Garcia Samuel I, Jacobson Ashley, Moore Gregory P, Frank Jesse, Gifford Wyatt, Johnson Samantha, Lazaro-Paulina Donell, Mullan Aidan, Finch Alexander S
Division of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Department of Emergency Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Int J Emerg Med. 2024 Nov 22;17(1):177. doi: 10.1186/s12245-024-00769-0.
In emergency medicine, triage encompasses more than the initial prioritization of treatment; it also includes decisions about the most suitable level of care and disposition for each patient. However, the increasing use of mobile technology by patients in the emergency department (ED) introduces a new factor. This study aims to explore the relationship between patients' cellphone use at the time of initial assessment and final disposition in the ED.
A prospective, cross-sectional study was conducted on 292 patients who presented to the ED between 9/1/2021 and 8/9/2022. Patients were stratified into two cohorts based on their behavior during the initial assessment: actively using a cell phone (n = 32) or not using a cell phone (n = 259). Final disposition was dichotomously recorded as admission or discharge. Hospital admission, hospital observation, and admission to the ED observation unit were consolidated into the combined category of admission.
Patients not actively using their cell phone on initial assessment exhibited a discharge rate of 64%, while those engaged with their cellphones displayed notably higher dismissal rates at 94%. The calculated odds ratio (OR) of 8.4 (95% confidence interval: 1.96-36.0, p = 0.004) underscores a significantly heightened likelihood of dismissal among individuals actively using their cellphones, suggesting a potential association between cellphone use and a reduced probability of hospital admission.
The study suggests an association between cellphone use during initial ED assessment and higher discharge rates. While this introduces a novel concept, the study's potential contribution to more informed and efficient triage decisions warrants careful consideration in future research and clinical applications.
在急诊医学中，分诊不仅仅是对治疗进行初步优先级排序；它还包括为每位患者决定最合适的护理级别和处置方式。然而，急诊科（ED）患者对移动技术的使用日益增加，这引入了一个新因素。本研究旨在探讨患者在初次评估时使用手机与急诊科最终处置之间的关系。
对2021年9月1日至2022年8月9日期间到急诊科就诊的292例患者进行了一项前瞻性横断面研究。根据患者在初次评估时的行为，将其分为两个队列：积极使用手机组（n = 32）和不使用手机组（n = 259）。最终处置结果分为入院或出院，并进行二分记录。住院、住院观察和入住急诊科观察病房合并为入院这一综合类别。
初次评估时未积极使用手机的患者出院率为64%，而使用手机的患者出院率显著更高，为94%。计算得出的优势比（OR）为8.4（95%置信区间：1.96 - 36.0，p = 0.004），这突出表明积极使用手机的个体出院可能性显著增加，表明手机使用与住院概率降低之间可能存在关联。
该研究表明在急诊科初次评估期间使用手机与较高的出院率之间存在关联。虽然这引入了一个新概念，但该研究对更明智和高效的分诊决策的潜在贡献值得在未来研究和临床应用中仔细考虑。
