title: Incidence of priapism in emergency departments in the United States.
abstract: OBJECTIVE
  Priapism is a complex medical emergency that often requires prompt management. In this study, we examine the incidence of this condition in a United States population based setting, and assess patient and emergency department attributes associated with an increased likelihood of hospitalization.
  
  
  METHODS
  Emergency department visits with a primary diagnosis of priapism between 2006 and 2009 were abstracted from the Nationwide Emergency Department Sample. Univariable and multivariable analyses were performed of patient and hospital characteristics of those admitted with priapism.
  
  
  RESULTS
  Between 2006 and 2009 a weighted estimate of 32,462 visits to the emergency department for priapism was recorded in the United States, which represents a national incidence of 5.34 per 100,000 male subjects per year. The incidence of emergency department visits increased by 31.4% during the summer compared to the winter months. Overall 4,320 visits (13.3%) resulted in hospitalization/admission for further management. On multivariable analyses independent predictors of admission included Charlson comorbidity index score 3 or greater (OR 5.67, p <0.001), insurance status (Medicaid vs private OR 1.60, p = 0.001), hospital location (rural vs urban nonteaching OR 0.32, p <0.001), median ZIP code income (very high OR 0.65, p = 0.005), emergency department volume (very high vs very low OR 1.61, p = 0.004), sickle cell disease (OR 2.22, p <0.001) and drug abuse (OR 5.47, p <0.001).
  
  
  CONCLUSIONS
  Emergency department visits for priapism are relatively uncommon and occur more frequently during the summer months. The majority of patients are treated and released expediently. Predictors of hospital admission included comorbidity profile, insurance, hospital location and emergency department volume.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany. Electronic address: f.roghmann@gmail.com.
authors.forename: Florian
authors.initials: F
authors.lastname: Roghmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Sammon
authors.forename: Miriam
authors.initials: M
authors.lastname: Ouerghi
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.forename: Shyam
authors.initials: S
authors.lastname: Sukumar
authors.forename: Orchidee
authors.initials: O
authors.lastname: Djahangirian
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Zorn
authors.forename: Khurshid R
authors.initials: KR
authors.lastname: Ghani
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandaglia
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
authors.forename: Pierre
authors.initials: P
authors.lastname: Karakiewicz
authors.forename: Joachim
authors.initials: J
authors.lastname: Noldus
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011317:Priapism / Q000453:epidemiology*; D014481:United States
keywords: CCI; Charlson comorbidity index; EAPC; ED; NEDS; Nationwide Emergency Department Sample; PDE5i; emergencies; emergency department; emergency service; estimated annual percent change; hospital; incidence; patient admission; phosphodiesterase type 5 inhibitors; priapism