Emergency Department, Hopital Pitié-Salpetriere, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Pierre et Marie Curie Paris 6, Paris, France.
Emergency Department, Hopital Bicêtre, Assistance Publique-Hôpitaux de Paris, le Kremlin-Bicêtre, France.
Ann Emerg Med. 2013 Nov;62(5):449-456. doi: 10.1016/j.annemergmed.2013.04.017. Epub 2013 May 23.
We seek to evaluate whether age greater than 75 years is an independent predictor of prolonged waiting time in the emergency department (ED).
We retrospectively analyzed all adult attendances to 9 EDs within the Paris area during 2011. The primary endpoint was target waiting time exceeded, defined as a waiting time for medical assessment longer than the maximal recommended waiting time according to triage level. To assess our primary objective, we performed logistic regression using patient- and ED-related variables to determine whether age greater than 75 years was independently associated with higher rate of target waiting time exceeded.
A total of 317,793 patients were included, of whom 173,629 (55%) had an exceeded target waiting time. Mean age was 45.8 years and 12.7% were older than 75 years. Target waiting time was exceeded for 55% of patients: 53% for patients younger than 75 years (95% confidence interval [CI] 53% to 54%) versus 64% for older patients (95% CI 63% to 65%), relative risk 1.20. In the multivariate analysis, age greater than 75 years was independently associated with an exceeded target waiting time (odds ratio [OR] 1.30; 95% CI 1.27 to 1.33). Other variables associated with exceeded target waiting time were triage level (OR 5.45 [95% CI 5.32 to 5.60] for triage level 2 versus triage level 4), high daily occupancy (OR 3.78 [95% CI 3.53 to 4.03]), day of the week (OR 1.12 [95% CI 1.09 to 1.14] for Monday), and time of the visit (OR 1.79 [95% CI 1.76 to 1.82] from 6 pm to 8 am).
Patients older than 75 years are less likely to be seen within the target waiting time.
我们旨在评估 75 岁以上的年龄是否是急诊科（ED）就诊患者等待时间延长的独立预测因素。
我们回顾性分析了 2011 年期间巴黎地区 9 个 ED 所有成人就诊患者的资料。主要终点是目标等待时间延长，定义为根据分诊级别，患者接受医疗评估的等待时间长于最长推荐等待时间。为评估我们的主要目标，我们使用患者和 ED 相关变量进行了逻辑回归，以确定年龄大于 75 岁是否与更高的目标等待时间延长率独立相关。
共纳入 317793 例患者，其中 173629 例（55%）的目标等待时间延长。平均年龄为 45.8 岁，12.7%的患者年龄大于 75 岁。55%的患者目标等待时间延长：75 岁以下患者中 53%（95%置信区间[CI]53%至 54%），75 岁以上患者中 64%（95%CI 63%至 65%），相对风险为 1.20。多变量分析显示，年龄大于 75 岁与目标等待时间延长独立相关（比值比[OR]1.30；95%CI 1.27 至 1.33）。与目标等待时间延长相关的其他变量包括分诊级别（与分诊级别 4 相比，分诊级别 2 的 OR 为 5.45[95%CI 5.32 至 5.60]）、高日常占用率（OR 3.78[95%CI 3.53 至 4.03]）、就诊日（周一 OR 1.12[95%CI 1.09 至 1.14]）和就诊时间（下午 6 点至上午 8 点 OR 1.79[95%CI 1.76 至 1.82]）。
年龄大于 75 岁的患者不太可能在目标等待时间内就诊。
