scholarly journals Factors Associated with Emergency Department Length of Stay in Critically Ill Patients: A Single-Center Retrospective Study

2021 ◽  
Vol 27 ◽  
Author(s):  
Zhiwei Yang ◽  
Kun Song ◽  
Hang Lin ◽  
Changluo Li ◽  
Ning Ding
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Single Center ◽  
Factors Associated

scholarly journals Increased Length of Stay of Critically Ill Patients in the Emergency Department Associated with Higher In-hospital Mortality

2021 ◽  
Vol 25 (11) ◽  
pp. 1221-1225
Author(s):  
Ankur Verma ◽  
Amit Vishen ◽  
Meghna Haldar ◽  
Sanjay Jaiswal ◽  
Rinkey Ahuja ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals Analysis of Factors Affecting the Length of Stay in the Emergency Department for Critically Ill Patients Transferred to Regional Emergency Medical Centers

2022 ◽  
Author(s):  
Hyungbok Lee ◽  
Sangrim Lee ◽  
Hyeoneui Kim
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prediction Models ◽  
Emergency Operation ◽  
Factors Affecting ◽  
Interhospital Transfer ◽  
Triage Level

Abstract BackgroundTransferring an emergency patient to another emergency department (ED) is necessary when she/he is unable to receive necessary treatment from the first visited ED, although the transfer poses potential risks for adverse clinical outcomes and lowering the quality of emergency medical services by overcrowding the transferred ED. This study aimed to understand the factors affecting the ED length of stay (LOS) of critically ill patients and to investigate whether they are receiving prompt treatment through Interhospital Transfer (IHT).MethodsThis study analyzed 968 critically ill patients transferred to the ED of the study site in 2019. Machine learning based prediction models were built to predict the ED LOS dichotomized as greater than 6 hours or less. Explanatory variables in patient characteristics, clinical characteristics, transfer-related characteristics, and ED characteristics were selected through univariate analyses.ResultsAmong the prediction models, the Logistic Regression (AUC 0.85) model showed the highest prediction performance, followed by Random Forest (AUC 0.83) and Naïve Bayes (AUC 0.83). The Logistic Regression model suggested that the need for emergency operation or angiography (OR 3.91, 95% CI=1.65–9.21), the need for Intensive Care Unit (ICU) admission (OR 3.84, 95% CI=2.53–5.83), fewer consultations (OR 3.57, 95% CI=2.84–4.49), a high triage level (OR 2.27, 95% CI=1.43–3.59), and fewer diagnoses (OR 1.32, 95% CI=1.09–1.61) coincided with a higher likelihood of 6-hour-or-less stays in the ED. Furthermore, an interhospital transfer handoff led to significantly shorter ED LOS among the patients who needed emergency operation or angiography, or ICU admission, or had a high triage level.ConclusionsThe results of this study suggest that patients prioritized in emergency treatment receive prompt intervention and leave the ED in time. Also, having a proper interhospital transfer handoff before IHT is crucial to provide efficient care and avoid unnecessarily longer stay in ED.

scholarly journals Intensive care unit admission protocol controlled by intensivists can reduce transfer delays from the emergency department in critically ill patients

2018 ◽  
Vol 26 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Ji Eun Kim ◽  
Seul Lee ◽  
Jinwoo Jeong ◽  
Dong Hyun Lee ◽  
Jin-Heon Jeong
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Unit Admission ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Unit Length ◽  
Intensive Care Unit Length ◽  
Before And After

Background: Delayed transfer of patients from the emergency department to the intensive care unit is associated with adverse clinical outcomes. Critically ill patients with delayed admission to the intensive care unit had higher in-hospital mortality and increased hospital length of stay. Objectives: We investigated the effects of an intensive care unit admission protocol controlled by intensivists on the emergency department length of stay among critically ill patients. Methods: We designed the intensive care unit admission protocol to reduce the emergency department length of stay in critically ill patients. Full-time intensivists determined intensive care unit admission priorities based on the severity of illness. Data were gathered from patients who were admitted from the emergency department to the intensive care unit between 1 April 2016 and 30 November 2016. We retrospectively analyzed the clinical data and compared the emergency department length of stay between patients admitted from the emergency department to the intensive care unit before and after intervention. Results: We included 292 patients, 120 and 172 were admitted before and after application of the intensive care unit admission protocol, respectively. The demographic characteristics did not differ significantly between the groups. After intervention, the overall emergency department length of stay decreased significantly from 1045.5 (425.3–1665.3) min to 392.0 (279.3–686.8) min (p < 0.001). Intensive care unit length of stay also significantly decreased from 6.0 (4.0–11.8) days to 5.0 (3.0–10.0) days (p = 0.015). Conclusion: Our findings suggest that introduction of the intensive care unit admission protocol controlled by intensivists successfully decreased the emergency department length of stay and intensive care unit length of stay among critically ill patients at our institution.

scholarly journals Multi-Drug Resistant Gram-Negative Infections Among Critically Ill Patients: Analysis of Baseline Characteristics and Factors Associated with Mortality

2020 ◽  
Author(s):  
Fadi Aljamaan ◽  
Esraa Altawil ◽  
Mohamad-Hani Temsah ◽  
Ahmad Almeman
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Resistant ◽  
Gram Negative ◽  
Factors Associated ◽  
Icu Length Of Stay ◽  
Acinetobacter Spp ◽  
Apache Iv

Abstract BackgroundBacterial infections are a frequent cause of hospitalization and a leading cause of death, particularly with the emergence of antibiotics resistance. The emergence of Carbapenem resistance among gram-negative bacteria (GNB) is one of the evolving alerts as its use is considered the last resort of treatment [1]. Therefore, this urged studying the risk factors for the development of multi-drug resistant [2] GNB, identify the clinical outcomes and factors associated with mortality, especially among critically ill patients who are expected to have the worst outcomes.Materials/methodsThis is a retrospective observational study of critically ill patients who had an infection with Carbapenem-resistant Enterobacteriaceae (CRE), or MDR Pseudomonas aeruginosa, or MDR Acinetobacter spp. between May 2016- Nov 2018. Baseline demographics, co-morbidities, and clinical outcomes were collected and were evaluated for association with 28 days mortality. ResultsA total of 255 patients with MDR Gram-negative cultures were screened, 77 patients met the inclusion criteria. Pseudomonas aeruginosa was the most common index organism (53% of patients), followed by Acinetobacter spp. and CRE, respectively. The mortality rate at 28 days was (59.7%). Non-survivors were significantly older (mean age 64 vs. 44 years, P= 0.0001), had significantly worse disease severity scores on ICU admission, higher incidence of chronic kidney disease (CKD) (43% vs. 16%, P= 0.010), required more continuous renal replacement therapy (CRRT) (54% vs. 13% P= 0.0001), had longer hospital length of stay prior to infection (median 34 vs. 13 days, P= 0.018), and required longer inotropic and vasopressors support (median 19 vs. 8 days, P = 0.0001). In multivariate logistic regression the following factors were significantly associated with mortality; requirement of inotropic support [OR 10.01 (95% CI 1.55-64.77); P= 0.015], age [OR 1.05 (95% CI 1.0-1.1); P=0.01], APACHE IV score on ICU admission [OR 1.03 (95% CI 1.0- 1.06); P= 0.04], and ICU length of stay [OR 1.03 (95% CI 1.0- 1.06); P= 0.035].ConclusionMDR Gram-negative infection is associated with significant in-hospital mortality among critically ill patients. Old age, high APACHE IV score, higher ICU length of stay, and higher hemodynamic support are associated with higher mortality.Trial registrationretrospectively registered.

scholarly journals Emergency Department Length of Stay for Critically Ill Patients Followed Up in Red Zone

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Emergency Room ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Waiting Times ◽  
Annual Number ◽  
Mortality And Morbidity ◽  
Lengths Of Stay

Objectives: The patients in red zone areas face acute or potentially life-threatening situations, complaints, vital disorders, diseases, or injuries that require emergent evaluation and treatment to prevent probable mortality and morbidity. We aimed to determine the variations in the lengths of stay of patients at the emergency department by examining different parameters and evaluate determinants that affect lengths of stay (in emergency room) of critically ill patients. Materials and Methods: All emergency department patients that were followed up in the red zone were included in this study. Patients’ demographic data, major complaints on admission, vital findings, performed procedures and examinations, elapsed time for the diagnoses, patients’ lengths of stay, and the causes of their prolonged waiting times were recorded and statistically analyzed. Results: The times elapsed for the diagnoses ranged between 6 min to 18 h in this study (mean: 1.62 ± 1.79 h). Patients’ lengths of stay was between 6 min to 58 h (mean length of stay was 5.51 ± 5.73 h). The waiting time for cases that required consultation (7.17 h) was found to be statistically longer than those cases that required no consultations (3.40 h). Conclusion: To prevent delays in emergency room to inpatient unit transfers, hospital administrators should manage their bed capacities to a level that is compatible with the annual number of patient admissions. Increasing the number of geriatric wards may facilitate inpatient transfers of patients over 60 years age from emergency room and shorten the length of stay of that age group.

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