ED crowding and the outcomes of out-of-hospital cardiac arrest.
OBJECTIVE
Emergency department (ED) overcrowding is a worldwide problem associated with adverse outcomes. This study was performed to investigate the association between ED overcrowding and the outcomes and quality of cardiopulmonary resuscitation for out-of-hospital cardiac arrest (OHCA).


METHODS
Prospectively collected data including patients' demographics, Utstein factors, and outcomes on 608 consecutive OHCA patients at a single ED from January 2008 to December 2012 were retrospectively analyzed. The patients were categorized into 4 groups according to ED occupancy rate. The primary outcome was resuscitation outcome, a composite of rates of return of spontaneous circulation (ROSC), survival at discharge, and neurologic outcome at 6months. The secondary outcome was resuscitation quality assessed by time to advanced airway, time to first drug administration, resuscitation duration in refractory cases, and rate of initiation of therapeutic hypothermia after ROSC in the ED.


RESULTS
There was no significant difference in rates of ROSC, survival at discharge, and good neurologic outcome according to ED occupancy rate in the univariate and multivariate analyses (P>.05). In addition, ED overcrowding was not associated with resuscitation quality (P>.05).


CONCLUSIONS
Emergency department overcrowding was not associated with the outcomes of OHCA or resuscitation quality.
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Jiwon
J
Kang
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Joonghee
J
Kim
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea. Electronic address: emdrjyh@gmail.com.
You Hwan
YH
Jo
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Kyuseok
K
Kim
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Jae Hyuk
JH
Lee
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Taeyun
T
Kim
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Jungyoup
J
Lee
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Ji Eun
JE
Hwang
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Euigi
E
Jung
D000368:Aged; D001509:Bed Occupancy; D016887:Cardiopulmonary Resuscitation; D003441:Crowding; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D061665:Time-to-Treatment