Is ED length of stay before ICU admission related to patient mortality?
OBJECTIVE
To describe and identify the relationship between ED length of stay (LOS) and mortality after ICU admission.


METHODS
We undertook a retrospective cohort study of records from the Australian and New Zealand Intensive Care Society Adult Patient Database (from 1 January 2000 to 31 December 2006). Data from 45 hospitals and 48 803 ED patients directly transferred to ICU were included. Patients were divided into ED LOS<8 h and ED LOS>or=8 h. Univariate and multivariate analyses were performed.


RESULTS
Median ED LOS was 3.9 h (interquartile range 2.0-6.8). Patients transferred within 8 h (80.9%) were younger (P<0.001) and more seriously ill (higher mortality and mechanical ventilation rate) than those transferred>or=8 h. There was no clear relationship between ED LOS and hospital survival for patients admitted directly to ICU (odds ratio=1.01 per hour, 95% confidence intervals 0.99-1.02).


CONCLUSIONS
Although 20% of critically ill patients spend more than 8 h in ED before transfer to ICU, we were unable to demonstrate an adverse relationship between time in ED and hospital mortality.
Department of Intensive Care, The Alfred Hospital, Prahran, Australia. mothershiplanded@hotmail.com
Angus W
AW
Carter
David
D
Pilcher
Michael
M
Bailey
Peter
P
Cameron
Graeme J
GJ
Duke
Jamie
J
Cooper
D000328:Adult; D001315:Australia; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D010360:Patient Transfer; D012189:Retrospective Studies