Andreas Asheim1,2, Sara Marie Nilsen1, Fredrik Carlsen3, Lars Eide Næss-Pleym4,5, Oddvar Uleberg4, Jostein Dale4, Lars P Bache-Wiig Bjørnsen4,6, Johan Håkon Bjørngaard7,8. 1. Center for Health Care Improvement, St. Olav's hospital HF. 2. Department of Mathematical Sciences, Norwegian University of Science and Technology. 3. Department of Economics, Norwegian University of Science and Technology. 4. Department of Emergency Medicine and Pre-hospital Services, St. Olav's hospital HF. 5. Department of Research and Development, Norwegian Air Ambulance Foundation. 6. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology. 7. Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim. 8. Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway.
Abstract
OBJECTIVE: To assess whether prolonged length of stay in the emergency department was associated with risk of death. METHODS: We analysed data from 165,183 arrivals at St. Olav's University Hospital's emergency department from 2011 to 2018, using an instrumental variable method. As instruments for prolonged length of emergency department stay, we used indicators measured before arrival of the patient. These indicators were used to study the association between prolonged length of emergency department stay and risk of death, being discharged from the emergency department and length of hospitalisation for those who were hospitalised. RESULTS: Mean length of stay in the emergency department was 2.9 hours, and 30-day risk of death was 3.4%. Per hour prolonged length of stay in the emergency department, the overall change in risk of death was close to zero, with a narrow 95% confidence interval of -0.5 to 0.7 percentage points. Prolonged emergency department stay was associated with a higher probability of being discharged from the emergency department without admission to the hospital. We found no substantial differences in length of hospitalisation for patients who were admitted. CONCLUSION: In this study, prolonged emergency department stay was not associated with increased risk of death.
OBJECTIVE: To assess whether prolonged length of stay in the emergency department was associated with risk of death. METHODS: We analysed data from 165,183 arrivals at St. Olav's University Hospital's emergency department from 2011 to 2018, using an instrumental variable method. As instruments for prolonged length of emergency department stay, we used indicators measured before arrival of the patient. These indicators were used to study the association between prolonged length of emergency department stay and risk of death, being discharged from the emergency department and length of hospitalisation for those who were hospitalised. RESULTS: Mean length of stay in the emergency department was 2.9 hours, and 30-day risk of death was 3.4%. Per hour prolonged length of stay in the emergency department, the overall change in risk of death was close to zero, with a narrow 95% confidence interval of -0.5 to 0.7 percentage points. Prolonged emergency department stay was associated with a higher probability of being discharged from the emergency department without admission to the hospital. We found no substantial differences in length of hospitalisation for patients who were admitted. CONCLUSION: In this study, prolonged emergency department stay was not associated with increased risk of death.