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Long emergency department (ED) waiting times are believed to be associated with poor outcomes for sick patients who require admission. A large population-based study of busy Canadian EDs examined patients who were discharged from the ED after treatment or did not wait. There was an increased 7-day mortality rate in patients discharged after treatment during shifts with long mean waiting times. Leaving before assessment was not associated with adverse outcomes. The authors suggest that during shifts with long mean waiting times, important processes of care are impeded and decision making altered. These results support the use of time to assessment as a care quality indicator in EDs (BMJ 2011;342:d2983).
Plasma N-terminal pro-brain natriuretic peptide (NTproBNP) levels are known to be raised in patients with acute atrial fibrillation (AF), reaching a peak within 24 h of onset and then falling back to normal levels if AF persists. The authors of a prospective study published in Heart (2011;97:914–17) measured levels of NTproBNP in patients …