized settings utilized by paramedics and emergency physicians.Twenty-five 25 physicians were asked perform advanced a manikin car's left front seat, with access patient through opened driver's door or from back seat. Available included Macintosh Airtraq laryngoscopes, as well...
During the COVID-19 pandemic, several home monitoring programs have described success of reducing hospital admissions, but only a few studies investigated experiences patients and health care professionals.The objective our study was to determine patients' professionals' satisfaction with employing COVID-box.In this single-center, retrospective, observational study, professionals were asked anonymously fill out multiple-choice questionnaires questions on 5-point or 10-point Likert scale. The...
To evaluate whether a text message (TM) alert system for trained volunteers contributed to early cardiopulmonary resuscitation, the use of automated external defibrillators (AEDs), return spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA) patients region with above-average rates.Data on all OHCA 2012 (non-TM group) were compared those 2018 (TM group). The association presence TM ROSC was assessed multivariate regression analyses.TM responders reached 42...
Background Older patients experience high rates of adverse outcomes after an emergency department ( ED ) visit. Early identification those at risk could guide preventive interventions and tailored treatment decisions, but available models perform poorly in discriminating highest risk. This study aims to develop validate a prediction model for functional decline mortality older presenting our . Methods A multicenter prospective follow‐up s the Leiden University Medical Center LUMC ;...