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
- Authors
- Kim, June-Sung; Seo, Dong Woo; Kim, Youn-Jung; Jeong, Jinwoo; Kang, Hyunggoo; Han, Kap Su; Kim, Su Jin; Lee, Sung Woo; Ahn, Shin; Kim, Won Young
- Issue Date
- 7월-2020
- Publisher
- MDPI
- Keywords
- emergency department crowding; in-hospital cardiac arrest; quality control; length of stay
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.9, no.7
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 9
- Number
- 7
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/54499
- DOI
- 10.3390/jcm9072284
- ISSN
- 2077-0383
- Abstract
- 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 rho = 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.
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