Hymel Greg, Leskovan John J, Thomas Zachary, Greenbaum Joshua, Ledrick David
Department of Emergency Medicine, Mercy St. Vincent Medical Center, Toledo, USA.
Department of Trauma Surgery, Mercy St. Vincent Medical Center, Toledo, USA.
Cureus. 2020 Sep 10;12(9):e10354. doi: 10.7759/cureus.10354.
Introduction Emergency Department (ED) boarding delays initiation of time-sensitive protocols for trauma patients and makes them susceptible to increased mortality and morbidity. In this study, we compared the ED boarding times of non-trauma patients and ED length of stay (LOS) of trauma patients. Methods This was a single-center retrospective cohort study in a Level 1 trauma center. The median boarding time among non-trauma patients and ED LOS among trauma patients was determined by month between the period of April 2018 to March 2019. Linear regression and Pearson correlation coefficient were used to express the magnitude and direction of the relationship between these two variables. Results During the study period, the mean number of non-trauma patients admitted in our ED per month was 1,154 and trauma patients was 89. The mean of the median boarding time per month for non-trauma patients was 76 minutes, and the mean of the median ED LOS per month for trauma patients was 198 minutes. There was a significant positive correlation between boarding time for non-trauma patients and ED LOS for trauma patients (Pearson correlation coefficient: 0.73; p = 0.007). Conclusion The long boarding times for non-trauma patients is associated with ED LOS for trauma patients, indicating that the total patient volume in the hospital contributes to the trauma patient's stay in the ED. Thus, ED LOS of trauma patients can be minimized by improving overall ED and hospital flow, including non-trauma patients.
引言
急诊科(ED)的滞留时间会延误对创伤患者启动时间敏感型诊疗方案,并使他们更易出现死亡率和发病率上升的情况。在本研究中,我们比较了非创伤患者的急诊科滞留时间以及创伤患者的急诊科住院时长(LOS)。
方法
这是一项在一级创伤中心开展的单中心回顾性队列研究。通过确定2018年4月至2019年3月期间各月的情况,得出非创伤患者的中位滞留时间以及创伤患者的急诊科住院时长。采用线性回归和皮尔逊相关系数来表示这两个变量之间关系的大小和方向。
结果
在研究期间,我们急诊科每月收治的非创伤患者平均数量为1154例,创伤患者为89例。非创伤患者每月中位滞留时间的平均值为76分钟,创伤患者每月急诊科住院时长中位数的平均值为198分钟。非创伤患者的滞留时间与创伤患者的急诊科住院时长之间存在显著正相关(皮尔逊相关系数:0.73;p = 0.007)。
结论
非创伤患者较长的滞留时间与创伤患者的急诊科住院时长相关,这表明医院的患者总量会影响创伤患者在急诊科的停留时间。因此,通过改善包括非创伤患者在内的急诊科和医院整体流程,可以将创伤患者的急诊科住院时长降至最低。