| Increasing wait times predict increasing mortality foremergency medical admissions. | |
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MedLine Citation:
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PMID: 21317786 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The actual impact of emergency department (ED) 'wait' time on hospital mortality in patients admitted as a medical emergency has often been debated. We have evaluated the impact of such waits on 30-day mortality, for all medical patients over a 7-year period. METHODS: All patients admitted as medical emergencies by the ED between 2002 and 2008 were studied; we looked at the impact of time to medical referral and subsequent time to a ward bed on any inhospital death within 30 days. Significant univariate predictors of outcome, including Charlson's comorbidity and acute illness severity score, were entered into a multivariate regression model, adjusting the univariate estimates of the readmission status on mortality. RESULTS: We studied 23 114 consecutive acute medical admissions between 2002 and 2008. The triage category inthe ED was highly predictive of subsequent 30-day mortality ranging from 4.8 (category 5) to 46.1% (category1). After adjustment for all outcome predictors,including comorbidity and illness severity, bothdoor-to-team and team-to-ward times were independent predictors of death within 30 days with respective odds ratios of 1.13 (95%confidence interval 1.07-1.18), and 1.07 (95% confidence interval 1.02-1.13). CONCLUSION: Delay to admission have been shown to be independently adversely related to mortality outcome. We recommend maximal target limits of 4 and 6 h for referrals and admissions, respectively, based on these mortality observations. |
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Authors:
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Patrick K Plunkett; Declan G Byrne; Tomás Breslin; Kathleen Bennett; Bernard Silke |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-11 |
Journal Detail:
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Title: European journal of emergency medicine : official journal of the European Society for Emergency Medicine Volume: - ISSN: 1473-5695 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9442482 Medline TA: Eur J Emerg Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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aDepartment of Emergency Medicine bDivision of Internal Medicine cDepartment of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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