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Emine Polat Nilden Tuygun Halise Akca Can Demir Karacan 《The Journal of emergency medicine》2017,52(4):499-503
Background
Colchicine poisoning is an uncommon but serious form of drug intoxication. It may produce life-threatening systemic effects. In toxic doses it produces nausea and vomiting and bone marrow suppression, often leading to sepsis, hypocalcemia, adult respiratory distress syndrome, and direct cardiotoxic effects.Objective
The aim of this study was to describe demographic features and the outcome of patients poisoned with colchicine.Methods
A retrospective study of the pediatric intensive care unit database was performed for patients ≤18 years of age who had colchicine poisoning between July 2008 and July 2013.Results
The total number of patients with drug poisoning in the study period was 144. Nine of 144 were related to colchicine poisoning. The median age was 4 years (range 20 months to 16 years) and the number of females was five. Six of the nine cases presented after ingesting <0.5 mg/kg, whereas two patients had consumed 0.5 to 0.8 mg/kg. One patient had received colchicine >0.8 mg/kg. Three patients died.Conclusions
Among drug intoxications, colchicines can lead to severe clinical conditions. All patients suspected of having colchicine intoxication should be managed in the pediatric intensive care unit regardless of the actual degree of poisoning. 相似文献3.
Amber Rice Jennifer Dudek Toni Gross Tomi St Mars Dale Woolridge 《The Journal of emergency medicine》2017,52(6):894-901
Background
The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs.Objective
To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona.Methods
This was a cross-sectional study conducted using data from ED visits between 2011 and 2014 recorded in the Arizona Hospital Discharge Database. The primary outcome measure was the mortality rate for ED visits by patients under 18 years old. Rates were compared prior to and after facility certification by the Arizona Pediatric Prepared Emergency Care program.Results
The total number of ED visits by children during the study period was 1,928,409. Of these, 1,127,294 were at facilities undergoing certification. For hospitals becoming certified, overall ED mortality rates were 35.2 deaths/100,000 ED visits (95% confidence interval [CI] 29.5–41.7) in the precertification analysis and 34.4 deaths/100,000 ED visits (95% CI 30.4–38.9) in the postcertification analysis. The injury-related ED visit mortality rate for certified hospitals showed a decrease from 40.0 injury-related deaths/100,000 ED visits (95% CI 28.6–54.4) in the precertification analysis to 25.8 injury-related deaths/100,000 ED visits (95% CI 18.7–34.8) in the postcertification analysis.Conclusion
The implementation of the Arizona pediatric ED verification system was associated with a trend toward lower mortality. These results offer a platform for further research on pediatric ED preparedness efforts and their effects on improved patient outcomes. 相似文献4.
Anita A. Thomas Katie Von Derau Miranda C. Bradford Emily Moser Alexander Garrard Suzan Mazor 《The Journal of emergency medicine》2019,56(4):398-404
Background
Washington State was one of the first states to legalize recreational marijuana. Increased availability of marijuana may result in more unintentional pediatric exposure, which often presents as altered mental status with unknown cause.Objectives
To quantify unintentional pediatric marijuana exposures reported to the Washington Poison Center (WAPC) prior to and after legalization and commercial availability of recreational marijuana.Methods
Data were obtained from the WAPC database, toxiCALL®. Patients ≤ 9 years old with a reported marijuana exposure between July 2010 and July 2016 were included in the analysis. Patient and exposure characteristics were summarized and median exposure frequencies were calculated for the periods prior to and after legalization.Results
There were 161 cases meeting the inclusion criteria that occurred between July 2010 and July 2016. Of these, 130 (81%) occurred in the 2.5-year period after legalization of recreational marijuana in January 2013. The median age of exposed children was 2 years (range 0–9 years). Eighty-one percent of the exposures occurred in the child's own home. The number of exposures per month increased after recreational marijuana was legalized in November 2012, and increased further once recreational marijuana shops were legally allowed to open in July 2014.Conclusion
Reported unintentional pediatric marijuana exposure has increased in the state of Washington since recreational marijuana was legalized. As marijuana becomes more available, clinicians should be aware of the risk of unintentional pediatric marijuana exposure, and this should inform lawmakers regarding regulations around childhood exposure to marijuana. 相似文献5.
Abigail M. Schuh Eileen J. Klein Rebecca J. Allred Ana Christensen Julie C. Brown 《The Journal of emergency medicine》2017,52(2):169-175
Background
Pediatric adnexal torsion is rare, can be challenging to recognize, and may result in ovarian loss.Objective
We sought to identify and compare the defining characteristics of adnexal torsion in premenarchal and postmenarchal girls.Methods
A retrospective cohort study was performed at a tertiary care children's hospital, including patients diagnosed postnatally with adnexal (ovarian or tubal) torsion between 1997 and 2013. Proportions were compared using relative risk regression.Results
Adnexal torsion was found in 59 premenarchal and 43 postmenarchal girls. Abdominal pain was the most common chief complaint (54%). History included reports of pain (96%), vomiting (67%), and fever (19%). Excluding 12 patients with isolated tubal torsion and 19 with a teratoma, there were no statistically significant differences in ovarian loss in premenarchal vs. postmenarchal girls (47% and 25% respectively; relative risk [RR] = 1.8 [95% confidence interval {CI} 0.9–3.8]), left- vs. right-sided torsion (47% and 32%; RR = 1.5 [95% CI 0.8–2.7]), pain duration ≤ 2 days vs. > 2 days (31% and 41%; RR = 0.8 [95% CI 0.4–1.5]; n = 64) and severe pain vs. mild to moderate (38% and 33%; RR = 1.1 [95% CI 0.7–1.5]; n = 56).Conclusions
The diagnosis of pediatric adnexal torsion is difficult and often delayed. Pain and tenderness may not be isolated to a unilateral lower quadrant. Although traditionally considered a postmenarchal problem, in a pediatric academic emergency department adnexal torsion occurred with similar frequency in premenarchal and postmenarchal girls. The potential for organ salvage means that adnexal torsion should be considered in all females presenting with acute abdominal pain regardless of age or menstrual history. 相似文献6.
Background
Return visits to the emergency department (RTED) contribute to overcrowding and may be a quality of care indicator. Previous studies focused on factors predicting returns to and from the same center. Little is known about RTEDs across a range of community and specialty hospitals within a large geographic area.Objective
We sought to measure the frequency of pediatric RTEDs and describe their directional pattern across centers in a large catchment area.Methods
We conducted a multicenter, retrospective cross-sectional study of pediatric emergency visits in the Vancouver lower mainland within 1 year. Visits were linked across study sites, including one pediatric quaternary care referral center and 17 sites ranging from large regional centers to smaller community emergency departments (EDs). Returns were defined as subsequent visits to any site with a compatible diagnosis within 7 days of an index visit.Results
Among a total of 139,278 index ED visits by children, 12,133 (8.7% [95% confidence interval 8.6–8.9%]) were associated with 14,645 return visits to an ED. Three quarters of all index visits occurred at a general ED center, of which 8.9% had at least one RTED and 22% of these returns occurred at the pediatric ED (PED). Among PED index visits, 8.2% had at least one RTED and 13.6% of these returned to a general center. Overall, 38.9% of all RTEDs occurred at the PED. Multivariate regression did not identify any statistically significant association between ED crowding measures and likelihood of RTEDs.Conclusions
Compared to single-center studies, this study linking hospitals within a large geographic area identified a higher proportion of RTEDs with a disproportionate burden on the PED. 相似文献7.
Megan Sutter Laiene Olabarrieta Landa Amilkar Calderón Chagualá Helmer Chacón Peralta Gina Vergara Torres Paul B. Perrin Juan Carlos Arango-Lasprilla 《PM & R》2017,9(1):8-14
Background
Stroke is a primary cause of death and disability in upper-middle–income countries such as Colombia. Given the lack of comprehensive rehabilitation for stroke patients in Colombia, there is a need to assess longitudinal mental health problems poststroke in this region.Objective
To compare the course of mental health in stroke patients to healthy controls over the first year poststroke in Ibague, Colombia.Design
Cross-sectional study.Setting
The Psychological Attention Center of Antonio Nariño University in Ibague, Colombia.Participants
Stroke patients (n = 50) and age- and gender-matched healthy controls (n = 50).Methods
Patients and controls completed self-report Spanish versions of demographic information, injury-related characteristics, and mental health questionnairesMain Outcome Measurements
Outcomes assessed included mental health (depression, anxiety, and stress) at 3, 6, and 12 months poststroke.Results
Hierarchical linear models suggested that stroke patients had worse depression and anxiety over time than controls (P < .001). Among patients, depression and anxiety decreased over time (P < .001), whereas stress increased over time (P < .01). The findings suggest that although anxiety and depression improved over time in stroke patients, their mental health remained significantly lower than that of controls.Conclusions
This is the first study to examine the course of mental health over the first year poststroke in Latin America, specifically in Ibague, Colombia. Despite the improvements in anxiety and depression over the first year poststroke, patient anxiety and depression were still worse in comparison to those in healthy controls. The current findings indicate a need for rehabilitation services in Colombia, especially targeting mental health issues.Level of Evidence
I 相似文献8.
Background
Ideally, high-stakes examinations assess 1 dimension of medical knowledge to produce precise estimates of a candidate’s performance. It has not been reported whether the American Board of Physical Medicine and Rehabilitation Part 1 Certification Examination (ABPMR-CE-1) is unidimensional or not.Objective
To examine the ABPMR-CE-1 to measure how many dimensions it assesses.Design
Retrospective observational study.Setting
We assessed examination results from the 2015 ABPMR-CE-1.Participants
A total of 489 deidentified candidates taking the 2015 ABPMR-CE-1.Methods
A 1-parameter Item Response Theory (IRT) measurement model was utilized. A Principal Components Analysis (PCA) of standardized residual correlations was used to detect multidimensionality.Main Outcome Measure
Number of primary dimensions reflected in the 325 test questions.Results
The results of the dimensionality analysis indicated that the ABPMR-CE-1 examination is highly unidimensional from a psychometric perspective. Expert content review of the substantive content of small contrasting clusters of questions provided additional assurance of the unidimensional nature of the examination.Conclusions
The ABPMR-CE-1 appears indeed to measure a single construct, which suggests a sound structure of the examination. It closely approximates the assumption of statistical unidimensionality.Level of Evidence
Not applicable. 相似文献9.
Gardner Yost Laura Coyle Kristen Milkevitch Roy Adair Antone Tatooles Geetha Bhat 《PM & R》2017,9(1):40-45
Background
Left ventricular assist devices (LVADs) have become an increasingly popular and effective means for treating advanced heart failure. LVAD implantation requires extensive surgery and postoperative rehabilitation. The Functional Independence Measure (FIM) has been used to quantify functional gains in numerous patient populations, including those with stroke and spinal cord injury. This study investigated functional improvements in patients undergoing LVAD implantation using the FIM score.Objective
To assess functional improvements in patients with advanced heart failure who underwent LVAD implantation.Design
Retrospective.Setting
Inpatient rehabilitation unit.Subjects
Ninety consecutive patients who received acute inpatient rehabilitation after continuous flow LVAD implantation.Methods
Demographic, laboratory, and functional outcomes data including inpatient rehabilitation unit (IRU) length of stay (LOS), discharge disposition, and FIM score were collected for all patients. Paired t-tests were used to assess change in functional measures and laboratory data.Main Outcome Measures
Primary outcome measures included FIM gain, FIM efficiency, discharge disposition, rates of readmission after discharge from rehabilitation, and LOS in the rehabilitation unit.Results
The FIM gain was statistically significant at 28.4 ± 12.3 (P < .001) and compared favorably with benchmarks for mean FIM gains at our facility (26.4), regionally (21.5), and nationally (22.7) for patients admitted to IRUs with a cardiac diagnosis. FIM efficiency (FIM gain/IRU LOS) was 1.9 ± 1.0 compared with the mean FIM efficiency at our facility (2.2), regionally (2.1), and nationally (2.2). Seventy-four percent (n = 67) of patients were discharged directly home after inpatient rehabilitation, 17% (n = 16) were readmitted to the acute hospital service, and 8% (n = 7) required additional rehabilitation at a subacute rehabilitation facility. The IRU LOS was 16.2 ± 6.9 days.Conclusions
Our study indicates that most patients with an LVAD achieve clinically meaningful functional gains from acute inpatient rehabilitation, with the majority of patients being discharged home. Further studies need to be performed to analyze clinical outcomes after acute inpatient rehabilitation.Level of Evidence
IV 相似文献10.
Heather A. Heaton David M. Nestler Derick D. Jones Rachelen S. Varghese Christine M. Lohse Eric S. Williamson Annie T. Sadosty 《The Journal of emergency medicine》2017,52(3):370-376
Background
Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role.Objectives
Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs).Methods
A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes. After training by a staff member with significant experience in implementing scribe programs, scribes provided 1-to-1 support to a provider as staffing allowed. Comparisons were made between scribed and nonscribed visits.Results
There were 49,389 patient visits during the study period (39,926 adult [80.84%] and 9463 pediatric [19.16%] visits), of which 7865 (15.9%) were scribed. For adults, scribed visits produced 0.20 additional RVUs per patient (p < 0.001). Scribes generated additional RVUs in Emergency Severity Index (ESI) 2 (p < 0.001) and 3 (p < 0.001) patients. There were variable effects of scribes on RVUs by diagnostic codes. For pediatric patients, scribed encounters generated 0.08 fewer RVUs per patient (p = 0.007). ESI score had no effect on RVUs. The impact of scribes on pediatric diagnostic groupings was inconsistent.Conclusions
Scribes had a positive impact on RVUs in adult but not pediatric patients. Among adults, scribes led to higher RVUs in ESI 2 and 3 but not 4 and 5 patients, perhaps suggesting a limitation to improve revenue capture on lower-acuity patients. 相似文献11.
Kerrin C. DePeter Stephen M. Blumberg Sarah Dienstag Becker James A. Meltzer 《The Journal of emergency medicine》2017,52(4):426-432
Background
Despite being an effective analgesic for children with fractures, some clinicians may avoid prescribing ibuprofen due to its potentially harmful effect on bone healing.Objective
To determine if exposure to ibuprofen is associated with an increased risk of bone healing complications in children with fractures.Methods
We performed a retrospective study of children aged 6 months to 17 years who presented to the pediatric emergency department (PED) with a fracture of the tibia, femur, humerus, scaphoid, or fifth metatarsus and who followed up with the orthopedic service. We chose these fractures due to their higher risk for complications. We classified patients as exposed if they received ibuprofen in the PED or during hospitalization or were prescribed ibuprofen at discharge. The main outcome was a bone healing complication as evidenced by nonunion, delayed union, or re-displacement on follow-up radiographs.Results
Of the 808 patients included in the final analysis, 338 (42%) were exposed to ibuprofen. Overall, 27 (3%) patients had a bone healing complication; 8 (1%) developed nonunion, 3 (0.4%) developed delayed union, and 16 (2%) developed re-displacement. Ten (3%) patients who were exposed to ibuprofen, and 17 (4%) who were not, developed a bone healing complication (odds ratio 0.8, 95% confidence interval 0.4–1.8; p = 0.61). There was no significant association between ibuprofen exposure and the development of a bone healing complication despite adjustment for potential confounders.Conclusion
Children with extremity fractures who are exposed to ibuprofen do not seem to be at increased risk for clinically important bone healing complications. 相似文献12.
Alexander J. Bajorek Chloe Slocum Richard Goldstein Jacqueline Mix Paulette Niewczyk Colleen M. Ryan Carla Tierney Hendricks Ross Zafonte Jeffrey C. Schneider 《PM & R》2017,9(1):1-7
Background
A significant proportion of burn injury patients are admitted to inpatient rehabilitation facilities (IRFs). There is increasing interest in the use of functional variables, such as cognition, in predicting IRF outcomes. Cognitive impairment is an important cause of disability in the burn injury population, yet its relationship to IRF outcomes has not been studied.Objective
To assess how cognitive function affects rehabilitation outcomes in the burn injury population.Design
Retrospective study.Setting
Inpatient rehabilitation facilities in the United States.Participants
A total of 5347 adults admitted to an IRF with burn injury between 2002 and 2011.Methods or Interventions
Multivariable regression was used to model rehabilitation outcome measures, using the cognitive domain of the Functional Independence Measure (FIM) instrument as the independent variable and controlling for demographic, medical, and facility covariates.Main Outcome Measurements
FIM total gain, readmission to an acute care setting at any time during inpatient rehabilitation, readmission to an acute care setting in the first 3 days of IRF admission, rate of discharge to the community setting, and length of stay efficiency.Results
Cognitive FIM total at admission was a significant predictor of FIM total gain, length of stay efficiency, and acute readmission at 3 days (P < .05). Cognitive FIM total scores did not have an impact on acute care readmission rate or discharge to the community setting.Conclusions
Cognitive status may be an important predictor of rehabilitation outcomes in the burn injury population. Future work is needed to further examine the impact of specific cognitive interventions on rehabilitation outcomes in this population.Level of Evidence
II 相似文献13.
14.
Eduard Alentorn-Geli Nathan R. Wanderman Andrew T. Assenmacher Bassem T. Elhassan Joaquín Sánchez-Sotelo Robert H. Cofield John W. Sperling 《PM & R》2017,9(10):1006-1012
Background
Theoretically, patients with only one functional arm secondary to contralateral amputation or paralysis will subject their only functional upper extremity to increased loads. This could become an issue after reverse shoulder arthroplasty (RSA). However, there are no reported data on the implant survival or function for patients with a nonfunctional contralateral upper extremity.Objective
To report the outcomes of RSA in patients with contralateral upper extremity amputation or paralysis.Design
Retrospective case series.Setting
Tertiary university hospital.Patients
All patients who underwent RSA between January 2004 and December 2013.Methods
Of 1335 RSA procedures performed, 5 patients had a minimum 2-year follow-up and nonfunctional contralateral upper extremity. There were 3 men and 2 women, with a mean (standard deviation) age and length of follow-up of 72.4 (7.5) years and 56.4 (24-132) months. Two of the patients had a contralateral upper extremity amputation, and the other 3 had contralateral upper extremity paralysis as a result of stroke, traumatic brain injury, and traumatic brachial plexus injury at birth.Main Outcomes
Pain, range of motion, functional scores (Simple Shoulder Test, American Shoulder and Elbow Society and Quick-Disability of the Arm, Shoulder and Hand), satisfaction, complications/reoperations, and radiographic loosening.Results
RSA resulted in substantial improvement in pain (P = .008), forward flexion (P = .02), and external range of motion (P = .01). The mean (standard deviation) Simple Shoulder Test, American Shoulder and Elbow Society, and Quick-Disability of the Arm, Shoulder, and Hand scores were 9.8 (1.3), 82 (13), and 17.8 (13.4), respectively. The results were excellent in 3, satisfactory in 1, and unsatisfactory in 1 patient (due only to external rotation limited to 10°). Subjectively, all 5 patients felt greatly improved and stated they would undergo RSA again. There were no complications or reoperations. There were no shoulders with component loosening.Conclusions
RSA seems to be a safe, effective, and successful surgical procedure for patients with a nonfunctional contralateral upper extremity. Studies with larger sample sizes and longer follow-up will hopefully validate the present findings.Level of Evidence
IV 相似文献15.
Sara J. Morgan Janna L. Friedly Dagmar Amtmann Rana Salem Brian J. Hafner 《Archives of physical medicine and rehabilitation》2017,98(1):105-113
Objective
To determine relationships between pain sites and pain intensity/interference in people with lower limb amputations (LLAs).Design
Cross-sectional survey.Setting
Community.Participants
Lower limb prosthesis users with unilateral or bilateral amputations (N=1296; mean time since amputation, 14.1y).Interventions
Not applicable.Main Outcome Measures
Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity (1 item to assess average pain), PROMIS pain interference (4-item short form to assess the consequences of pain in desired activities), and questions that asked participants to rate the extent to which each of the following were a problem: residual limb pain (RLP), phantom limb pain (PLP), knee pain on the nonamputated side, back pain, and shoulder pain.Results
Nearly three quarters (72.1%) of participants reported problematic pain in 1 or more of the listed sites. Problematic PLP, back pain, and RLP were reported by 48.1%, 39.2%, and 35.1% of participants, respectively. Knee pain and shoulder pain were less commonly identified as problems (27.9% and 21.7%, respectively). Participants also reported significantly (P<.0001) higher pain interference (T-score ± SD, 54.7±9.0) than the normative sample based on the U.S. population (T-score ± SD, 50.0±10.0). Participants with LLAs rated their pain intensity on average ± SD at 3.3±2.4 on a 0-to-10 scale. Pain interference (ρ=.564, P<.0001) and intensity (ρ=.603, P<.0001) were positively and significantly correlated with number of pain sites reported.Conclusions
Problematic pain symptoms, especially RLP, PLP, and back pain, affect most prosthetic limb users and have the potential to greatly restrict participation in life activities. 相似文献16.
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Scott M. Alter Brian Walsh Patrick J. Lenehan Richard D. Shih 《The Journal of emergency medicine》2017,52(6):833-838
Background
Radiation concerns are changing the way emergency physicians evaluate patients. This is especially prevalent in pediatrics, and exemplified by abdominal pain management. Large academic center-based studies suggest appendix ultrasound (U/S) is sensitive and specific for appendicitis, with low nondiagnostic rates.Objectives
We sought to determine the diagnostic rate of appendix U/S and incidence of follow-up computed tomography (CT) imaging for pediatric patients at a community hospital.Methods
Design: Retrospective cohort. Setting: Emergency department with 85,000 annual visits. Population: Patients younger than 21 years old that had an appendix U/S over a 12-month period. U/S were performed by technicians and interpreted by radiologists. Investigators classified readings as “diagnostic” (“positive” and “negative”) or “non-diagnostic” (“borderline” and “appendix not visualized”) and identified follow-up CT studies and interpretations.Results
There were 441 pediatric appendix U/S performed; 26% were diagnostic (14% positive for appendicitis, 12% negative) and 74% nondiagnostic (5% borderline, 69% appendix not visualized). Follow-up CT scans were obtained in 19% of all patients, including 8% with positive U/S, 4% negative, 32% borderline, and 22% not visualized. Follow-up CT was nearly four times more likely in the nondiagnostic group than the diagnostic group (23% vs. 6%, p < 0.0001).Conclusion
The utility of U/S to diagnose appendicitis at a community hospital is limited by a high rate of nondiagnostic studies. Some patients with diagnostic U/S even had follow-up CT imaging. To minimize radiation exposure in children, improvements should be made in the performance and acceptance of U/S as the primary modality of abdominal pain imaging at community hospitals. 相似文献18.
Daniel Cushman Masaru Teramoto Bradley Curtis David T. Lee Austin Marcolina Zachary McCormick 《PM & R》2017,9(10):1013-1019
Background
Patients have expressed concern about undergoing procedures involving trainees, even with direct attending physician supervision. Little literature has examined the effect of trainee involvement on patient outcomes.Objective
We aimed to evaluate the effect of trainee involvement on patient complications, immediate pain reduction, and fluoroscopic time for different fluoroscopic injection types.Design
Retrospective review.Setting
Four academic outpatient institutions with Accreditation Council for Graduate Medical Education (ACGME)?accredited residency (physical medicine and rehabilitation, or anesthesiology) or fellowship (sports medicine or pain medicine) programs from 2000 to 2015.Patients
All patients receiving fluoroscopically guided hip (HI), sacroiliac joint (SIJI), transforaminal epidural (TFEI), and/or interlaminar epidural injections (ILEI, performed at only 1 institution).Methods
Outcome measures were examined based on the presence or absence of a trainee during the procedure.Main Outcome Measurements
The primary outcome was the number of immediate complications, with secondary outcomes being fluoroscopic time per injection (FTPI) and immediate numeric rating scale percentage improvement.Results
Trainees were involved in 67.0% of all injections (N = 7,833). Complication rates or improvements in numeric rating scale scores showed no significant differences with trainee involvement for any injection type (P > .05). Trainee involvement was associated with increased FTPI for ILEIs (18.2 ± 10.1 seconds with trainees versus 15.1 ± 8.5 seconds without trainees, P < .001), but not for HIs (P = .60) or SIJIs (P = .51). Trainee involvement with TFEIs was dependent on institution for outcome with respect to FTPI (P < .001), with 28.1 ± 17.9 seconds with trainees and 32.1 ± 22.1 seconds without trainees (P = 0.51).Conclusions
This large multicenter study of academic institutions demonstrates that trainee involvement in fluoroscopically guided injections does not affect immediate patient complications or pain improvement. Trainee involvement does not increase fluoroscopic time for most injections, although there is an institutional difference seen. This study supports the notion that appropriate trainee supervision likely does not compromise patient safety for fluoroscopically guided injections.Level of Evidence
II 相似文献19.
20.