Introduction: Sexually transmitted infections (STIs) are a common reason for Emergency Department (ED) visits.  The objective of this study was to see if there were gender differences in CDC diagnosis and treatment guidelines as documented by emergency physicians.

Methods: A retrospective chart review was performed to idenitfy patients treate for urethritis, cervicitis, and PID in the EDs of three hospitals in a PA network during a calendar year.  Cases were reviewed to assess for compliance in documentation with CDC guidelines. Descriptive statistics were used to assess the distributions of study variables by patient sex.  Student t-tess, chi-square tests, and logistic regression were used in the analysis.  Statistical significance was set at p less than or equal to 0.05.

Results: 286 patient records were identified, of these 39 were excluded due to incorrect disease coding, the patient was admitted and treated as an inpatient for their disease, or the patient left the emergency department after refusing care.  Of the 247 participangs, 159  (64.4%) were female.  Females were significantly younger (26.6 years, SD=8.0) than males (31.2, SD=11.5%), (95%CI:2.0-7.0, p=0.0003). All of the males (n=88) in the cohort presented with urethritis;25.8% of females presented with cervicitis and 75.2% with PID. Compliance with documentation for the 5 CDC criteria ranged from 68.8% for patient history to 93.5% for patient diagnostic testing including urine pregnancy, and gonorrhea/chlamydia cultures. Significant differences were obesrved by patient sex.  54% of the charts had symptoms recorded for female patients that were consistent with CDC characteristics for diagnostic critera compared to over 95% for males , (OR=16.9, 95% CI 5.9-48.4, p less than 0.001). Similar results were observed for patient discharge instructions, with physicians completely documenting deliver of discharge instructions to 51.6% females compared to 97.7% of complet documentation in males OR=42.3;95%CI;10.0-178.6, p <0.001). No significant sex differences in documentaion were observed for exam or fo therapeutic antibiotic treatment. Conclusion: This retrospective study found patient gender differences in documentaiton compliance with CDC guidelines for the diagnosis and treatment of urethritis, cervicitis and PID

Background/Objective: To determine the prevalence of homelessness or at-risk for homelessness in the ED setting.

Methods: Using a 5 question screening tool derived from teh US department of Housing and Urband Development (HUD), Health and Human Services (HHS) and the Beterans Administration (VA) definition for homelessness, we surveyed all patients meeting inclusion criteria on scheudled shifts in one of three EDs in Northeastern Pennsylvania  Two survey periods were selected to represent seasonal variations.

Results: 4395 subjects were included in the analysis.  The mean age of participants was 50.8 (SD 20.5) and 2,557(58.2%) were women.  The mean age of those who screened positive for homelessness or at-risk for homelessness was 43.1 (SD16.6). Overall, 136 (3.1%) participants screened positive for at-risk for homelessness and 309 (7.0%) screened positive for homelessness.  103 (9.8%) subjects screened positive for homelessness or at-risk for homelessness on weekends and 312 (10.3%) on weekedays (p=-.64).  The proportion of those screening positive for homelessness or at-risk for homelessness varied by site: 145 (7.5%) at hte trauma cetner, 151 (9.1%) at the suburban site and 149 (18.7%) at the center city site, p<0.001.  There was no statistical significance to the difference between the trauma center and the suburban site (p=.088), but there was statistical significance between both the suburban and the trauma cneter when compared to the center city site (both p<0.0001).  The proportion of those screening positive for homelessness in the summer months (156,7.5%) was similar to those in the winter months (153, 6.6%), p=-.23, but it did favor summer months if those who were at-risk for homelessness were included (230, 11.1%, summer versus 215, 9.2% winter; p=0.045).

Conclusions: In our study, the overall prevalence of homelessness or at-risk for homelessness was 10.1%. This prevalence did not seem to vary between weekdays and weekends.  Additionally summer months had a prevalence that was was concerning as winter months.  The prevalence does, however, seem to vary by institutional characteristics even in the same geographic region.  Understanding the patterns of prevalence of homelessness is a step toward considering possible interventions to assist this vulnerable population