Dear Editor: I read with great interest the article entitled “Application of Queuing Analytic Theory to Decrease Waiting Times in Emergency Department: Does it Make Sense?” in the autumn issue of Archives of Trauma Research (1). As an Emergency physician in the United States, I can share the frustration of the authors that throughput of patients in the Emergency Department can often be hindered by numerous medical and logistical factors. In the United States, unlike most countries, Emergency Department care is not reserved to patients with acute severe conditions alone. Rather, under US law, Emergency Departments regularly provide care to patients who often do not have access to health care in other settings (2).

Introduction: Peripheral facial palsy (PFP) is commonly diagnosed in every Emergency Department. Despite being a benign condition in most cases, PFP causes loss in quality of life mostly due to facial dysmorphia. The etiology of PFP remains unknown in most cases, while medical opinion on epidemiology, risk factors and optimal treatment is not consensual. The aim of this study was to review the demographic characteristics of our patients and the medical care administered in our Emergency Department. Materials and Methods: Emergency episodes occurring in a 4-year period and codified as facial nerve pathology were analyzed. IBM SPSS software was used for statistical analysis. Results: In total, 582 Emergency episodes were obtained. Due to inexpressive representation of other causes of PFP in our study, we focused our analyses on the 495 patients who were considered to have idiopathic PFP. There was equal distribution among genders, and all age ranges were affected. There were no clear epidemic phenomena. Hypertension was not a statistically significant risk factor for Bell's palsy. Most patients sought medical care in the early stages of the disease and complained of isolated facial weakness. Most patients had mild-to-moderate symptoms. Previous upper way infections (PUAI) were more frequent among children. There was a statistically significant difference regarding computed tomography (CT) scan requests among specialties. Conclusion: Epidemiologic findings were consistent with most literature on Bell's palsy. Drug therapy is widely used and follows current guidelines. The role of PUAI in the pediatric population must be investigated. Despite evidence of good medical practice, there was an excess of CT scans requested by physicians other than otorhinolaryngologists.

Background: Hospital readmission places a high burden on both health care systems and patients. Most readmissions are thought to be related to the quality of the health care system.Objectives: The aim of this study was to examine the causes and rates of early readmission in Emergency Department in a Tehran hospital.Patients and Methods: A cross-sectional investigation was performed to study readmission of inpatients at a large academic hospital in Tehran, Iran. Patients admitted to hospital from July 1, 2014 to December 30, 2014 via the Emergency Department were enrolled.Descriptive statistics were used to summarize the distribution demographics in the sample. Data was analyzed by chi2 test using SPSS 20 software.Results: The main cause of readmission was complications related to surgical procedures (31.0%). Discharge from hospital based on patient request at the patient’s own risk was a risk factor for Emergency readmission in 8.5%, a very small number were readmitted after complete treatment (0.6%). The only direct complication of treatment was infection (17%).Conclusions: Postoperative complications increase the probability of patients returning to hospital. Physicians, nurses, etc., should focus on these specific patient populations to minimize the risk of postoperative complications. Future studies should assess the relative connections of various types of patient information (e.g., social and psychosocial factors) to readmission risk prediction by comparing the performance of models with and without this information in a specific population.