The impact of crowding on time until abdominal CT interpretation in emergency department patients with acute abdominal pain

Postgraduate Medicine
Angela M MillsJesse M Pines

Abstract

We assessed the relationship between emergency department (ED) crowding and delays in care in patients presenting with abdominal pain who receive abdominal computed tomography (CT). Prospective cohort study of adults who presented over a 1-year period to 2 urban academic EDs with abdominal pain and received CT. Each subject had 3 validated crowding measures assigned at enrollment (ED census, waiting room number, number of admitted patients). These were normalized to quartiles to signify least to most crowded. The Cuzick test was used for trend and log-linear regression and tested the association between ED crowding and time from triage to CT read. The time interval was further decomposed into triage to room, room to CT order, and order to CT read times. The adjusted analysis controlled for age, sex, race, pain score, time of day, triage level, and site. 767 patients were enrolled (mean age, 44 +/- 17 years; 61% female; 60% black). Median time from triage to CT read was 375 minutes (interquartile range [IQR], 276-497). Individual time intervals included triage to room (46 minutes [IQR, 16-111]), room to CT order (83 minutes [IQR, 38-151]), and order to CT read (203 minutes [IQR, 138-375]). Across waiting room quartiles, triage t...Continue Reading

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Citations

Feb 3, 2012·JAMA : the Journal of the American Medical Association·Christopher FeeRenee Y Hsia
Sep 3, 2013·The Journal of Emergency Medicine·Sion JoBoyoung Park
May 29, 2012·Journal of the American College of Radiology : JACR·Richard DuszakWilliam D Donovan
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Jan 15, 2011·Annals of Emergency Medicine·Jesse M Pines, Melissa L McCarthy
May 23, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Antonia S StangAstrid Guttmann
Dec 16, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Adam J SingerJesse M Pines
Nov 22, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Amanda CrichlowAngela M Mills
Jan 31, 2015·Journal of the American College of Radiology : JACR·Christine M HughesRichard Duszak
Aug 25, 2016·Medicina intensiva·R García-GigorroJ C Montejo González
May 2, 2015·HERD·Christopher DeFlitchHarold L Paz
Jul 31, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jesse M PinesElizabeth M Datner
Nov 2, 2019·BMC Emergency Medicine·Hamid Reza RasouliMohsen Abbasi Farajzadeh
Jul 30, 2020·The Western Journal of Emergency Medicine·Todd A JaffeKori S Zachrison
Nov 17, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Aditi U JoshiJudd E Hollander
Oct 4, 2017·The American Journal of Emergency Medicine·Angela M MillsRamin Khorasani

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