Effects of Emergency Department Length of Stay on Prognosis for Critically Ill Patients Undergoing Traumatic Emergency Surgery

ABSTRACT

PURPOSE: Prolonged stay in the emergency department (ED) have been associated with high mortality, but this association remains controversial. We examined the relationship between emergency department length of stay (EDLOS) and the mortality in critically ill patients undergoing traumatic emergency surgery. METHODS: A retrospective cohort study was conducted at an academic medical center with 257 critically ill patients undergoing traumatic emergency surgery from 2003 to 2004. Patients were classified into two groups those spending less than 4 hours in the emergency department and those spending over 4 hours. The groups were compared for hospital-mortality, and the data were entered into multinominal logistic regression, ROC curve, and life table using 12.0 version of SSPS. RESULTS: The overall mortality rate was 16.0%. Average length of stay was 220.1+/-138.5 minutes and 191.3+/-112.9 minutes in the survivors and non-survivor groups, respectively (p=0.212). Hospital-mortality and cumulative survival rate were similar in the group spending less than 4 hours to those in the group spending over 4 hours. The mortality was mainly related to the severity of the patients' condition (SAPS II). CONCLUSION: EDLOS did not affect hospital mortality, and EDLOS of more than 4 hours was not associated with worse prognosis.