Outcomes of critically ill COVID‐19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study
Dublin Core
Title
Outcomes of critically ill COVID‐19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study
Subject
COVID-19, Boarders, Pandemic, Emergency department, Critically ill patients
Description
Background Boarding of critically ill patients in the emergency department (ED) has long been known to compro-
mise patient care and affect outcomes. During the COVID-19 pandemic, multiple hospitals worldwide experienced
overcrowded emergency rooms. Large influx of patients outnumbered hospital beds and required prolonged length
of stay (LOS) in the ED. Our aim was to assess the ED LOS effect on mortality and morbidity, in addition to the predic-
tors of in-hospital mortality, intubation, and complications of critically ill COVID-19 ED boarder patients.
Methods This was a retrospective cohort study, investigating 145 COVID-19-positive adult patients who were criti-
cally ill, required intensive care unit (ICU), and boarded in the ED of a tertiary care center in Lebanon. Data on patients
who boarded in the emergency from January 1, 2020, till January 31, 2021, was gathered and studied.
Results Overall, 66% of patients died, 60% required intubation, and 88% developed complications. Multiple risk
factors were associated with mortality naming age above 65 years, vasopressor use, severe COVID pneumonia find-
ings on CT chest, chemotherapy treatment in the previous year, cardiovascular diseases, chronic kidney diseases,
prolonged ED LOS, and low SaO2<95% on triage. In addition, our study showed that staying long hours in the ED
increased the risk of developing complications.
Conclusion To conclude, all efforts need to be drawn to re-establish mitigation strategies and models of critical care
delivery in the ED to alleviate the burden of critical boarders during pandemics, thus decreasing morbidity and mor-
tality rates. Lessons from this pandemic should raise concern for complications seen in ED ICU boarders and allow
the promotion of health measures optimizing resource allocation in future pandemic crises.
Keywords COVID-19, Boarders, Pandemic, Emergency department, Critically ill patients
mise patient care and affect outcomes. During the COVID-19 pandemic, multiple hospitals worldwide experienced
overcrowded emergency rooms. Large influx of patients outnumbered hospital beds and required prolonged length
of stay (LOS) in the ED. Our aim was to assess the ED LOS effect on mortality and morbidity, in addition to the predic-
tors of in-hospital mortality, intubation, and complications of critically ill COVID-19 ED boarder patients.
Methods This was a retrospective cohort study, investigating 145 COVID-19-positive adult patients who were criti-
cally ill, required intensive care unit (ICU), and boarded in the ED of a tertiary care center in Lebanon. Data on patients
who boarded in the emergency from January 1, 2020, till January 31, 2021, was gathered and studied.
Results Overall, 66% of patients died, 60% required intubation, and 88% developed complications. Multiple risk
factors were associated with mortality naming age above 65 years, vasopressor use, severe COVID pneumonia find-
ings on CT chest, chemotherapy treatment in the previous year, cardiovascular diseases, chronic kidney diseases,
prolonged ED LOS, and low SaO2<95% on triage. In addition, our study showed that staying long hours in the ED
increased the risk of developing complications.
Conclusion To conclude, all efforts need to be drawn to re-establish mitigation strategies and models of critical care
delivery in the ED to alleviate the burden of critical boarders during pandemics, thus decreasing morbidity and mor-
tality rates. Lessons from this pandemic should raise concern for complications seen in ED ICU boarders and allow
the promotion of health measures optimizing resource allocation in future pandemic crises.
Keywords COVID-19, Boarders, Pandemic, Emergency department, Critically ill patients
Creator
Tharwat El Zahran1*, Sally Al Hassan1
, Victoria Al Karaki1
, Lina Hammoud1
, Christelle El Helou1
, Malak Khalifeh1
,
Moustafa Al Hariri1,2, Hani Tamim3,4 and Imad El Majzoub1
, Victoria Al Karaki1
, Lina Hammoud1
, Christelle El Helou1
, Malak Khalifeh1
,
Moustafa Al Hariri1,2, Hani Tamim3,4 and Imad El Majzoub1
Source
https://doi.org/10.1186/s12245-023-00551-8
Date
2023
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Tharwat El Zahran1*, Sally Al Hassan1
, Victoria Al Karaki1
, Lina Hammoud1
, Christelle El Helou1
, Malak Khalifeh1
,
Moustafa Al Hariri1,2, Hani Tamim3,4 and Imad El Majzoub1, “Outcomes of critically ill COVID‐19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12216.