Patient characteristics associated with longer emergency department stay: a rapid review

Emergency Medicine Journal : EMJ
Sara A KreindlerMelissa Raynard

Abstract

Prolonged emergency department (ED) stays make a disproportionate contribution to ED overcrowding, but the factors associated with longer stays have not been systematically reviewed. To identify the patient characteristics associated with ED length of stay (LOS) and ascertain whether a predictive model existed. This rapid systematic review included published, English-language studies that assessed at least one patient-level predictor of ED LOS (defined as a continuous or dichotomous variable) in an adult or mixed adult/paediatric population within an Organization for Economic Cooperation and Development country. Findings were synthesised narratively. We identified 35 relevant studies; most included multiple predictors, but none developed a predictive model. The factors most commonly associated with long ED LOS were need for admission (10 of 10 studies) and older age (which may be a proxy for age-related differences in health condition and severity; 9 of 10), receipt of diagnostic tests or consults (8 of 8) and ambulance arrival (4 of 5). Acuity often showed a bell-shaped relationship with LOS (ie, patients with moderate acuity stayed longest). Methodological choices made in the interests of rapidity limited the review's compreh...Continue Reading

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