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  1. Article ; Online: Frequent incorrect documentation of tobacco use for emergency department adults that qualify for lung cancer screening.

    Pettit, Nicholas R

    The American journal of emergency medicine

    2022  Volume 55, Page(s) 82–83

    MeSH term(s) Adult ; Documentation ; Early Detection of Cancer ; Electronic Health Records ; Emergency Service, Hospital ; Humans ; Lung Neoplasms/diagnosis ; Tobacco Use
    Language English
    Publishing date 2022-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2022.02.057
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  2. Article ; Online: The emergency department: A key pillar in the cancer care continuum.

    Pettit, Nicholas R / Bischof, Jason J

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2023  Volume 30, Issue 12, Page(s) 1288–1289

    MeSH term(s) Humans ; Emergency Service, Hospital ; Continuity of Patient Care ; Neoplasms/diagnosis ; Neoplasms/therapy
    Language English
    Publishing date 2023-09-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14802
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  3. Article ; Online: A large back mass.

    Pettit, Nicholas / Corson-Knowles, Daniel

    Journal of the American College of Emergency Physicians open

    2021  Volume 2, Issue 4, Page(s) e12511

    Language English
    Publishing date 2021-07-31
    Publishing country United States
    Document type Journal Article
    ISSN 2688-1152
    ISSN (online) 2688-1152
    DOI 10.1002/emp2.12511
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  4. Article ; Online: Pilot intervention to increase uptake of lung cancer screening through the emergency department.

    Pettit, Nicholas R / Horner, Diane / Freeman, Sara / Rieger, Karen

    The American journal of emergency medicine

    2024  Volume 79, Page(s) 157–160

    Abstract: Introduction: The goal of this study is to demonstrate the feasibility of referring patients for lung cancer screening (LCS) from the emergency department (ED) as a method to increase the uptake of LCS.: Methods: This is a single-arm pilot study at a ...

    Abstract Introduction: The goal of this study is to demonstrate the feasibility of referring patients for lung cancer screening (LCS) from the emergency department (ED) as a method to increase the uptake of LCS.
    Methods: This is a single-arm pilot study at a large safety-net ED. ED LCS-eligible patients were offered a referral to our LCS clinic upon ED discharge. The primary outcome was the frequency at which patients connected with the LCS clinic.
    Results: During the study period, 105 patients were approached; 26 (24.8%) participated. Reasons for non-enrollment include 29 (27.6%) who were not interested in research, 10 (9.5%) who did not speak English, and 40 (38.1%) who did not meet the pack-years criteria. Seventeen patients (65.4%, 17/26) connected with the LCS clinic, with 10 (38.5%) having been seen in the clinic and received a low dose computed tomography (LDCT) scan. Of the 17 that were connected with the clinic, 7 (26.9%) had a non-LDCT chest CT scan in the past year. Of those that were not seen in the clinic (n = 9), 4 (44.4%) were unreachable via 3 phone calls and a post-marked letter, and 3 (33.3%) did not attend the scheduled appointment, and 2 (22.2%) were delayed due to COVID-19. Of those that had CT scans over the study period (n = 17), 0 scans were normal, one patient (5.9%) had asymptomatic lung cancer, 7 (41.2%) had pulmonary nodules, 11 (64.7%) had emphysema, and 9 (52.9%) had coronary artery disease.
    Conclusion: This pilot study suggests the feasibility and suggests initial indications of the efficacy of referring ED patients for LCS.
    MeSH term(s) Humans ; Early Detection of Cancer/methods ; Pilot Projects ; Lung Neoplasms/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Referral and Consultation ; Mass Screening/methods
    Language English
    Publishing date 2024-02-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2024.02.019
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  5. Article ; Online: Young male with coughing and chest pain.

    Motzkus, Christine / Pettit, Nicholas

    Journal of the American College of Emergency Physicians open

    2021  Volume 2, Issue 1, Page(s) e12371

    Language English
    Publishing date 2021-01-16
    Publishing country United States
    Document type Journal Article
    ISSN 2688-1152
    ISSN (online) 2688-1152
    DOI 10.1002/emp2.12371
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  6. Article ; Online: Retrospective review of patients with lung cancer presenting emergently.

    Pettit, Nicholas R / Noriega, Andrea / Missen, Marissa Rose Vander

    The American journal of emergency medicine

    2023  Volume 71, Page(s) 129–133

    Abstract: Background: A significant proportion of lung cancer patients receive their diagnosis as part of an emergency presentation (EPs) to emergency departments (EDs).: Objectives: This study aimed to describe EPs of lung cancer at a safety-net hospital ... ...

    Abstract Background: A significant proportion of lung cancer patients receive their diagnosis as part of an emergency presentation (EPs) to emergency departments (EDs).
    Objectives: This study aimed to describe EPs of lung cancer at a safety-net hospital system.
    Methods: We conducted a retrospective analysis of patients with lung cancer at a safety-net ED. EP was defined as a diagnosis of lung cancer due to an acute presentation with symptoms of undiagnosed lung cancer (e.g., cough, hemoptysis, shortness of breath). Non-EPs were the result of either incidental findings (trauma pan-scan) or as part of lung cancer screening.
    Results: A total of 333 patient charts were reviewed who had lung cancer. Of those, 248 (74.5%) were defined as having an EP. EPs were more likely stage IV than non-EPs (50.4% vs 32.9%). The percent mortality was higher for EP versus non-EP, 60.0% vs 49.4%. which is driven by a high mortality rate for stage IV EPs (77.5%). Most patients with an EP were seen in the ED (177, 71.4%) as the location of initial visit that had a workup concerning for lung cancer. Most of the EPs were admitted for completion of either their diagnostic work up and/or for symptom management (117, 66.5%). Logistic regression identified significant predictors for an EP including stage IV at diagnosis (OR 2.49, 95% CI 1.39-4.48) and lack of primary care (OR 0.07, 95% CI 0.009-0.53).
    Conclusion: Most patients with lung cancer present acutely as an EP with advanced stage in a safety-net health care setting. The ED plays an important role in the initial diagnosis of lung cancer and coordinating subsequent cancer care.
    MeSH term(s) Humans ; Retrospective Studies ; Early Detection of Cancer ; Lung Neoplasms/diagnosis ; Lung Neoplasms/epidemiology ; Hospitalization ; Emergency Service, Hospital
    Language English
    Publishing date 2023-06-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2023.06.027
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  7. Article ; Online: Novel referral pathway for patients with new solid tumors discharged from the emergency department: A pilot study.

    Pettit, Nicholas / Al-Hader, Ahmad

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2021  Volume 29, Issue 4, Page(s) 500–502

    MeSH term(s) Emergency Service, Hospital ; Humans ; Neoplasms/therapy ; Patient Discharge ; Pilot Projects ; Referral and Consultation
    Language English
    Publishing date 2021-12-02
    Publishing country United States
    Document type Letter
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14420
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  8. Article ; Online: Lower extremity pain and numbness.

    Pettit, Nicholas R

    Emergency medicine journal : EMJ

    2018  Volume 35, Issue 7, Page(s) 419–433

    Abstract: Clinical introduction: A 45-year-old man with no past medical history presents with bilateral lower extremity pain and perineal numbness after walking 10-15 min. The pain starts in his bilateral buttocks and radiates down into his thigh and into his ... ...

    Abstract Clinical introduction: A 45-year-old man with no past medical history presents with bilateral lower extremity pain and perineal numbness after walking 10-15 min. The pain starts in his bilateral buttocks and radiates down into his thigh and into his toes. He has no back pain, fever, difficulty urinating or stooling, incontinence or trauma. Social history is positive for smoking. Physical examination was only remarkable for non-dopplerable lower extremity pulses, and he was unable to ambulate down the ED hallway without becoming symptomatic. Ultrasound of his abdominal aorta (figure 1) was performed.emermed;35/7/419/F1F1F1Figure 1Transverse view of distal abdominal aorta, just proximal to the bifurcation. (A) The aorta without Doppler. (B) The same image with Doppler mode activated.
    Question: What is the most likely diagnosis based on the image?A. Lumbar stenosisB. Abdominal aortic aneurysmC. Aortic thrombusD. Aortic dissection.
    MeSH term(s) Humans ; Hypesthesia/etiology ; Leriche Syndrome/complications ; Leriche Syndrome/diagnosis ; Leriche Syndrome/physiopathology ; Lower Extremity/blood supply ; Lower Extremity/innervation ; Male ; Middle Aged ; Pain/etiology
    Language English
    Publishing date 2018-06-12
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2017-207248
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  9. Article ; Online: Man with productive cough.

    Pettit, Nicholas / Al-Hader, Ahmad

    Journal of the American College of Emergency Physicians open

    2020  Volume 1, Issue 4, Page(s) 669

    Keywords covid19
    Language English
    Publishing date 2020-06-12
    Publishing country United States
    Document type Journal Article
    ISSN 2688-1152
    ISSN (online) 2688-1152
    DOI 10.1002/emp2.12122
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  10. Article ; Online: Perspectives of emergency department physicians and nurses on reasons for preventable emergency department visits by patients with cancer.

    Pettit, Nicholas / Vachon, Eric / Lash, Rebecca / Spackman, Candice / Draucker, Claire Burke

    The American journal of emergency medicine

    2024  Volume 78, Page(s) 140–144

    Abstract: Background: Patients with cancer frequently visit the emergency department (ED) for medical care, yet approximately half of ED visits for patients with cancer are thought to be preventable. Preventable ED visits are associated with increased healthcare ... ...

    Abstract Background: Patients with cancer frequently visit the emergency department (ED) for medical care, yet approximately half of ED visits for patients with cancer are thought to be preventable. Preventable ED visits are associated with increased healthcare costs and poor patient experiences and outcomes. The voices of ED providers who work with patients with cancer in their everyday practices have not been solicited as it pertains to preventable visits.
    Objectives: The purpose of this study is to describe the perspectives of ED physicians and nurses on reasons for preventable ED visits by patients with cancer.
    Methods: A qualitative descriptive design guided the study. We conducted 23 semi-structured interviews with ED physicians and nurses to query them about their perspectives on the reasons for preventable ED visits by patients with cancer. Content analysis was conducted to list and describe the reasons they discussed.
    Results: Participants identified five "medical" and five "non-medical" causes of preventable ED visits. Medical reasons included uncontrolled cancer pain, gastrointestinal symptoms, anemia, fever, and on-going undiagnosed signs and symptoms. Non-medical reasons include patient hesitancy to contact primary care providers, lack of availability or responsiveness of primary providers, lack of access, lack of care coordination, and fears about diagnosis and treatment.
    Conclusion: The voices of ED providers should be included in discussions about the problem of preventable ED visits by patients with cancer. The reasons supplied by the participants suggest that solutions to the problem will need to occur at the patient, provider, system, and societal levels.
    MeSH term(s) Humans ; Emergency Room Visits ; Emergency Service, Hospital ; Neoplasms/therapy ; Physicians
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2024.01.015
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