Advertisement

POSTER ABSTRACTS

P36 THE IMPACT OF COMPREHENSIVE EARLY PREGNANCY LOSS MANAGEMENT IN THE EMERGENCY DEPARTMENT
      Objectives: To compare the outcomes of patients who present to the emergency department (ED) for early pregnancy loss (EPL) who receive comprehensive management in the ED versus referral for outpatient follow-up.
      Methods: We performed a retrospective chart review of patients who presented to two EDs in our hospital system with EPL between 2014 and 2019. Patients received ED management (EDM; all counseling and/or management performed in ED) or outpatient management (OPM; discharged from ED and managed as an outpatient). We compared patients with EDM and OPM on the proportion with complete EPL within one week, EPL-related complications, and time spent in the ED. We used multivariable logistic regression adjusted for age, race/ethnicity, insurance status, and specific EPL diagnosis to obtain odds ratios (ORs) and 95% confidence intervals (CIs) for the proportion of patients with complete EPL within one week.
      Results: We identified 126 patients with EDM and 37 with OPM, and 78.6% and 54.1%, respectively, had complete EPL within one week. After adjustment, the odds of complete EPL within one week was 4.5 times higher among EDM than OPM (adjusted OR 4.55, 95%CI 1.78-11.67). The mean time spent in the ED was two hours longer among patients with EDM (6.6 vs. 4.7 hours, p<0.001), but more patients with OPM had EPL-related return ED visits (37.8% vs 11.9%, p<0.001).
      Conclusions: Comprehensive EPL management has a positive impact on patient outcomes and on factors unique to the ED setting. Comprehensive care should be widely implemented to improve patient-centered care for patients seen in the ED with EPL.