https://scholars.lib.ntu.edu.tw/handle/123456789/566915
標題: | Why do general medical patients have a lengthy wait in the emergency department before admission? | 作者: | NIN-CHIEH HSU CHIN-CHUNG SHU YU-FENG LIN Yang M.-C. Su S. Ko W.-J. |
公開日期: | 2014 | 出版社: | Elsevier B.V. | 卷: | 113 | 期: | 8 | 起(迄)頁: | 557-561 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Emergency department (ED) overcrowding is a universal problem, especially with the shortage of hospital beds. We studied the characteristics and outcomes of patients with prolonged ED stays, which has rarely been studied before. Methods: We conducted a retrospective study at a tertiary medical center in Taiwan. Prolonged stay in the ED was defined as a stay of more than 72 hours in the ED before admission. The medical records were reviewed for data analysis. Results: From November 1, 2009 to January 31, 2010, a total of 1364 general medical patients were enrolled. The mean age was 66.4±17.8 years, with 53.4% male. The mean Charlson Comorbidity Index (CCI) was 3.0±3.1. The mean length of ED stay was 43.9±41.0 hours. The CCI (4.1±3.5 vs. 2.8±3.0, p<0.001) and do-not-resuscitate (DNR) rates (18.8% vs. 10.3%, p=0.001) of the patients with prolonged ED stays were higher than those of the patients with shorter stays. For patients with high CCI (?3) and DNR consent, the odds ratio of prolonged ED stay was 1.73 and 1.60, respectively. Patients with prolonged ED stays also had a lower Barthel index (60.3±34.8 vs. 66.4, p=0.011) and higher in-hospital mortality (11.6% vs. 6.0%, p=0.006). Conclusion: Complex comorbidities and terminal conditions with DNR consent were associated with the prolonged ED stay for general medical patients. The hospital manager should pay attention to general medical patients with multiple comorbidities as well as those who require palliative care. ? 2012. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84904393056&doi=10.1016%2fj.jfma.2012.08.005&partnerID=40&md5=6da76f5d0e74acef509d5f647f28ac84 https://scholars.lib.ntu.edu.tw/handle/123456789/566915 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2012.08.005 | SDG/關鍵字: | aged; article; Barthel index; Charlson Comorbidity Index; controlled study; crowding (area); data analysis; emergency ward; female; hospital admission; hospital patient; human; length of stay; major clinical study; male; medical record review; mortality; retrospective study; Taiwan; tertiary care center; comorbidity; emergency health service; hospital admission; length of stay; middle aged; multivariate analysis; odds ratio; statistical model; statistics and numerical data; time to treatment; very elderly; Aged; Aged, 80 and over; Comorbidity; Emergency Service, Hospital; Female; Hospital Mortality; Humans; Length of Stay; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Patient Admission; Retrospective Studies; Taiwan; Tertiary Care Centers; Time-to-Treatment |
顯示於: | 醫學系 |
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