title: The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis.
abstract: OBJECTIVE
  Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated.
  
  
  METHODS
  This was a retrospective study. A total of 195 patients were enrolled and analyzed. The sample was divided into 2 groups: nonmortality and mortality. A stepwise logistic regression model was developed to investigate 3 factors of clinical relevance predicting patient mortality.
  
  
  RESULTS
  The results of the stepwise logistic regression analysis revealed that hypotension (odds ratio [OR], 32.9; 95% confidence interval [CI], 6.9-156.0) and prolonged ED boarding stay (OR, 3.4; 95% CI 1.3-8.6) were both associated with higher mortality. Early operation (OR: 0.16; 95% CI: 0.06-0.45) was associated with lower mortality.
  
  
  CONCLUSIONS
  Prolonged ED boarding stay was associated with increased mortality in patients with necrotizing fasciitis. Early operation (within 24 hours of ED arrival) was associated with decreased mortality.
authors: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Chiayi County 613, Taiwan.
authors: Yu-Cheng
authors: YC
authors: Hong
authors: Meng-Hua
authors: MH
authors: Chou
authors: Estella H
authors: EH
authors: Liu
authors: Cheng-Ting
authors: CT
authors: Hsiao
authors: Jen-Tse
authors: JT
authors: Kuan
authors: Ju-Chan
authors: JC
authors: Lin
authors: I-Chuan
authors: IC
authors: Chen
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019115:Fasciitis, Necrotizing / Q000401:mortality* / Q000601:surgery; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014850:Waiting Lists