Relationship between emergency department crowding and initial management, mortality of severe trauma patients

Objective:
This study examined whether emergency department (ED) crowding influences the timing of the initial assessment and treatment in severe trauma patients, as well as their mortality rates.
Method:
This retrospective, observational study was conducted between January 2015 and October 2016, and included adult severe trauma patients who presented to the ED. The emergency department occupancy rate (EDOR) was used to measure ED crowding. The patients were divided into four groups using the EDOR quartile. The timeliness of the initial assessment and treatment in the four groups as well as the mortality rates were compared.
Results:
This study investigated 307 patients. The timing of the first computed tomography (CT) and laboratory test order, CT and laboratory test result acquisition, first transfusion, and patient transfer from the ED to the operating room were similar in the four groups. Multivariable logistic regression analysis did not show a significant difference in mortality between the groups.
Conclusion:
ED crowding was not associated with delays in the initial assessment and treatment of severe trauma patients, or in their mortality rates.

Key words: Wounds and injuries; Severe injury; Crowding; Blood transfusion; Mortality