Relationship of emergency department length of stay with outcome of multiple trauma patients admitted to ICU / 中华创伤杂志

ABSTRACT

Objective To evaluate the relationship between emergency department length of stay (EDLOS) and outcome of multiple trauma patients in ICU.Methods A retrospective cohort study was performed in multiple trauma patients admitted from the emergency department to ICU during 2010.Patients' data were recorded,including demographic information (gender,age,etc.),characteristics of injury (injury causes,diagnosis,ISS,GCS,emergency operation rate,type of operation),and outcome (inhospital mortality,length of ICU stay,total length of hospital stay,expenditure).Patients were assorted into delayed group (EDLOS ＞ 6 h) and non-delayed group (EDLOS ≤ 6 h),then demographic information,characteristics of injury,and outcome were compared between the two groups.Multivariate Logistic and linear regression analyses were performed to identify the correlation between EDLOS and outcome for all patients and for those with and without emergency operation.Results A total of 476 patients aged (47.5 ± 16.0) years were enrolled in the study and male patients accounted for 73.5％.Median ISS was 29 points (interquartile range,22-34 points),median EDLOS was 4.0 hours (interquartile range,2.8-6.4 hours),and inhospital mortality was 9.2％.Delayed (n =135) and non-delayed (n =341) groups were similar in age,gender,ISS,inhospital mortality (13.3％ vs 7.6％),length of ICU stay,and total length of hospital stay (P ＞ 0.05).Multivariate analysis demonstrated prolonged EDLOS increased inhospital mortality (OR=3.19,95％ CI 1.28-7.95,P ＜ 0.05),especially in patients without emergent operation (OR =4.01,95％ CI 1.31-12.27,P ＜ 0.05).However,prolonged EDLOS produced no effect on mortality in patients with emergent operation (OR =1.72,95％ CI 0.79-3.43,P ＞0.05),length of ICU stay,total length of hospital stay,and expenditure.Conclusion Prolonged EDLOS increases mortality of multiple trauma patients admitted to ICU,especially in patients without emergency operation,thus rapid transportation of these patients from emergency room to ICU will improve the outcome.