title: Is adequate pain relief and time to analgesia associated with emergency department length of stay? A retrospective study.
abstract: OBJECTIVE
  Evaluate the association of adequate analgesia and time to analgesia with emergency department (ED) length of stay (LOS).
  
  
  METHODS
  Post hoc analysis of real-time archived data.
  
  
  METHODS
  We included all consecutive ED patients ≥18 years with pain intensity >6 (verbal numerical scale from 0 to 10), assigned to an ED bed, and whose pain was re-evaluated less than 1 h after receiving analgesic treatment.
  
  
  METHODS
  The main outcome was ED-LOS in patients who had adequate pain relief (AR=↓50% pain intensity) compared with those who did not have such relief (NR).
  
  
  RESULTS
  A total of 2033 patients (mean age 49.5 years; 51% men) met our inclusion criteria; 58.3% were discharged, and 41.7% were admitted. Among patients discharged or admitted, there was no significant difference in ED-LOS between those with AR (median (25th-75th centile): 9.6 h (6.3-14.8) and 18.2 h (11.6-25.7), respectively) and NR (median (25th-75th centile): 9.6 h (6.6-16.0) and 17.4 h (11.3-26.5), respectively). After controlling for confounding factors, rapid time to analgesia (not AR) was associated with shorter ED-LOS of discharged and admitted patients (p<0.001 and <0.05, respectively). When adjusting for confounding variables, ED-LOS is shortened by 2 h (95% CI 1.1 to 2.8) when delay to receive analgesic is <90 min compared with >90 min for discharged and by 2.3 h (95% CI 0.17 to 4.4) for admitted patients.
  
  
  CONCLUSIONS
  In our study, AR was not linked with short ED-LOS. However, rapid administration of analgesia was associated with short ED-LOS.
authors.affiliation: Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.
authors.forename: Catalina
authors.initials: C
authors.lastname: Sokoloff
authors.forename: Raoul
authors.initials: R
authors.lastname: Daoust
authors.forename: Jean
authors.initials: J
authors.lastname: Paquet
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chauny
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000698:Analgesia; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010146:Pain; D059408:Pain Management; D010343:Patient Admission; D010351:Patient Discharge; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
keywords: Accident & Emergency Medicine