title: Association between emergency department length of stay and outcome of patients admitted either to a ward, intensive care or high dependency unit.
abstract: OBJECTIVE
  To evaluate the association of ED length of stay (EDLOS) and outcome of patients admitted to a ward, intensive care (ICU) or stepdown (high dependency) unit (SDU).
  
  
  METHODS
  
  
  
  METHODS
  Retrospective cohort study using linked administrative and clinical data.
  
  
  METHODS
  650-bed, university-affiliated, tertiary referral hospital, whose ED has approximately 60 000 patient presentations per annum.
  
  
  METHODS
  Adult patients admitted via the ED, to a ward (ED to ward), ICU (ED to ICU) or SDU (ED to SDU), and whose EDLOS was <24 h.
  
  
  METHODS
  Hospital outcome and LOS.
  
  
  RESULTS
  A total of 43 484 patients over 4 years. Median EDLOS was 2:36 h for ICU, 5:07 h for SDU and 7:19 h for ward (P < 0.01) patients. EDLOS differed significantly, based on hospital outcome, for ward (alive, 7:18 h vs died, 7:44 h, P < 0.001), but not SDU or ICU patients. At an EDLOS of 4 and 8 h, 19.4% and 5.2% of ICU, 52.1% and 15.5% of SDU and 77.9% and 32.6% of ward patients remained in the ED. EDLOS was not a significant predictor of death, in comparison with increasing age and admitting unit across all three groups, and higher triage acuity for ED to ward and ED to ICU.
  
  
  CONCLUSIONS
  EDLOS was greater for ED to ward patients, and of the ED to ward patients who died. At an EDLOS of 4 h there were fewer ICU, in comparison with ward, patients remaining in the ED. Future studies that report on EDLOS should differentiate for patients admitted from the ED to the ward, ICU or SDU.
authors: Intensive Care, Royal Adelaide Hospital, Adelaide, South Australia, Australia. arthas.flabouris@health.sa.gov.au
authors: Arthas
authors: A
authors: Flabouris
authors: Jellsingh
authors: J
authors: Jeyadoss
authors: John
authors: J
authors: Field
authors: Tom
authors: T
authors: Soulsby
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001315:Australia; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors