2023
Automatable end‐of‐life screening for older adults in the emergency department using electronic health records
Haimovich A, Xu W, Wei A, Schonberg M, Hwang U, Taylor R. Automatable end‐of‐life screening for older adults in the emergency department using electronic health records. Journal Of The American Geriatrics Society 2023, 71: 1829-1839. PMID: 36744550, PMCID: PMC10258151, DOI: 10.1111/jgs.18262.Peer-Reviewed Original ResearchMeSH KeywordsAgedCohort StudiesDeathElectronic Health RecordsEmergency Service, HospitalHumansReproducibility of ResultsRetrospective StudiesConceptsAdvance care planningDecision curve analysisLife screeningComorbidity indexCode statusPrognostic modelHealth systemOlder adultsCurve analysisOlder ED patientsPalliative care interventionsObservational cohort studyEmergency department visitsPalliative care servicesElixhauser Comorbidity IndexReceiver-operating characteristic curveIdentification of patientsMultivariable logistic regressionLarge regional health systemLife-limiting illnessRisk older adultsCode status ordersLife Screening ToolMortality predictive modelsElectronic health records
2021
Geriatric emergency department revisits after discharge with Potentially Inappropriate Medications: A retrospective cohort study
Hammouda N, Vargas-Torres C, Doucette J, Hwang U. Geriatric emergency department revisits after discharge with Potentially Inappropriate Medications: A retrospective cohort study. The American Journal Of Emergency Medicine 2021, 44: 148-156. PMID: 33621716, DOI: 10.1016/j.ajem.2021.02.004.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity Index scoreComorbidity Index scoreED revisitsEmergency Severity Index scoreEmergency departmentAcademic emergency departmentInappropriate medicationsHospital admissionChief complaintIndex scoreBeers criteriaMedicaid statusRisk factorsMedicare beneficiaries 65 yearsDay ED visitsUpdated Beers CriteriaRetrospective cohort studyEmergency department revisitsRetrospective chart reviewSeverity Index scoreBeneficiaries 65 yearsCovariate risk factorsMedicare beneficiaries 65Multiple logistic regressionEmergency Severity Index
2019
30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia
Kent T, Lesser A, Israni J, Hwang U, Carpenter C, Ko KJ. 30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia. Journal Of The American Geriatrics Society 2019, 67: 2254-2259. PMID: 31403717, PMCID: PMC6899685, DOI: 10.1111/jgs.16114.Peer-Reviewed Original ResearchConceptsIndex ED visitED revisitsEmergency departmentED visitsDementia diagnosisIndex encounterOdds ratioOlder adultsMedicare beneficiariesEmergency department revisit rateRevisit ratesED revisit ratesHigh ED utilizationSignificant predictorsNational emergency departmentSkilled nursing facilitiesLogistic regression modelsDementia codesED utilizationMedicaid statusOutpatient claimsRepresentative sampleContinuous feeClaims dataDementia patients
2017
Bouncing Back Elsewhere: Multilevel Analysis of Return Visits to the Same or a Different Hospital After Initial Emergency Department Presentation
Shy BD, Loo GT, Lowry T, Kim EY, Hwang U, Richardson LD, Shapiro JS. Bouncing Back Elsewhere: Multilevel Analysis of Return Visits to the Same or a Different Hospital After Initial Emergency Department Presentation. Annals Of Emergency Medicine 2017, 71: 555-563.e1. PMID: 28967514, DOI: 10.1016/j.annemergmed.2017.08.023.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChild, PreschoolEmergency Service, HospitalFemaleHealth Information ExchangeHumansInfantInfant, NewbornMaleMiddle AgedMultilevel AnalysisOdds RatioPatient ReadmissionQuality Assurance, Health CareQuality ImprovementRetrospective StudiesTime FactorsYoung AdultConceptsED visitsSame hospitalReturn visitsOdds ratioHealth information exchangeInitial emergency department presentationEmergency department return visitsInitial ED visitED return visitsInitial ED presentationEmergency department presentationsConfidence intervalsHospital-level dataEarly revisitsED presentationsInitial visitMale sexSecond HospitalStudy EDPatient visitsAcademic hospitalHospital variablesHealth information exchange networkDifferent hospitalsHospital
2016
A Multicenter Evaluation of Emergency Department Pain Care Across Different Types of Fractures
Siddiqui A, Belland L, Rivera-Reyes L, Handel D, Yadav K, Heard K, Eisenberg A, Khelemsky Y, Hwang U. A Multicenter Evaluation of Emergency Department Pain Care Across Different Types of Fractures. Pain Medicine 2016, 18: 41-48. PMID: 27245631, PMCID: PMC5283699, DOI: 10.1093/pm/pnw072.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesicsCohort StudiesEmergency Service, HospitalFemaleFractures, BoneHumansMaleMiddle AgedPainPain ManagementRetrospective StudiesUnited StatesConceptsPain careEmergency departmentType of fractureFracture typeOlder patientsBaseline pain scoresRetrospective cohort studyLong bone fracturesOpioid doseAnalgesic administrationAnalgesic usePain scoresCohort studyTriage acuityFinal diagnosisSubgroup analysisMulticenter evaluationED crowdingPatientsBone fracturesSecondary analysisAge-based differencesCareProcess outcomesGreater likelihood
2015
A Multicenter Evaluation of the Impact of Sex on Abdominal and Fracture Pain Care
Siddiqui A, Belland L, Rivera-Reyes L, Handel D, Yadav K, Heard K, Eisenberg A, Hwang U. A Multicenter Evaluation of the Impact of Sex on Abdominal and Fracture Pain Care. Medical Care 2015, 53: 948-953. PMID: 26465122, PMCID: PMC4610254, DOI: 10.1097/mlr.0000000000000430.Peer-Reviewed Original ResearchConceptsAbdominal painAnalgesic administrationPain careMulticenter evaluationFinal ED diagnosisInitial pain scoreSingle pain conditionRetrospective cohort reviewType of painSex-based disparitiesImpact of sexPain scoresCohort reviewED visitsSecondary outcomesPain conditionsPrimary outcomeMulticenter studyTriage acuityED diagnosisMultivariable modelMedication ordersSex disparitiesCare outcomesED crowding
2014
Is all pain is treated equally? A multicenter evaluation of acute pain care by age
Hwang U, Belland LK, Handel DA, Yadav K, Heard K, Rivera-Reyes L, Eisenberg A, Noble MJ, Mekala S, Valley M, Winkel G, Todd KH, Morrison R. Is all pain is treated equally? A multicenter evaluation of acute pain care by age. Pain 2014, 155: 2568-2574. PMID: 25244947, PMCID: PMC4250377, DOI: 10.1016/j.pain.2014.09.017.Peer-Reviewed Original ResearchConceptsAcute pain careFinal pain scoreOlder patientsYounger patientsPain carePain scoresCross-sectional observation studyType of painPatient-related characteristicsHealth care settingsFracture painAbdominal painPain medicationPain conditionsPain treatmentEmergency departmentCare treatmentCare settingsMulticenter evaluationPainPatientsOlder adultsCareAnalgesicsGreater reduction
2012
Predictors of patient length of stay in 9 emergency departments
Wiler JL, Handel DA, Ginde AA, Aronsky D, Genes NG, Hackman JL, Hilton JA, Hwang U, Kamali M, Pines JM, Powell E, Sattarian M, Fu R. Predictors of patient length of stay in 9 emergency departments. The American Journal Of Emergency Medicine 2012, 30: 1860-1864. PMID: 22633732, DOI: 10.1016/j.ajem.2012.03.028.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalHumansLength of StayPatient AdmissionPatient SatisfactionRetrospective StudiesUnited StatesConceptsOverall LOSAmbulance diversionPredictors of LOSAnnual ED censusEmergency department lengthLength of stayPercentage of increaseLog-transformed LOSDaily percentageCalendar year 2009Multicenter studyRetrospective studyAdverse outcomesEmergency departmentED censusPatient satisfactionPatient presentationPatient categoriesPatient LOSED crowdingPatient lengthPatientsDaily admissionsStaySignificant predictors
2011
Characteristics of Frequent Geriatric Users of an Urban Emergency Department
Wajnberg A, Hwang U, Torres L, Yang S. Characteristics of Frequent Geriatric Users of an Urban Emergency Department. Journal Of Emergency Medicine 2011, 43: 376-381. PMID: 22040771, DOI: 10.1016/j.jemermed.2011.06.056.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal PainAgedAged, 80 and overBlack or African AmericanChest PainChi-Square DistributionConfidence IntervalsEmergency Service, HospitalFemaleHealth Care SurveysHealth Services AccessibilityHispanic or LatinoHumansMaleOdds RatioPatient AcuityPrimary Health CareProspective StudiesRetrospective StudiesTriageUrban Health ServicesConceptsEmergency department utilizationYears of ageED usersED visitsOlder adultsFrequent Emergency Department UtilizationGeriatric usersProspective telephone surveyFrequent ED usersRetrospective chart reviewHealth-related qualityPrimary care providersUrban emergency departmentChart reviewED utilizationOlder patientsUrban EDUnique patientsEmergency departmentPrimary careOutpatient providersCare providersUsual sourceED crowdingUnivariate descriptive statisticsVariations in Crowding and Ambulance Diversion in Nine Emergency Departments
Handel DA, Pines J, Aronsky D, Genes N, Ginde AA, Hackman J, Hilton JA, Hwang U, Kamali M, Powell E, Sattarian M, Fu R. Variations in Crowding and Ambulance Diversion in Nine Emergency Departments. Academic Emergency Medicine 2011, 18: 941-946. PMID: 21906203, DOI: 10.1111/j.1553-2712.2011.01149.x.Peer-Reviewed Original ResearchConceptsEmergency departmentED bedsAmbulance diversionED visitsOverall mean LOSAnnual ED censusPrimary outcome variablePrimary study aimPrimary predictor variableDaily ED visitsPercentage of daysMean LOSAcute treatmentMulticenter studyED censusSurrogate markerED crowdingStudy aimMean differenceOutcome variablesDichotomous variablesTotal numberVisitsDaysDiversionFactors associated with delays to emergency care for bowel obstruction
Hwang U, Aufses AH, Bickell NA. Factors associated with delays to emergency care for bowel obstruction. The American Journal Of Surgery 2011, 202: 1-7. PMID: 21632032, DOI: 10.1016/j.amjsurg.2010.05.003.Peer-Reviewed Original ResearchConceptsSmall bowel obstructionFirst treatmentBowel obstructionSurgical resectionTertiary care medical centerEmergency department patientsPatient-related characteristicsHospital factorsIntestinal obstructionDepartment patientsED patientsRetrospective studyMedical recordsAdministrative databasesHospital careMedical CenterEmergency careGreater oddsPatientsObstructionResectionTreatmentCareEDFactors
2010
The Quality of Emergency Department Pain Care for Older Adult Patients
Hwang U, Richardson LD, Harris B, Morrison RS. The Quality of Emergency Department Pain Care for Older Adult Patients. Journal Of The American Geriatrics Society 2010, 58: 2122-2128. PMID: 21054293, PMCID: PMC3058876, DOI: 10.1111/j.1532-5415.2010.03152.x.Peer-Reviewed Original ResearchConceptsED pain carePain assessmentPain carePain scoresAdult patientsOlder patientsAcademic tertiary care EDYoung adultsFinal ED diagnosisRetrospective observational cohortTertiary care EDCharlson comorbidity scoreDegree of painOlder adult patientsLess opioid useCare process measuresAnalgesic medicationComorbidity scoreMild painED visitsObservational cohortOpioid useYounger patientsOpioid analgesicsPrior medicationEmergency Department Patient Volume and Troponin Laboratory Turnaround Time
Hwang U, Baumlin K, Berman J, Chawla NK, Handel DA, Heard K, Livote E, Pines JM, Valley M, Yadav K. Emergency Department Patient Volume and Troponin Laboratory Turnaround Time. Academic Emergency Medicine 2010, 17: 501-507. PMID: 20536804, PMCID: PMC10570502, DOI: 10.1111/j.1553-2712.2010.00738.x.Peer-Reviewed Original ResearchConceptsED patient volumeLaboratory turnaround timePatient volumeTroponin testTertiary care EDRetrospective cohort reviewEmergency department visitsLength of stayEmergency department (ED) patient volumePrimary predictor variableNumber of boardersAdjusted covariatesAdult patientsCohort reviewDepartment visitsHospital-based laboratoriesPatient characteristicsAppropriate therapyIll patientsVolume measuresTurnaround timeSubstantial burdenTimely treatmentTriage severityED beds
2009
Disparities in use of computed tomography for patients presenting with headache
Harris B, Hwang U, Lee WS, Richardson LD. Disparities in use of computed tomography for patients presenting with headache. The American Journal Of Emergency Medicine 2009, 27: 333-336. PMID: 19328379, PMCID: PMC2757437, DOI: 10.1016/j.ajem.2008.03.041.Peer-Reviewed Original ResearchConceptsHead CTEmergency departmentPatient characteristics influencesPercent of patientsCommon presenting complaintRetrospective cohort reviewED medical recordsPatient demographic factorsHistory of migraineUrban emergency departmentCause of headacheDemographic factorsCharlson scoreAdult patientsCohort reviewED evaluationPresenting complaintChief complaintMultivariable analysisCT evaluationMean ageStudy eligibilityFinal diagnosisInsurance statusClinical evaluation
2008
Emergency Department Crowding and Decreased Quality of Pain Care
Hwang U, Richardson L, Livote E, Harris B, Spencer N, Morrison R. Emergency Department Crowding and Decreased Quality of Pain Care. Academic Emergency Medicine 2008, 15: 1248-1255. PMID: 18945239, PMCID: PMC2729811, DOI: 10.1111/j.1553-2712.2008.00267.x.Peer-Reviewed Original ResearchConceptsNumber of boardersPain careEmergency departmentPain assessmentED censusAnalgesic medicationTertiary care emergency departmentFinal ED diagnosisTotal ED censusRetrospective observational studyOutcomes of interestEmergency department (ED) crowdingAdult patientsChief complaintPainful conditionsCare measuresMedication administrationPatient visitsED diagnosisObservational studyED crowdingInpatient bedsPatientsMedication orderingPatient careWhat Affects Time to Care in Emergency Room Appendicitis Patients?
Bickell NA, Hwang U, Anderson RM, Rojas M, Barsky CL. What Affects Time to Care in Emergency Room Appendicitis Patients? Medical Care 2008, 46: 417-422. PMID: 18362822, DOI: 10.1097/mlr.0b013e31815c1e66.Peer-Reviewed Original ResearchConceptsEmergency departmentAppendicitis patientsED LOSQuicker careSurgeon's diagnosisPrivate insuranceRetrospective observational studyTreatment of patientsTime-sensitive conditionsNonwhite patientsED lengthPatient factorsSpecialist consultationED staffingObservational studyMinority patientsPatientsED characteristicsIll individualsPatient safetyDiagnosisED qualityAppendicitisGreater numberModest effect
2006
The Effect of Emergency Department Crowding on the Management of Pain in Older Adults with Hip Fracture
Hwang U, Richardson LD, Sonuyi TO, Morrison RS. The Effect of Emergency Department Crowding on the Management of Pain in Older Adults with Hip Fracture. Journal Of The American Geriatrics Society 2006, 54: 270-275. PMID: 16460378, DOI: 10.1111/j.1532-5415.2005.00587.x.Peer-Reviewed Original ResearchConceptsPain assessmentEmergency departmentHip fractureED censusRisk factorsOlder adultsPatient-related risk factorsUnderassessment of painProspective cohort studyTertiary medical centerManagement of painTreatment of painNursing home residencePoor pain managementEmergency department (ED) crowdingAcute PhysiologyAnalgesic administrationComorbidity scoreCohort studyPain managementPain treatmentPhysiological scoreRetrospective reviewMean ageMeperidine use