Aoki Yoshihiro, Kumazaki Hiroshi, Terakawa Ion, Hatachi Takeshi, Shiroto Kosuke, Miyauchi Naoto, Suganuma Kazuki
Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan.
Department of International Patient Services Aizawa Hospital Nagano Japan.
Acute Med Surg. 2022 May 22;9(1):e758. doi: 10.1002/ams2.758. eCollection 2022 Jan-Dec.
This study aims to elucidate the foreign patient-specific factors associated with emergency department length of stay (EDLOS) in a regional core hospital emergency department (ED) in Japan.
This retrospective observational study included non-Japanese patients who visited the ED in a Japanese regional core hospital between April 1, 2018, and March 31, 2020. The effects on EDLOS were assessed using multivariate linear regression analysis, which included factors such as age, sex, consultation language, interpreter usage, arrival time, day of visit, mode of arrival, underlying disease, triage level, diagnosis of injury/noninjury, diagnostic investigations, consultation with specialists, and treatments or procedures.
Of 65,297 ED patients, there were 777 study patients, with a median age of 37 years (interquartile range [IQR], 24.0-50.0). The median EDLOS was 101 min (IQR, 63.0-153.0). Multivariate linear regression analysis indicated that an extended EDLOS was associated with: language apart from Japanese, Chinese, or English (51.7 min; 95% confidence interval [CI], 17.8-85.6), helicopter arrival (115.6 min; 95% CI, 48.8-182.5), blood testing (60.5 min; 95% CI, 34.6-86.4), computed tomography (23.8 min; 95% CI, 3.7-43.9), consultation with specialists (36.2 min; 95% CI, 11.8-60.6), intravenous fluid/medication (29.7 min; 95% CI, 3.3-56.1), and surgical procedure/reduction/fixation in the ED (38.8 min; 95% CI, 14.2-63.4).
Consultation in a language other than Japanese, English, or Chinese was associated with a longer EDLOS in a regional core hospital in Japan. Devising ways to accommodate patients who speak various languages could be important.
本研究旨在阐明日本一家地区核心医院急诊科中与外国患者特定因素相关的急诊留观时间（EDLOS）。
这项回顾性观察研究纳入了2018年4月1日至2020年3月31日期间在日本一家地区核心医院急诊科就诊的非日本患者。使用多元线性回归分析评估对EDLOS的影响，分析因素包括年龄、性别、会诊语言、是否使用口译员、到达时间、就诊日期、到达方式、基础疾病、分诊级别、损伤/非损伤诊断、诊断检查、与专科医生会诊以及治疗或操作。
在65297名急诊科患者中，有777名研究对象，中位年龄为37岁（四分位间距[IQR]，24.0 - 50.0）。中位EDLOS为101分钟（IQR，63.0 - 153.0）。多元线性回归分析表明，延长的EDLOS与以下因素相关：非日语、中文或英语的语言（51.7分钟；95%置信区间[CI]，17.8 - 85.6）、直升机送达（115.6分钟；95%CI，48.8 - 182.5）、血液检测（60.5分钟；95%CI，34.6 - 86.4）、计算机断层扫描（23.8分钟；95%CI，3.7 - 43.9）、与专科医生会诊（36.2分钟；95%CI，11.8 - 60.6）、静脉输液/用药（29.7分钟；95%CI，3.3 - 56.1）以及急诊科的外科手术/复位/固定（38.8分钟；95%CI，14.2 - 63.4）。
在日本一家地区核心医院，使用非日语、英语或中文进行会诊与更长的EDLOS相关。设计方法以容纳说各种语言的患者可能很重要。
