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Open Access Highly Accessed Research article

A survey of emergency department use in patients with cyclic vomiting syndrome

Thangam Venkatesan1*, Sally Tarbell2, Kathleen Adams2, Jennifer McKanry3, Trish Barribeau4, Kathleen Beckmann5, Walter J Hogan1, Nilay Kumar1 and BUK Li2

  • * Corresponding author: Thangam Venkatesan tvenkate@mcw.edu

  • † Equal contributors

Author Affiliations

1 Medical College of Wisconsin, Division of Gastroenterology and Hepatology, 9200, West Wisconsin Avenue, Milwaukee, WI-53226, USA

2 Medical College of Wisconsin, Division of Pediatric Gastroenterology and Nutrition, 9000 West Wisconsin Avenue Milwaukee, WI 53226, USA

3 Medical College of Wisconsin, Pediatric Medical Education, 9000 West Wisconsin Avenue, Milwaukee, WI 53226, USA

4 Children's Research Institute, Children's Hospital of Wisconsin, PO Box 1997 Milwaukee, WI 53201-1997, USA

5 Medical College of Wisconsin, Division of Pediatric Emergency Medicine, 9000 West Wisconsin Avenue Milwaukee, WI 53226, USA

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BMC Emergency Medicine 2010, 10:4  doi:10.1186/1471-227X-10-4

Published: 24 February 2010

Abstract

Background

Cyclic vomiting syndrome (CVS), a chronic disorder characterized by recurrent episodes of vomiting, is frequently unrecognized and is associated with high utilization of emergency department (ED) services.

Methods

A web-based survey was posted on the Cyclic Vomiting Syndrome Association (CVSA) website to assess utilization of ED services in patients with CVS.

Results

Of 251 respondents, 104 (41.4%) were adult CVS patients and 147 (58.6%) were caregivers of pediatric and adult patients. In the adult group, the median number of ED visits for CVS symptoms was 15(range 1 - 200), with a median of 7 ED visits prior to a diagnosis of CVS (range 0 - 150). In the caregiver group, the median number of ED visits was 10 (range 1 - 175) and the median number of ED visits prior to a diagnosis of CVS was 5 (range 0 - 65). CVS was not diagnosed in the ED in 89/104 (93%) adults and 119/147 (93%) patients in the caregiver group. CVS was not recognized in the ED in 84/95 (88%) of adults and 97/122 (80%) of patients in the caregiver group, despite an established diagnosis of CVS.

Conclusion

There is a sub-group of adult and pediatric CVS patients who are high utilizers of ED services and CVS is not recognized in the ED in the majority of patients. Improved efforts to educate ED physicians are indicated to optimize treatment of patients with CVS and to decrease potential overuse of ED services.