Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023;14(2):96-105.
doi: 10.5847/wjem.j.1920-8642.2023.016.

The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

Ahmed Faidh Ramzee  1 , Ayman El-Menyar  2   3 , Mohammad Asim  2 , Ahad Kanbar  1 , Khalid Ahmed  1 , Bahaa Daoud  1 , Saji Mathradikkal  1 , Ahmad Kloub  1 , Hassan Al-Thani  1 , Sandro Rizoli  1
Affiliations

The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

Ahmed Faidh Ramzee et al. World J Emerg Med. 2023.

Abstract

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.

Keywords: Emergency department; Length of stay; Management; Outcomes; Trauma; Trauma activation criteria.

PubMed Disclaimer

Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Trauma team activation (TTA) criteria at Hamad medical corporation.
Figure 2
Figure 2
Flow diagram for study design. LOS: hospital length of stay, given as median and interquartile range (IQR).
Figure 3
Figure 3
Hospital deaths versus alive in relation to EDLOS (P=0.001). EDLOS: emergency department length of stay.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Yarmohammadian MH, Rezaei F, Haghshenas A, Tavakoli N. Overcrowding in emergency departments:a review of strategies to decrease future challenges. J Res Med Sci. 2017;22:23. - PMC - PubMed
    1. Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding:a systematic review of causes, consequences and solutions. PLoS One. 2018;13(8):e0203316. - PMC - PubMed
    1. Richardson JD, Franklin G, Santos A, Harbrecht B, Danzl D, Coleman R, et al. Effective triage can ameliorate the deleterious effects of delayed transfer of trauma patients from the emergency department to the ICU. J Am Coll Surg. 2009;208(5):671–8. - PubMed
    1. Singer AJ, Thode HC, Jr, Viccellio P, Pines JM. The association between length of emergency department boarding and mortality. Acad Emerg Med. 2011;18(12):1324–9. - PubMed
    1. Kinney PE, Gursahani K, Armbrecht E, Dalawari P. Does emergency medicine length of stay predict trauma outcomes at a Level 1 Trauma Center? J Hosp Adm. 2015;4(5):1.

LinkOut - more resources