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J Korean Soc Emerg Med > Volume 33(4); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(4): 371-379.
급성 심부전 환자에서 응급실에서의 장기 체류와 병원 내 합병증 간의 상관 관계
천왕성 , 김기욱 , 최세민 , 오주석 , 정현호 , 박정택 , 경연영 , 오영민 , 최경호
가톨릭대학교 의정부성모병원 응급의학과
The association between prolonged length of stay in the emergency department and in-hospital complications in patients with acute heart failure
Wangsung Chun , Kiwook Kim , Se Min Choi , Joo Suk Oh , Hyun Ho Jeong , Jung Taek Park , Yeon Young Kyong , Young Min Oh , Kyoung Ho Choi
Department of Emergency Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
Correspondence  Kiwook Kim ,Tel: 031-820-3027, Fax: 031-820-3464, Email: kiwookkim@catholic.ac.kr,
Received: September 1, 2021; Revised: November 15, 2021   Accepted: November 18, 2021.  Published online: August 31, 2022.
A prolonged length of stay in the emergency department (EDLOS) is known to be associated with poorer outcomes in critically ill patients. However, this has not been proven in patients who visit the emergency department (ED) due to acute heart failure (AHF). We aimed to find out whether prolonged EDLOS is associated with major in-hospital complications in patients with AHF.
This is a retrospective cohort study of AHF patients who were admitted to intensive care units (ICU) via the ED of a single academic hospital from January 2015 to December 2019. We divided the patients into two groups: EDLOS <24 hours and EDLOS≥24 hours. The primary outcome was major in-hospital complications, which included in-hospital death, application of continuous renal replacement therapy, or extracorporeal membrane oxygenation treatment. Secondary outcomes included in-hospital death, prolonged ICU stay (≥10 days), and prolonged hospital stay (≥14 days) excluding ED stay.
A total of 265 patients were enrolled. Of these 163 patients stayed in the ED for over 24 hours. The multivariable logistic analysis demonstrated that EDLOS ≥24 hours was independently associated with major in-hospital complications (odds ratio [OR], 3.296; 95% confidence interval [CI], 1.291-8.413; P=0.013). Analysis of the secondary outcomes showed that EDLOS ≥24 hours was associated with in-hospital death (OR, 2.607; 95% CI, 1.005-6.759; P=0.049) and prolonged hospital stay ≥14 days (OR, 2.458; 95% CI, 1.303-4.636; P=0.006).
Our study showed that in patients with AHF who visited ED and were admitted to the ICU, prolonged EDLOS was associated with major in-hospital complications.
Key words: Emergency department; Heart failure; Length of stay
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