2023
Sociodemographic Disparities in Queue Jumping for Emergency Department Care
Sangal R, Su H, Khidir H, Parwani V, Liebhardt B, Pinker E, Meng L, Venkatesh A, Ulrich A. Sociodemographic Disparities in Queue Jumping for Emergency Department Care. JAMA Network Open 2023, 6: e2326338. PMID: 37505495, PMCID: PMC10383013, DOI: 10.1001/jamanetworkopen.2023.26338.Peer-Reviewed Original ResearchConceptsCross-sectional studyHigh acuityPatient demographicsSame acuityLatino ethnicityNon-Hispanic raceEmergency department careBed placementTime of triageNon-Hispanic blacksNon-Hispanic whitesED visitsPrimary outcomeED arrivalED patientsMedicaid insuranceMean ageTriage acuityStudy visitAcuity patientsSociodemographic disparitiesED outcomesHigher oddsMAIN OUTCOMECare access
2021
Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act
Sangal RB, Powers E, Rothenberg C, Ndumele C, Ulrich A, Hsiao A, Venkatesh AK. Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act. Annals Of Emergency Medicine 2021, 78: 593-598. PMID: 34353651, DOI: 10.1016/j.annemergmed.2021.06.014.Peer-Reviewed Original ResearchConceptsProportion of patientsPatient portal accessEmergency departmentOpen notesClinical notesPortal accessPublic insuranceUrgent care centersCentury Cures ActDifferent patient demographicsSingle health systemPatient demographicsPrimary outcomeCures ActPatient utilizationPatient visitsCare centerObservational studyPatientsDigital health toolsAge 18Health systemHealth toolsUnique barriersNon-English speakers
2020
The cost of waiting: Association of ED boarding with hospitalization costs
Baloescu C, Kinsman J, Ravi S, Parwani V, Sangal RB, Ulrich A, Venkatesh AK. The cost of waiting: Association of ED boarding with hospitalization costs. The American Journal Of Emergency Medicine 2020, 40: 169-172. PMID: 33272871, DOI: 10.1016/j.ajem.2020.10.058.Peer-Reviewed Original ResearchConceptsED boardingHospitalization costsED crowdingHospital spendingHospital care accessMultivariate linear regression analysisED patient volumeCost of careQuality of careEmergency department boardingCross-sectional analysisPublic health crisisED lengthEffective careCare accessHospital levelInpatient bedsED characteristicsLinear regression analysisPatient volumeCareMedicare spendingMultivariate regressionPatientsRegression analysisIdentification of Patients with Nontraumatic Intracranial Hemorrhage Using Administrative Claims Data
Sangal RB, Fodeh S, Taylor A, Rothenberg C, Finn EB, Sheth K, Matouk C, Ulrich A, Parwani V, Sather J, Venkatesh A. Identification of Patients with Nontraumatic Intracranial Hemorrhage Using Administrative Claims Data. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105306. PMID: 33070110, PMCID: PMC7686163, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105306.Peer-Reviewed Original ResearchAssociation between patient-physician gender concordance and patient experience scores. Is there gender bias?
Chekijian S, Kinsman J, Taylor RA, Ravi S, Parwani V, Ulrich A, Venkatesh A, Agrawal P. Association between patient-physician gender concordance and patient experience scores. Is there gender bias? The American Journal Of Emergency Medicine 2020, 45: 476-482. PMID: 33069544, DOI: 10.1016/j.ajem.2020.09.090.Peer-Reviewed Original ResearchConceptsPatient satisfaction surveyFemale patientsProvider scoresOverall assessment scoreEmergency departmentPatient satisfactionPhysician genderPatient-physician gender concordanceFemale physiciansAssessment scoresGender concordancePatient satisfaction survey dataSatisfaction surveyEffect of patientFemale emergency physiciansPatient experience scoresLogistic regression modelsCross-sectional analysisElectronic health recordsPatients' oddsAdult patientsPatient genderEmergency physiciansLower oddsEmergency careAssociation between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system?
Lord K, Rothenberg C, Parwani V, Finn E, Khan A, Sather J, Ulrich A, Chaudhry S, Venkatesh A. Association between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system? The American Journal Of Emergency Medicine 2020, 45: 548-550. PMID: 32839053, DOI: 10.1016/j.ajem.2020.07.040.Peer-Reviewed Original Research
2018
Emergency physician empathy does not explain variation in admission rates
Parwani V, Ashkenasi D, Rothenberg C, Ulrich A, Chekijian S, Shapiro M, Melnick E, Venkatesh A. Emergency physician empathy does not explain variation in admission rates. The American Journal Of Emergency Medicine 2018, 37: 767-768. PMID: 30220643, DOI: 10.1016/j.ajem.2018.08.025.Peer-Reviewed Original ResearchReal-Time Surveys Reveal Important Safety Risks During Interhospital Care Transitions for Neurologic Emergencies
Sather J, Rothenberg C, Finn EB, Sheth KN, Matouk C, Pham L, Parwani V, Ulrich A, Venkatesh AK. Real-Time Surveys Reveal Important Safety Risks During Interhospital Care Transitions for Neurologic Emergencies. American Journal Of Medical Quality 2018, 34: 53-58. PMID: 29987938, DOI: 10.1177/1062860618785248.Peer-Reviewed Original ResearchConceptsEmergency departmentMultidisciplinary quality improvement effortNeuroscience intensive care unitTertiary health care systemIll neurologic patientsIntensive care unitAdvanced practice providersHealth care systemQuality improvement effortsClinician typeIll patientsNeurologic emergencyCare unitCare transitionsClinical surveyNeurologic patientsPractice providersPatient transferCare systemImportant safety risksPatientsRiskReal-time surveySafety risksImprovement effortsEmergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service
Lord K, Parwani V, Ulrich A, Finn EB, Rothenberg C, Emerson B, Rosenberg A, Venkatesh AK. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. The American Journal Of Emergency Medicine 2018, 36: 1246-1248. PMID: 29605480, DOI: 10.1016/j.ajem.2018.03.043.Peer-Reviewed Original ResearchConceptsAdverse hospitalization outcomesRapid response team activationGeneral medical servicesHospitalization outcomesEmergency departmentED boardingComposite outcomeCare escalationPrimary outcomeAdverse outcomesRRT activationPatient encountersConsecutive patient encountersGeneral medicine serviceInpatient hospital stayMedical servicesEmergency department boardingED departureHospital mortalityHospital deathHospital stayED admissionPatient demographicsHospital admissionIntensive careSpontaneous rupture of the ascending aorta
Bin Mahmood SU, Ulrich A, Safdar B, Geirsson A, Mangi AA. Spontaneous rupture of the ascending aorta. Journal Of Cardiac Surgery 2018, 33: 107-114. PMID: 29405382, DOI: 10.1111/jocs.13535.Peer-Reviewed Original ResearchConceptsAortic ruptureAortic diameterSpontaneous ruptureHereditary connective tissue disordersHigh-risk patientsConnective tissue disordersOperating room timeRisk of ruptureOperative mortalityChest painMedian doorMost patientsAortic diseaseTissue disordersRoom timePatientsRapid diagnosisSuccessful managementMultidisciplinary approachEmergency protocolsAortaRuptureHypertensionPainEtiologyOpening of Psychiatric Observation Unit Eases Boarding Crisis
Parwani V, Tinloy B, Ulrich A, D'Onofrio G, Goldenberg M, Rothenberg C, Patel A, Venkatesh A. Opening of Psychiatric Observation Unit Eases Boarding Crisis. Academic Emergency Medicine 2018, 25: 456-460. PMID: 29266537, DOI: 10.1111/acem.13369.Peer-Reviewed Original ResearchConceptsED LOSLength of stayMedian ED LOSTotal LOSPsychiatric admission ratesCrisis intervention unitSecondary outcomesPrimary outcomeObservation unitAdmission ratesPrimary analysisTertiary care academic medical centerPsychiatric chief complaintsBehavioral health staffInpatient psychiatric bedsAcute psychiatric careAcademic medical centerHours of careEmergency department boardingAdult EDAdult patientsPreintervention periodChief complaintPediatric hospitalInpatient admissions
2017
Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016
Tomassoni AJ, Hawk KF, Jubanyik K, Nogee DP, Durant T, Lynch KL, Patel R, Dinh D, Ulrich A, D’Onofrio G. Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016. MMWR Morbidity And Mortality Weekly Report 2017, 66: 107-111. PMID: 28151928, PMCID: PMC5657834, DOI: 10.15585/mm6604a4.Peer-Reviewed Case Reports and Technical NotesConceptsIntensive care unitEmergency departmentYale-New Haven HospitalEmergency medical services (EMS) crewsInterviews of patientsContinuous naloxone infusionNew Haven HospitalPublic health alertsRespiratory failureCare unitNaloxone infusionEndotracheal intubationOpioid overdoseNaloxone distributionPatientsRoute of intoxicationSubsequent episodesHealth alertsOpioid antidoteFentanylHospitalPublic healthFamily membersCocaineRapid notification
2014
The Initial Response to the Boston Marathon Bombing
Gates JD, Arabian S, Biddinger P, Blansfield J, Burke P, Chung S, Fischer J, Friedman F, Gervasini A, Goralnick E, Gupta A, Larentzakis A, McMahon M, Mella J, Michaud Y, Mooney D, Rabinovici R, Sweet D, Ulrich A, Velmahos G, Weber C, Yaffe MB. The Initial Response to the Boston Marathon Bombing. Annals Of Surgery 2014, 260: 960-966. PMID: 25386862, PMCID: PMC5531449, DOI: 10.1097/sla.0000000000000914.Peer-Reviewed Original ResearchConceptsTrauma centerExcellent outcomesUrgent surgical interventionLower extremity soft tissueInitial responseExtremity soft tissueMultidisciplinary care deliveryMultiple casualty incidentsUnderwent amputationHospital mortalityBony injuriesSurgical interventionMedical responseLower extremitiesAdequate preparationPatientsCare deliveryField tourniquetsOperating roomOptimal outcomesSoft tissueImmediate fatalitiesOutcomesCasualty incidentsCentral database
2011
Impact of an Emergency Department Closure on the Local Emergency Medical Services System
Sayed M, Mitchell PM, White LF, Rubin-Smith JE, Maciejko TM, Obendorfer DT, Ulrich AS, Dyer S, Olshaker JS. Impact of an Emergency Department Closure on the Local Emergency Medical Services System. Prehospital Emergency Care 2011, 16: 198-203. PMID: 22191683, DOI: 10.3109/10903127.2011.640418.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAmbulancesBostonConfidence IntervalsEmergency Medical ServicesEmergency Service, HospitalEmergency TreatmentFemaleHumansMaleMassachusettsNeeds AssessmentOutcome Assessment, Health CareProspective StudiesRisk AssessmentTime FactorsTransportation of PatientsTrauma CentersUrban PopulationConceptsBoston Medical CenterEmergency departmentED volumeUrban EMS systemED closureAmbulance diversionLocal emergency medical services systemAdult patient visitsEmergency department closureMean emergency departmentTotal ED volumeRatio of patientsEmergency medical services (EMS) providersBusy emergency departmentEmergency medical services systemSignificant increaseEmergency medical servicesEMS systemMedical services systemPatient visitsMedical CenterMedical service providersHospital destinationMultivariate analysisSignificant decrease
2009
Abdominal 64-MDCT for suspected appendicitis: the use of oral and IV contrast material versus IV contrast material only.
Anderson SW, Soto JA, Lucey BC, Ozonoff A, Jordan JD, Ratevosian J, Ulrich AS, Rathlev NK, Mitchell PM, Rebholz C, Feldman JA, Rhea JT. Abdominal 64-MDCT for suspected appendicitis: the use of oral and IV contrast material versus IV contrast material only. American Journal Of Roentgenology 2009, 193: 1282-8. PMID: 19843742, DOI: 10.2214/ajr.09.2336.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal PainAcute DiseaseAdministration, OralAdultAgedAged, 80 and overAppendicitisArea Under CurveContrast MediaDiagnosis, DifferentialFemaleHumansInjections, IntravenousMaleMiddle AgedRadiographic Image Interpretation, Computer-AssistedRadiography, AbdominalReference StandardsROC CurveSensitivity and SpecificityTomography, X-Ray ComputedTriiodobenzoic AcidsConceptsNontraumatic abdominal painDiagnosis of appendicitisAbdominal painContrast materialGroup 2Group 1Contrast mediumAcute nontraumatic abdominal painUrban academic emergency departmentDiagnostic accuracyPresence of appendicitisSmall bowel obstructionOral contrast materialGroup 2 subjectsAcademic emergency departmentGroup 1 subjectsAdult patientsClinical suspicionClinical outcomesEmergency departmentCT examinationsRadiologic diagnosisAppendicitisPatientsCases of disagreement
2006
Length of Stay by Route of Contrast Administration for Diagnosis of Appendicitis by Computed‐tomography Scan
Berg ER, Mehta SD, Mitchell P, Soto J, Oyama L, Ulrich A. Length of Stay by Route of Contrast Administration for Diagnosis of Appendicitis by Computed‐tomography Scan. Academic Emergency Medicine 2006, 13: 1040-1045. PMID: 16973641, DOI: 10.1197/j.aem.2006.06.047.Peer-Reviewed Original ResearchConceptsAbdominal computed tomographyLength of stayOral contrastRectal contrastComputed tomographyContrast administrationED lengthPatient satisfactionPhase 2 patientsUrban academic EDEmergency department lengthDiagnosis of appendicitisConfidence intervalsWilcoxon rank sum testPhase 1 subjectsRank sum testAdult patientsPrimary outcomeAcademic EDComputed-tomography scansPatient throughput timeAppendicitisPatientsCT orderStay
2005
Bench to Bedside: Pharmacogenomics, Adverse Drug Interactions, and the Cytochrome P450 System
Sikka R, Magauran B, Ulrich A, Shannon M. Bench to Bedside: Pharmacogenomics, Adverse Drug Interactions, and the Cytochrome P450 System. Academic Emergency Medicine 2005, 12: 1227-1235. PMID: 16282513, DOI: 10.1197/j.aem.2005.06.027.Peer-Reviewed Original ResearchConceptsAdverse drug interactionsDrug interactionsCytochrome P450 familyCytochrome P450 systemPreventable medical errorsClinical effectsTherapeutic implicationsHealth careP450 systemPharmaceutical agentsMedical errorsCytochrome P450P450 familyPharmacogenomicsCYP2C19PopulationBasic biochemistryCYP2E1CYP2C9CYP3A4CYP2D6PhysiciansCYP1A2BedsideCare
2004
Blunt Abdominal Trauma: Performance of CT without Oral Contrast Material
Stuhlfaut JW, Soto JA, Lucey BC, Ulrich A, Rathlev NK, Burke PA, Hirsch EF. Blunt Abdominal Trauma: Performance of CT without Oral Contrast Material. Radiology 2004, 233: 689-94. PMID: 15516605, DOI: 10.1148/radiol.2333031972.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesAdolescentAdultAgedContrast MediaFemaleHematomaHemoperitoneumHumansInjections, IntravenousIntestine, LargeIntestine, SmallIohexolLaparotomyMaleMesenteryMiddle AgedPeritoneal DiseasesPneumoperitoneumPredictive Value of TestsRetrospective StudiesSensitivity and SpecificityTomography, X-Ray ComputedWounds, NonpenetratingConceptsOral contrast materialMesenteric injurySolid organ injuryCT findingsNegative predictive valuePositive predictive valueContrast materialPredictive valueMesenteric hematomaOrgan injurySurgical repairFree fluidMulti-detector row scannersBowel wall abnormalitiesBlunt abdominal traumaMulti-detector row CTInvestigational Review BoardMulti-detector rowPerformance of CTHospital courseIntraabdominal injuriesAbdominal traumaAbdominopelvic CTBowel wallFalse-positive results
2000
Clinical Characteristics as Predictors of Recurrent Alcohol‐related Seizures
Rathlev N, Ulrich A, Fish S, D'Onofrio G. Clinical Characteristics as Predictors of Recurrent Alcohol‐related Seizures. Academic Emergency Medicine 2000, 7: 886-891. PMID: 10958128, DOI: 10.1111/j.1553-2712.2000.tb02066.x.Peer-Reviewed Original ResearchConceptsAlcohol-related seizuresClinical characteristicsBlood pressureEthanol levelsRecurrent seizuresLower riskLower-risk clinical characteristicsPlacebo-treated patientsDiastolic blood pressureSubset of patientsSystolic blood pressureRetrospective secondary analysisDaily ethanol consumptionRecurrent alcoholPlacebo armRandomized trialsPrevious seizuresEmergency departmentEthanol abuseClinical dataDrug treatmentHeart rateEthanol consumptionSeizuresRespiratory rate
1999
Lorazepam for the Prevention of Recurrent Seizures Related to Alcohol
D'Onofrio G, Rathlev N, Ulrich A, Fish S, Freedland E. Lorazepam for the Prevention of Recurrent Seizures Related to Alcohol. New England Journal Of Medicine 1999, 340: 915-919. PMID: 10094637, DOI: 10.1056/nejm199903253401203.Peer-Reviewed Original ResearchConceptsPlacebo groupRecurrent seizuresSecond seizureLorazepam groupEmergency departmentNormal salineAlcohol abusePrimary end pointDouble-blind studyChronic alcohol abuseYears of ageIntravenous lorazepamHospital dischargeConsecutive patientsGeneralized seizuresEntry criteriaCommon causePatientsSeizuresEnd pointLorazepamObservation periodSignificant reductionHospitalSaline