Does emergency medicine length of stay predict trauma outcomes at a Level 1 Trauma Center?

Abstract

Objective: Previous studies looking at emergency department (ED) crowding and delays of care on outcome measures for certain medical and surgical patients excluded trauma patients. The objectives of this study were to assess the relationship of trauma patients’ ED length of stay (EDLOS) on hospital length of stay (HLOS) and on mortality; and to examine the association of ED and hospital capacity on EDLOS.Methods: This was a retrospective database review of Level 1 and 2 trauma patients at a single site Level 1 Trauma Center in the Midwest over a one year period. Out of a sample of 1,492, there were 1,207 patients in the analysis after exclusions. The main outcome was the difference in hospital mortality by EDLOS group (short was less than 4 hours vs. long, greater than 4 hours). HLOS was compared by EDLOS group, stratified by Trauma Injury Severity Score (TRISS) category (< 0.5, 0.51-0.89, > 0.9) to describe the association between ED and hospital capacity on EDLOS.Results: There was no significant difference in mortality by EDLOS (4.8% short and 4% long, p = .5). There was no significant difference in HLOS between EDLOS, when adjusted for TRISS. ED census did not affect EDLOS (p = .59), however; EDLOS was longer when the percentage of staffed hospital beds available was lower (p < .001).Conclusions: While hospital overcrowding did increase EDLOS, there was no association between EDLOS and mortality or HLOS in leveled trauma patients at this institution.

Maturation process and international accreditation of trauma system in a rapidly developing country

“…ED time was categorized into � 4h and >4h. The cut-off 4h was chosen based on the National Hospital Ambulatory Medical Care Survey published by the CDC [9].…”

Identificação e caracterização dos erros de prescrição e intervenções farmacêuticas realizadas na Unidade de Emergência Referenciada (UER) do Hospital de Clínicas/Unicamp

“…Para Chalfin et al (CHALFIN et al, 2007) , Singer et al (SINGER et al, 2011) e Mowery et al (MOWERY et al, 2011), o aumento do tempo de permanência de pacientes na unidade de emergência influenciou negativamente no desfecho dos mesmos, sendo condizente com o encontrado em nosso estudo que apresentou erros de prescrição mais graves para pacientes internados por mais tempo. Já para Parkhe et al (PARKHE et al, 2002) e Kinney et al (KINNEY et al, 2015) não houve correlação significativa entre o tempo de permanência de pacientes na unidade de emergência e o desfecho, apresentando resultado contrário ao que sugere o resultado do nosso estudo.…”