Prevalence of Prolonged Length of Stay in an Emergency Department in Urban Denmark: A Retrospective Health Records Repository Review

Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.

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Prolonged Emergency Department Length of Stay as a Predictor of Adverse Outcomes in Patients with Intracranial Hemorrhage

Journal of Critical Care Medicine ◽

10.1155/2015/526319 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Erica M. Jones ◽

Amelia K. Boehme ◽

Aimee Aysenne ◽

Tiffany Chang ◽

Karen C. Albright ◽

...

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Adverse Outcome ◽

Independent Predictor ◽

Adverse Outcomes ◽

Stroke Patients ◽

Significant Independent Predictor ◽

Prolonged Length ◽

Stroke Center ◽

Shift Change

Objectives. Extended time in the emergency department (ED) has been related to adverse outcomes among stroke patients. We examined the associations of ED nursing shift change (SC) and length of stay in the ED with outcomes in patients with intracerebral hemorrhage (ICH). Methods. Data were collected on all spontaneous ICH patients admitted to our stroke center from 7/1/08–6/30/12. Outcomes (frequency of pneumonia, modified Rankin Scale (mRS) score at discharge, NIHSS score at discharge, and mortality rate) were compared based on shift change experience and length of stay (LOS) dichotomized at 5 hours after arrival. Results. Of the 162 patients included, 60 (37.0%) were present in the ED during a SC. The frequency of pneumonia was similar in the two groups. Exposure to an ED SC was not a significant independent predictor of any outcome. LOS in the ED ≥5 hours was a significant independent predictor of discharge mRS 4–6 (OR 3.638, 95% CI 1.531–8.645, and P = 0.0034) and discharge NIHSS (OR 3.049, 95% CI 1.491–6.236, and P = 0.0023) but not death. Conclusions. Our study found no association between nursing SC and adverse outcome in patients with ICH but confirms the prior finding of worsened outcome after prolonged length of stay in the ED.

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38.4 REVENUE ENHANCEMENT FOR BEHAVIORAL HEALTH PATIENTS WITH PROLONGED LENGTH OF STAY IN A PEDIATRIC EMERGENCY DEPARTMENT

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2019.07.868 ◽

2019 ◽

Vol 58 (10) ◽

pp. S357

Author(s):

Steven Rogers

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Behavioral Health ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Prolonged Length ◽

Revenue Enhancement

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236: An Analysis of Prolonged Length of Stay in a Pediatric Emergency Department

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2009.06.265 ◽

2009 ◽

Vol 54 (3) ◽

pp. S74

Author(s):

R. Place ◽

J. Howell ◽

S. Malubay ◽

M. Kou

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Prolonged Length

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The association between length of stay in the emergency department and short term mortality

10.21203/rs.2.16591/v1 ◽

2019 ◽

Author(s):

Torgny Wessman ◽

Johan Ärnlöv ◽

Axel Carlsson ◽

Ulf Ekelund ◽

Olle Melander ◽

...

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Hospital Care ◽

Mortality Rates ◽

University Hospital ◽

Short Term ◽

Opposite Pattern ◽

Prolonged Length ◽

Short Term Mortality ◽

Clinical Urgency

Abstract Background: Prolonged length of stay at the emergency department (ED-LOS) has been associated with increased mortality and hospital stay. The aim of this study was to investigate the association between ED-LOS and 7- and 30-days mortality in patients triaged according to Rapid Emergency Triage and Treatment System – Adult (RETTS-A), the most common used triage tool in Sweden. Methods: All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n=639 385) were included. Logistic regression analysis was used to determine association between prolonged ED-LOS and 7 and 30-days mortality rates. All patients were triaged according to the RETTS-A and subsequently separated into five quintiles of ED-LOS. Results : In patients triaged with the highest medical urgency, longer ED-LOS was associated with a lower risk for 7-days mortality, for triage priority 1: OR 0.94 (CI 95% 0.92-0.96) compared to OR 1.03 (CI 95% 0.99-1.07) for triage priority 4, and for 30-days mortality: OR 0.97 (CI 95% 0.96-0.99) OR for triage priority 1 compared to 1.03 (CI 95% 1.01-1.05) for triage priority 4. In contrast, the opposite pattern appeared evident in the 3 other triage groups, where a longer ED-LOS was generally associated with an increased mortality risk. Pro-longed ED-LOS in patients admitted to in-hospital care was associated with lower 30- and 7-days mortality independently of triage priority whereas the opposite was observed for patients not admitted to in-hospital care. Conclusion: Prolonged ED-LOS was associated with increased short term mortality in patients with lower clinical urgency and in patients not admitted to in-hospital care.

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Predicting Hospital Admission and Prolonged Length of Stay in Older Adults in the Emergency Department: The PRO-AGE Scoring System

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2020.01.010 ◽

2020 ◽

Vol 76 (3) ◽

pp. 255-265 ◽

Cited By ~ 1

Author(s):

Pedro K. Curiati ◽

Luiz A. Gil-Junior ◽

Christian V. Morinaga ◽

Fernando Ganem ◽

Jose A.E. Curiati ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Length Of Stay ◽

Hospital Admission ◽

Scoring System ◽

Prolonged Length

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Prolonged Length of Stay in the Emergency Department and Increased Risk of In-Hospital Cardiac Arrest: A nationwide Population-Based Study in South Korea, 2016–2017

Journal of Clinical Medicine ◽

10.3390/jcm9072284 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2284 ◽

Cited By ~ 1

Author(s):

June-sung Kim ◽

Dong Woo Seo ◽

Youn-Jung Kim ◽

Jinwoo Jeong ◽

Hyunggoo Kang ◽

...

Keyword(s):

Emergency Department ◽

Cardiac Arrest ◽

Length Of Stay ◽

South Korea ◽

Retrospective Cohort ◽

Population Based ◽

Population Based Study ◽

Prolonged Length ◽

Increased Risk ◽

Hospital Cardiac Arrest

This study was to determine whether prolonged emergency department (ED) length of stay (LOS) is associated with increased risk of in-hospital cardiac arrest (IHCA). A retrospective cohort with a nationwide database of all adult patients who visited the EDs in South Korea between January 2016 and December 2017 was performed. A total of 18,217,034 patients visited an ED during the study period. The median ED LOS was 2.5 h. IHCA occurred in 9,180 patients (0.2%). IHCA was associated with longer ED LOS (4.2 vs. 2.5 h), and higher rates of intensive care unit (ICU) admission (58.6% vs. 4.7%) and in-hospital mortality (35.7% vs. 1.5%). The ED LOS correlated positively with the development of IHCA (Spearman ρ = 0.91; p < 0.01) and was an independent risk factor for IHCA (odds ratio (OR) 1.10; 95% confidence interval (CI), 1.10–1.10). The development of IHCA increased in a stepwise fashion across increasing quartiles of ED LOS, with ORs for the second, third, and fourth relative to the first being 3.35 (95% CI, 3.26–3.44), 3.974 (95% CI, 3.89–4.06), and 4.97 (95% CI, 4.89–5.05), respectively. ED LOS should be reduced to prevent adverse events in patients visiting the ED.

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