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Olle Melander

Principal investigator

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

Author

  • Torgny Wessman
  • Johan Ärnlöv
  • Axel Carl Carlsson
  • Ulf Ekelund
  • Per Wändell
  • Olle Melander
  • Toralph Ruge

Summary, in English

The detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short-term mortality in patients admitted to the EDs of two large University hospitals in Sweden. 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 retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7- and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles of ED-LOS. Mortality rate was highest in highest triage priority level (7-day mortality 5.24%, and 30-day mortality 9.44%), and decreased by lower triage priority group. For patients with triage priority levels 2–4, prolonged ED-LOS was associated with increased mortality, especially for lowest priority level, OR for priority level 4 and highest quintile of ED-LOS 30-day mortality 1.49 (CI 95% 1.20–1.85). For patients with highest triage priority level the opposite was at hand, with decreasing mortality risk with increasing quintile of ED-LOS for 7-day mortality, and lower mortality for the two highest quintile of ED-LOS for 30-day mortality. In patients not admitted to in-hospital care higher ED-LOS was associated with higher mortality. Our data suggest that increased ED-LOS could be associated with slightly increased short-term mortality in patients with lower clinical urgency and dismissed from the ED.

Department/s

  • Emergency medicine
  • EpiHealth: Epidemiology for Health
  • Cardiovascular Research - Hypertension
  • EXODIAB: Excellence in Diabetes Research in Sweden

Publishing year

2021

Language

English

Publication/Series

Internal and Emergency Medicine

Document type

Journal article

Publisher

Springer

Topic

  • Anesthesiology and Intensive Care
  • Cardiac and Cardiovascular Systems

Keywords

  • Elderly
  • Emergency department crowding
  • Emergency department length of stay
  • Emergency medicine
  • Emergency room
  • Epidemiology
  • Mortality rate

Status

Epub

Research group

  • Emergency medicine
  • Cardiovascular Research - Hypertension

ISBN/ISSN/Other

  • ISSN: 1828-0447