Cargando…
Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea
BACKGROUND: Prolonged emergency department length of stay (EDLOS) in critically ill patients leads to increased mortality. This nationwide study investigated patient and hospital characteristics associated with prolonged EDLOS and in-hospital mortality in adult patients admitted from the emergency d...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677700/ https://www.ncbi.nlm.nih.gov/pubmed/36411433 http://dx.doi.org/10.1186/s12873-022-00745-y |
_version_ | 1784833861896634368 |
---|---|
author | Lee, Kyung-Shin Min, Hye Sook Moon, Jae Young Lim, Daesung Kim, Younghwan Ko, Eunsil Kim, You Sun Kim, Joohae Lee, Jeehye Sung, Ho Kyung |
author_facet | Lee, Kyung-Shin Min, Hye Sook Moon, Jae Young Lim, Daesung Kim, Younghwan Ko, Eunsil Kim, You Sun Kim, Joohae Lee, Jeehye Sung, Ho Kyung |
author_sort | Lee, Kyung-Shin |
collection | PubMed |
description | BACKGROUND: Prolonged emergency department length of stay (EDLOS) in critically ill patients leads to increased mortality. This nationwide study investigated patient and hospital characteristics associated with prolonged EDLOS and in-hospital mortality in adult patients admitted from the emergency department (ED) to the intensive care unit (ICU). METHODS: We conducted a retrospective cohort study using data from the National Emergency Department Information System. Prolonged EDLOS was defined as an EDLOS of ≥ 6 h. We constructed multivariate logistic regression models of patient and hospital variables as predictors of prolonged EDLOS and in-hospital mortality. RESULTS: Between 2016 and 2019, 657,622 adult patients were admitted to the ICU from the ED, representing 2.4% of all ED presentations. The median EDLOS of the overall study population was 3.3 h (interquartile range, 1.9–6.1 h) and 25.3% of patients had a prolonged EDLOS. Patient characteristics associated with prolonged EDLOS included night-time ED presentation and Charlson comorbidity index (CCI) score of 1 or higher. Hospital characteristics associated with prolonged EDLOS included a greater number of staffed beds and a higher ED level. Prolonged EDLOS was associated with in-hospital mortality after adjustment for selected confounders (adjusted odds ratio: 1.18, 95% confidence interval: 1.16–1.20). Patient characteristics associated with in-hospital mortality included age ≥ 65 years, transferred-in, artificially ventilated in the ED, assignment of initial triage to more urgency, and CCI score of 1 or higher. Hospital characteristics associated with in-hospital mortality included a lesser number of staffed beds and a lower ED level. CONCLUSIONS: In this nationwide study, 25.3% of adult patients admitted to the ICU from the ED had a prolonged EDLOS, which in turn was significantly associated with an increased in-hospital mortality risk. Hospital characteristics, including the number of staffed beds and the ED level, were associated with prolonged EDLOS and in-hospital mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-022-00745-y. |
format | Online Article Text |
id | pubmed-9677700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96777002022-11-22 Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea Lee, Kyung-Shin Min, Hye Sook Moon, Jae Young Lim, Daesung Kim, Younghwan Ko, Eunsil Kim, You Sun Kim, Joohae Lee, Jeehye Sung, Ho Kyung BMC Emerg Med Research BACKGROUND: Prolonged emergency department length of stay (EDLOS) in critically ill patients leads to increased mortality. This nationwide study investigated patient and hospital characteristics associated with prolonged EDLOS and in-hospital mortality in adult patients admitted from the emergency department (ED) to the intensive care unit (ICU). METHODS: We conducted a retrospective cohort study using data from the National Emergency Department Information System. Prolonged EDLOS was defined as an EDLOS of ≥ 6 h. We constructed multivariate logistic regression models of patient and hospital variables as predictors of prolonged EDLOS and in-hospital mortality. RESULTS: Between 2016 and 2019, 657,622 adult patients were admitted to the ICU from the ED, representing 2.4% of all ED presentations. The median EDLOS of the overall study population was 3.3 h (interquartile range, 1.9–6.1 h) and 25.3% of patients had a prolonged EDLOS. Patient characteristics associated with prolonged EDLOS included night-time ED presentation and Charlson comorbidity index (CCI) score of 1 or higher. Hospital characteristics associated with prolonged EDLOS included a greater number of staffed beds and a higher ED level. Prolonged EDLOS was associated with in-hospital mortality after adjustment for selected confounders (adjusted odds ratio: 1.18, 95% confidence interval: 1.16–1.20). Patient characteristics associated with in-hospital mortality included age ≥ 65 years, transferred-in, artificially ventilated in the ED, assignment of initial triage to more urgency, and CCI score of 1 or higher. Hospital characteristics associated with in-hospital mortality included a lesser number of staffed beds and a lower ED level. CONCLUSIONS: In this nationwide study, 25.3% of adult patients admitted to the ICU from the ED had a prolonged EDLOS, which in turn was significantly associated with an increased in-hospital mortality risk. Hospital characteristics, including the number of staffed beds and the ED level, were associated with prolonged EDLOS and in-hospital mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-022-00745-y. BioMed Central 2022-11-21 /pmc/articles/PMC9677700/ /pubmed/36411433 http://dx.doi.org/10.1186/s12873-022-00745-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lee, Kyung-Shin Min, Hye Sook Moon, Jae Young Lim, Daesung Kim, Younghwan Ko, Eunsil Kim, You Sun Kim, Joohae Lee, Jeehye Sung, Ho Kyung Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea |
title | Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea |
title_full | Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea |
title_fullStr | Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea |
title_full_unstemmed | Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea |
title_short | Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea |
title_sort | patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in korea |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677700/ https://www.ncbi.nlm.nih.gov/pubmed/36411433 http://dx.doi.org/10.1186/s12873-022-00745-y |
work_keys_str_mv | AT leekyungshin patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT minhyesook patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT moonjaeyoung patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT limdaesung patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT kimyounghwan patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT koeunsil patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT kimyousun patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT kimjoohae patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT leejeehye patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea AT sunghokyung patientandhospitalcharacteristicspredictprolongedemergencydepartmentlengthofstayandinhospitalmortalityanationwideanalysisinkorea |