Get the Latest Research in the January Annals

Here is a quick look at two articles published in the January issue of Annals of Emergency Medicine. Visit www.annemergmed.com to read the full text.

A Clinical Prediction Model to Estimate Risk for Thirty Day Adverse Events in Emergency Department Patients With Symptomatic Atrial Fibrillation

By T.W. Barrett, et al.

Editor’s Capsule Summary

What is already known on this topic: Emergency department (ED) management of symptomatic atrial fibrillation varies greatly with respect to rate control, rhythm conversion, and disposition.
What question this study addressed: What clinical factors are associated with predefined 30-day adverse events after an ED visit for symptomatic atrial fibrillation?
What this study adds to our knowledge: Twenty-eight percent of the 638 admitted patients and 18% of the 192 patients discharged from the ED had a 30-day adverse outcome. Increased age, inadequate ventricular rate control, dyspnea, current smoking, and beta-blocker treatment were associated with adverse events.
How this is relevant to clinical practice: The findings of this observational study will inform future efforts to define optimal management strategies.

By A.S. Kim, et al.

Editor’s Capsule Summary

What is already known on this topic: ED patients with dizziness and vertigo are often discharged home when a serious cause is not identified.
What question this study addressed: How often do such patients have a bad outcome?
What this study adds to our knowledge: Using 6 months of data from a database of all California ED visits, the investigators found that about 2% of the 31,000 patients with an ED discharge diagnosis of dizziness or vertigo died or had a serious vascular event (neurologic or cardiac) in the subsequent 6 months, with the preponderance of events in the first month.
How this is relevant to clinical practice: Prospectively identifying which of these patients will suffer an event remains a challenge.