TY - JOUR
T1 - How vital are the vital signs? A multi-center observational study from emergency departments of Pakistan
AU - Mehmood, Amber
AU - He, Siran
AU - Zafar, Waleed
AU - Baig, Noor
AU - Sumalani, Fareed Ahmed
AU - Razzak, Juanid Abdul
N1 - Funding Information:
We are acknowledge the data collection team at each participating site and are also thankful to Ms. Bobbi Nicotera for providing language edits of the paper. This work was funded by NIH-Fogarty JHU-AKU grant through International Collaborative Trauma and Injury Research and Training (ICTIRT) program (NIH grant #D43TW007292). The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health. This article has been published as part of BMC Emergency Medicine Volume 15 Supplement 2, 2015: Articles from the Pakistan National Emergency Departments Surveillance Study (Pak-NEDS). The full contents of the supplement are available online at http://www.biomedcentral.com/ bmcemergmed/supplements/15/S2. Publication of this supplement was funded by the Johns Hopkins School of Public Health.
Publisher Copyright:
© 2015 Mehmood et al.
PY - 2015/12/11
Y1 - 2015/12/11
N2 - Background: Vital signs play a critical role in prioritizing patients in emergency departments (EDs), and are the foundation of most triage methods and disposition decisions. This study was conducted to determine the frequency of vital signs documentation anytime during emergency department treatment and to explore if abnormal vital signs were associated with the likelihood of admission for a set of common presenting complaints. Methods: Data were collected over a four-month period from the EDs of seven urban tertiary care hospitals in Pakistan. The variables included age, sex, hospital type (government run vs. private), presenting complaint, ED vital signs, and final disposition. Patients who were >12 years of age were included in the analysis. The data were analyzed to describe the proportion of patients with documented vitals signs, which was then crossed-tabulated with top the ten presenting complaints to identify high-acuity patients and correlation with their admission status. Results: A total of 274,436 patients were captured in the Pakistan National Emergency Department Surveillance (Pak-NEDS), out of which 259,288 patients were included in our study. Vital signs information was available for 90,569 (34.9%) patients and the most commonly recorded vitals sign was pulse (25.7%). Important information such as level of consciousness was missing in the majority of patients with head injuries. Based on available information, only 13.3% with chest pain, 12.8% with fever and 12.8% patients with diarrhea could be classified as high-acuity. In addition, hospital admission rates were two- to four-times higher among patients with abnormal vital signs, compared with those with normal vital signs. Conclusion: Most patients seen in the EDs in Pakistan did not have any documented vital signs during their visit. Where available, the presence of abnormal vital signs were associated with higher chances of admission to the hospital for the most common presenting symptoms.
AB - Background: Vital signs play a critical role in prioritizing patients in emergency departments (EDs), and are the foundation of most triage methods and disposition decisions. This study was conducted to determine the frequency of vital signs documentation anytime during emergency department treatment and to explore if abnormal vital signs were associated with the likelihood of admission for a set of common presenting complaints. Methods: Data were collected over a four-month period from the EDs of seven urban tertiary care hospitals in Pakistan. The variables included age, sex, hospital type (government run vs. private), presenting complaint, ED vital signs, and final disposition. Patients who were >12 years of age were included in the analysis. The data were analyzed to describe the proportion of patients with documented vitals signs, which was then crossed-tabulated with top the ten presenting complaints to identify high-acuity patients and correlation with their admission status. Results: A total of 274,436 patients were captured in the Pakistan National Emergency Department Surveillance (Pak-NEDS), out of which 259,288 patients were included in our study. Vital signs information was available for 90,569 (34.9%) patients and the most commonly recorded vitals sign was pulse (25.7%). Important information such as level of consciousness was missing in the majority of patients with head injuries. Based on available information, only 13.3% with chest pain, 12.8% with fever and 12.8% patients with diarrhea could be classified as high-acuity. In addition, hospital admission rates were two- to four-times higher among patients with abnormal vital signs, compared with those with normal vital signs. Conclusion: Most patients seen in the EDs in Pakistan did not have any documented vital signs during their visit. Where available, the presence of abnormal vital signs were associated with higher chances of admission to the hospital for the most common presenting symptoms.
KW - Emergency Department
KW - Guidelines
KW - Pakistan
KW - Surveillance
KW - Triage
UR - http://www.scopus.com/inward/record.url?scp=84977612721&partnerID=8YFLogxK
U2 - 10.1186/1471-227X-15-S2-S10
DO - 10.1186/1471-227X-15-S2-S10
M3 - Article
C2 - 26690816
AN - SCOPUS:84977612721
SN - 1471-227X
VL - 15
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
IS - 2
M1 - S10
ER -
