We hypothesized that an emergency short-stay ward (ESSW) mainly operated by emergency medicine physicians may reduce the length of patient stay in emergency department without expense of clinical outcomes.We retrospectively analysed adult patients who visited the emergency department of the study hospital and were subsequently admitted to wards from 2017 to 2019. We divided study participants into three groups: patients admitted to ESSW and treated by the department of emergency medicine (ESSW-EM), patients admitted to ESSW and treated by other departments (ESSW-Other) and patients admitted to general wards (GW). The co-primary outcomes were ED length of stay and 28-day hospital mortality.In total, 29,596 patients were included in the study, and 8,328 (31.3%), 2,356 (8.9%), and 15,912 (59.8%) of them were classified as ESSW-EM, ESSW-Other and GW groups, respectively. The ED length of stay of the ESSW-EM (7.1 h ± 5.4) was shorter than those of the ESSW-Other (8.0 ± 6.2, P < 0.001) and the GW (10.2 ± 9.8, P < 0.001 for both). Hospital mortality of ESSW-EM (1.9%) was lower than that of GW (4.1%, P < 0.001). In the multivariable linear regression analysis, the ESSW-EM was independently associated with shorter ED length of stay compared with the both ESSW-Other (coefficient, 1.08; 95% confidence interval, 0.70-1.46; P < 0.001) and GW (coefficient, 3.35; 95% confidence interval, 3.12-3.57; P < 0.001). In the multivariable logistic regression analyses, the ESSW-EM was independently associated with lower hospital mortality compared with both the ESSW-Other group (adjusted P = 0.030) and the GW group (adjusted P < 0.001).In conclusion, the ESSW-EM was independently associated with shorter ED length of stay compared with both the ESSW-Other and the GW in the adult ED patients. Independent association was found between the ESSW-EM and lower hospital mortality compared with the GW.
Doppler optical coherence tomography (DOCT) is a non-destructive imaging technique designed to measure the movement of a sample by applying the Doppler effect to optical coherence tomography (OCT) signal data. It was designed to acquire a tomography image of the tympanic membrane (TM) and a calculated Doppler signal in real time with OCT using the CUDA parallel processing algorithm while inducing vibration of the TM with an audio signal. Afterwards, the thickness of the TM inside the ROI was measured using software, and the degree of response was analyzed according to the thickness. To measure the tomographic thickness of the TM responding to sound waves, image processing was used to acquire the upper and lower boundaries of the TM. To reduce the error in thickness measurement according to the angle of the TM, the shortest distance between the upper and lower boundaries at each pixel was used to reduce the error in the thickness measurement. In addition, by mapping the thickness information to a two-dimensional array, the movement of the TM in response to sound waves was finally analyzed through a histogram according to the thickness of the TM. Finally, we were able to obtain the tendency of the response according to the thickness of the TM, and quantitatively analyze the change in the reactivity according to the area of the TM.
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