Prolonged Length of Stay in the Emergency Department and Increased Risk of In-Hospital Cardiac Arrest: A nationwide Population-Based Study in South Korea, 2016-2017.
This study was to determine whether prolonged emergency department (ED) length of stay (LOS) is associated with increased risk of in-hospital cardiac arrest (IHCA). A retrospective cohort with a nationwide database of all adult patients who visited the EDs in South Korea between January 2016 and December 2017 was performed. A total of 18,217,034 patients visited an ED during the study period. The median ED LOS was 2.5 h. IHCA occurred in 9,180 patients (0.2%). IHCA was associated with longer ED LOS (4.2 vs. 2.5 h), and higher rates of intensive care unit (ICU) admission (58.6% vs. 4.7%) and in-hospital mortality (35.7% vs. 1.5%). The ED LOS correlated positively with the development of IHCA (Spearman ρ = 0.91; p < 0.01) and was an independent risk factor for IHCA (odds ratio (OR) 1.10; 95% confidence interval (CI), 1.10-1.10). The development of IHCA increased in a stepwise fashion across increasing quartiles of ED LOS, with ORs for the second, third, and fourth relative to the first being 3.35 (95% CI, 3.26-3.44), 3.974 (95% CI, 3.89-4.06), and 4.97 (95% CI, 4.89-5.05), respectively. ED LOS should be reduced to prevent adverse events in patients visiting the ED.
['Kim|June-Sung|JS|', 'Seo|Dong Woo|DW|', 'Kim|Youn-Jung|YJ|', 'Jeong|Jinwoo|J|0000-0003-1745-5127', 'Kang|Hyunggoo|H|0000-0002-9522-2532', 'Han|Kap Su|KS|0000-0003-0205-1269', 'Kim|Su Jin|SJ|0000-0003-3769-9647', 'Lee|Sung Woo|SW|0000-0003-4492-0258', 'Ahn|Shin|S|', 'Kim|Won Young|WY|0000-0002-6904-5966']
length of stay in-hospital cardiac arrest emergency department crowding quality control