title: Time spent in the emergency department and mortality rates in severely injured patients admitted to the intensive care unit: An observational study.
abstract: OBJECTIVE
  The aim of this study was to identify the determinants of a shorter emergency department time (EDt) in patients with severe trauma (STPs) admitted to the intensive care unit and determine whether EDt influences mortality.
  
  
  METHODS
  A prospective observational study of STPs (2005-2007) was conducted. With the variables available from the ED, 2 multiple logistic regression models (MLRM) were created: one for the factors associated with EDt less than or equal to median and the other with mortality.
  
  
  RESULTS
  A total of 243 patients were included. The mean age was 43 years; 76% were male. The overall mortality rate was 20%. The median EDt was 120 minutes. The independent factors that were associated with the MLRM for an EDt of 120 minutes or less included age less than 60 years, mechanical ventilation, severe traumatic brain injury, and a trauma and injury severity score of 20 or higher. The MLRM for mortality was age greater than 60 years, mechanical ventilation, traumatic brain injury and shock. An EDt of 120 minutes or less was associated with an increased risk of death in the univariate analysis but not in the MLRM.
  
  
  CONCLUSIONS
  Patients in the ED with indicators of high trauma severity have a reduced EDt but a higher mortality rate. Advanced age increases both mortality and EDt. With the factors included in the model, EDt was not an independent factor for mortality in STPs.
authors.affiliation: Intensive Care Unit, Hospital Universitario Arnau de Vilanova, 25198 Lleida, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Serviá
authors.forename: Mariona
authors.initials: M
authors.lastname: Badia
authors.forename: Ignacio
authors.initials: I
authors.lastname: Baeza
authors.forename: Neus
authors.initials: N
authors.lastname: Montserrat
authors.forename: Margarida
authors.initials: M
authors.lastname: Justes
authors.forename: Xavier
authors.initials: X
authors.lastname: Cabré
authors.forename: Pedro
authors.initials: P
authors.lastname: Valdrés
authors.forename: Javier
authors.initials: J
authors.lastname: Trujillano
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy; D055815:Young Adult