Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.
Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Emerg Med Australas. 2021 Oct;33(5):932-934. doi: 10.1111/1742-6723.13820. Epub 2021 Jun 29.
Did not wait (DNW) is a frequently cited ED key performance indicator. We conducted a network-based observational study of consecutive DNW presentations.
Prospective cohort study of Western Sydney Local Health District with a primary outcome measure of reported 30-day all-cause mortality and secondary outcomes of demographic characteristics and representation risk. For re-presenting patients who were subsequently admitted, a manual review of electronic records and incident report systems based on a priori plan assessed each case for the length of stay and adverse outcomes.
During the study window, there were 1114 DNW presentations with 172 (15.4%) re-presentation within 72 h. The analysis of re-presented patients did not reveal adverse outcomes or prolonged length of stay. A review of available outcomes data revealed one DNW patient died within 30 days but had a previous palliative plan for terminal illness.
While a proportion of DNW patients re-presented within 72 h, an excess prevalence of poor outcomes were not observed.
未等待（DNW）是急诊科常用的关键绩效指标之一。我们对连续的 DNW 就诊进行了基于网络的观察性研究。
对西悉尼地方卫生区进行前瞻性队列研究，主要结局指标为报告的 30 天全因死亡率，次要结局指标为人口统计学特征和代表性风险。对于随后入院的再次就诊患者，根据事先制定的计划，通过电子病历和事件报告系统的人工审查，评估每个病例的住院时间和不良结局。
在研究期间，共有 1114 例 DNW 就诊，其中 172 例（15.4%）在 72 小时内再次就诊。对再次就诊患者的分析并未显示不良结局或延长的住院时间。对现有结局数据的回顾显示，1 例 DNW 患者在 30 天内死亡，但有晚期疾病的姑息治疗计划。
虽然有一定比例的 DNW 患者在 72 小时内再次就诊，但并未观察到不良结局的发生率过高。
