Background: We aimed to explore the impact of the emergency department length of stay (EDLOS) on the outcome of trauma patients.
Methods: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS (<4 h, 4-12 h,12-24 h, and >24 h). Data were analyzed using Chi-square test (categorical variables), Student's t -test (continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital mortality.
Results: The study involved 7,026 patients with a mean age of 32.1±15.6 years. One-fifth of patients had a short EDLOS (<4 h) and had higher level trauma team T1 activation (TTA-1), higher Injury Severity Score (ISS), higher shock index (SI), and more head injuries than the other groups ( P =0.001). Patients with an EDLOS >24 h were older ( P =0.001) and had more comorbidities ( P =0.001) and fewer deaths ( P =0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1 (odds ratio [ OR ]=4.081, 95% CI : 2.364-7.045), head injury ( OR =3.920, 95% CI : 2.413-6.368), blood transfusion ( OR =2.773, 95% CI : 1.668-4.609), SI ( OR =2.132, 95% CI : 1.364-3.332), ISS ( OR =1.077, 95% CI : 1.057-1.096), and age ( OR =1.040, 95% CI : 1.026-1.054).
Conclusions: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes; however, the burden of prolonged boarding in the ED needs further elaboration.
Competing Interests: Conflicts of interest: This study was presented in part at the 2022 Academic Surgical Congress 1-3 February 2022, Orlando, FL, USA. The authors have no conflicts of interest and no financial issues to disclose.
(Copyright: © World Journal of Emergency Medicine.)