title: Acute care needs in an Indian emergency department: A retrospective analysis.
abstract: BACKGROUND
  Emergencies such as road traffic accidents (RTAs), acute myocardial infarction (AMI) and cerebrovascular accident (CVA) are the most common causes of death and disability in India. Robust emergency medicine (EM) services and proper education on acute care are necessary. In order to inform curriculum design for training programs, and to improve the quality of EM care in India, a better understanding of patient epidemiology and case burden presenting to the emergency department (ED) is needed.
  
  
  METHODS
  This study is a retrospective chart review of cases presenting to the ED at Kerala Institute of Medical Sciences (KIMS), a private hospital in Trivandrum, Kerala, India, from November 1, 2011 to April 21, 2012 and from July 1, 2013 to December 21, 2013. De-identified charts were systematically sampled and reviewed.
  
  
  RESULTS
  A total of 1 196 ED patient charts were analyzed. Of these patients, 55.35% (n=662) were male and 44.7% (n=534) were female. The majority (67.14%, n=803) were adults, while only 3.85% (n=46) were infants. The most common chief complaints were fever (21.5%, n=257), renal colic (7.3%, n=87), and dyspnea (6.9%, n=82). The most common ED diagnoses were gastrointestinal (15.5%, n=185), pulmonary (12.3%, n=147), tropical (11.1%, n=133), infectious disease and sepsis (9.9%, n=118), and trauma (8.4%, n=101).
  
  
  CONCLUSIONS
  The patient demographics, diagnoses, and distribution of resources identified by this study can help guide and shape Indian EM training programs and faculty development to more accurately reflect the burden of acute disease in India.
authors.affiliation: Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Clark
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Watson
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Leemann
authors.affiliation: Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts, USA.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Breaud
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts, USA; Boston University Center for Global Health and Development, Boston, Massachusetts, USA.
authors.forename: Frank G
authors.initials: FG
authors.lastname: Feeley
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts, USA; Boston University Center for Global Health and Development, Boston, Massachusetts, USA.
authors.forename: James
authors.initials: J
authors.lastname: Wolff
authors.affiliation: Max Hospital, New Delhi, India.
authors.forename: Tamorish
authors.initials: T
authors.lastname: Kole
authors.affiliation: Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts, USA; Boston University Center for Global Health and Development, Boston, Massachusetts, USA; Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: Jacquet
keywords: Acute care; Education; Emergency care systems; Emergency department; Emergency department utilization