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Review
. 2024 Feb 23;13(5):1269.
doi: 10.3390/jcm13051269.

Association between Boarding of Frail Individuals in the Emergency Department and Mortality: A Systematic Review

Pasquale Iozzo  1 , Noemi Spina  2 , Giovanna Cannizzaro  2 , Valentina Gambino  2 , Agostina Patinella  2 , Stefano Bambi  3 , Ercole Vellone  1   4 , Rosaria Alvaro  1 , Roberto Latina  5
Affiliations
Review

Association between Boarding of Frail Individuals in the Emergency Department and Mortality: A Systematic Review

Pasquale Iozzo et al. J Clin Med. .

Abstract

(1) Background: Older patients who attend emergency departments are frailer than younger patients and are at a high risk of adverse outcomes; (2) Methods: To conduct this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We systematically searched literature from PubMed, Embase, OVID Medline®, Scopus, CINAHL via EBSCOHost, and the Cochrane Library up to May 2023, while for grey literature we used Google Scholar. No time restrictions were applied, and only articles published in English were included. Two independent reviewers assessed the eligibility of the studies and extracted relevant data from the articles that met our predefined inclusion criteria. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the studies; (3) Results: Evidence indicates that prolonged boarding of frail individuals in crowded emergency departments (Eds) is associated with adverse outcomes, exacerbation of pre-existing conditions, and increased mortality risk; (4) Conclusions: Our results suggest that frail individuals are at risk of longer ED stays and higher mortality rates. However, the association between the mortality of frail patients and the amount of time a patient spends in exposure to the ED environment has not been fully explored. Further studies are needed to confirm this hypothesis.

Keywords: boarding; emergency department; length of stay; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure A1
Figure A1
Search strategy.
Figure 1
Figure 1
PRISMA flow diagram.
See this image and copyright information in PMC

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