000096822 001__ 96822
000096822 005__ 20210902121907.0
000096822 0247_ $$2doi$$a10.1111/hae.13911
000096822 0248_ $$2sideral$$a116378
000096822 037__ $$aART-2020-116378
000096822 041__ $$aeng
000096822 100__ $$0(orcid)0000-0001-8848-5425$$aFernández-Mosteirín, N.$$uUniversidad de Zaragoza
000096822 245__ $$aElectronic medical record alert in patients with hemophilia at a teaching hospital emergency department
000096822 260__ $$c2020
000096822 5060_ $$aAccess copy available to the general public$$fUnrestricted
000096822 5203_ $$aP157
Introduction: Patients with hemophilia are often not treated appropriately when they present out-of-hours to an emergency department (ED). Delays in replacement therapy can affect morbi- mortality. Clinical decision support systems include electronic medical record alerts (EMRA) and guidelines that assist in diagnosis and treatment.
Aim: Audit the computerized automated alert tool in the electronic medical record in order to notify the need of health care provision of hemophilia patients in ED.
Methods: Retrospective review (February 2015- March 2019) of health care alert notification emails regarding of hemophilia patients in our centre, received and generated by computer alert in the electronic medical record of the ED.
Results: 164 visits to ED were registered, corresponding to 39 (37.5%) of the 104 hemophilia patients (pts) from our center. 28 of 80 pts with hemophilia A (HA) and 11 of 24 pts with HB. Median age 25 years (range: 5- 67). 31 were adults (median 33 years; range: 15-67) and 8 children under 15 (range 5- 14). Distribution by type and severity: HA: severe 9, moderate 2, mild 17; HB: severe 8, moderate 1, mild 2. 16 were under prophylaxis and 23 on demand. 11 went once to ED, 9 twice, 5 pts 3 times and 14 (36.6%) >5 times (5 with associated comorbidities). Causes for consultation (59 due to trauma and 57 directly related to hemophilia): Cutaneous/muscle bleed 18 episodes (Iliopsoas 5, cutaneous 5, other muscle 8), Joint pain 38 (bleed 8, synovitis 5, sprain 6, contusion 9, knee pain 2, post- traumatic fracture 3, nonspecific pain 5), abdominal pain 14 (gastroenteritis 5, gastrointestinal bleed 4, inguinal hernia 1, nonspecific pain 4), traumatic incise wound 4, infection 14, treatment administration 15, gingivorrhagia 7, colic pain/hematuria 7, toothache 4, allergic skin reaction 4, epistaxis 3, head trauma 2 and other causes not related to hemophilia 34 episodes. 23 hospital admissions were made in16 pts. The average length of stay of all patients admitted to ED was 4.8 hours as opposed to 2.4 hours (range: 0.1- 44.3) in hemophiliacs.
Discussion/Conclusion: In our experience, only one third of patients consult with symptoms related to hemophilia at ED. The reason for hospital admission is mostly associated to other comorbidities. EMRA system allows early care provision, better compliance with the healthcare protocol, and shorten the length of stay and reducing morbidity in hemophilia patients.
000096822 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000096822 590__ $$a4.287$$b2020
000096822 591__ $$aHEMATOLOGY$$b27 / 76 = 0.355$$c2020$$dQ2$$eT2
000096822 592__ $$a1.213$$b2020
000096822 593__ $$aGenetics (clinical)$$c2020$$dQ1
000096822 593__ $$aMedicine (miscellaneous)$$c2020$$dQ1
000096822 593__ $$aHematology$$c2020$$dQ1
000096822 655_4 $$ainfo:eu-repo/semantics/conferenceObject$$vinfo:eu-repo/semantics/publishedVersion
000096822 700__ $$0(orcid)0000-0001-5408-9264$$aCalvo Villas, J.M.$$uUniversidad de Zaragoza
000096822 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000096822 773__ $$g26, S2 (2020), P157 [108-109]$$pHaemophilia$$tHAEMOPHILIA$$x1351-8216
000096822 85641 $$uhttps://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.13911$$zTexto completo de la revista
000096822 8564_ $$s238034$$uhttps://zaguan.unizar.es/record/96822/files/texto_completo.pdf$$yVersión publicada
000096822 8564_ $$s636167$$uhttps://zaguan.unizar.es/record/96822/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
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000096822 951__ $$a2021-09-02-10:40:26
000096822 980__ $$aARTICLE