Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide
analysis in Korea

Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide
analysis in Korea

Emergency department, Critical care, Intensive care unit, Length of stay, In-hospital mortality

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 Infor‑
mation System. Prolonged EDLOS was defned 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 nighttime ED presentation and Charlson comorbidity index (CCI) score of 1 or higher. Hospital characteristics associated
with prolonged EDLOS included a greater number of stafed beds and a higher ED level. Prolonged EDLOS was associ‑
ated with in-hospital mortality after adjustment for selected confounders (adjusted odds ratio: 1.18, 95% confdence
interval: 1.16–1.20). Patient characteristics associated with in-hospital mortality included age≥65 years, transferred-in,
artifcially ventilated in the ED, assignment of initial triage to more urgency, and CCI score of 1 or higher. Hospital char‑
acteristics associated with in-hospital mortality included a lesser number of stafed 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 signifcantly associated with an increased in-hospital mortality risk. Hospital characteris‑
tics, including the number of stafed beds and the ED level, were associated with prolonged EDLOS and in-hospital
mortality

Kyung‑Shin Lee, Hye Sook Min, Jae Young Moon, Daesung Lim, Younghwan Kim, Eunsil Ko, You Sun Kim, Joohae Kim, Jeehye Lee and Ho Kyung Sung

BMC Emergency Medicine

(2022) 22:183

Fajar bagus W

PDF

English

Text