PMID- 21209130
OWN - NLM
STAT- MEDLINE
DCOM- 20120821
LR  - 20220408
IS  - 2044-5423 (Electronic)
IS  - 2044-5415 (Linking)
VI  - 20
IP  - 7
DP  - 2011 Jul
TI  - The association between a prolonged stay in the emergency department and adverse 
      events in older patients admitted to hospital: a retrospective cohort study.
PG  - 564-9
LID - 10.1136/bmjqs.2009.034926 [doi]
AB  - OBJECTIVE: Patient safety studies have identified older adults as a high-risk 
      group for adverse events (AEs). As frequent users of the emergency department 
      (ED), they are vulnerable to the negative consequences of ED crowding. The study 
      objective was to determine whether a prolonged ED stay is associated with an 
      increased risk for the occurrence of AEs for older patients admitted to hospital. 
      METHODS: This retrospective cohort study was conducted at the largest adult 
      tertiary care facility in Atlantic Canada (1 July 2005-31 March 2006). All 
      community-dwelling persons 65 years and older admitted to an acute inpatient unit 
      from the ED were eligible. The exposure of interest was total length of stay 
      (LOS) in the ED. The primary outcome was the occurrence of an AE in-hospital. AEs 
      were identified from administrative diagnostic data using previously validated 
      screening criteria. RESULTS: The average age of 982 eligible participants was 
      77.8 years (SD 7.8). The majority (75.0%) experienced a prolonged ED LOS as 
      defined by national guidelines. There was evidence of at least one AE in 140 
      (14.3%) records. After adjustment, for every hour spent in the ED, the odds of 
      experiencing an AE in-hospital increased 3% (OR 1.03, 95% CI 1.004 to 1.05). 
      Those with an AE had twice the hospital LOS (20.2 vs 9.8 days, p < 0.00001). 
      INTERPRETATION: A prolonged ED stay for older admitted patients is associated 
      with an increased risk of an in-hospital AE. The longer hospital LOS associated 
      with AEs further reduces the availability of acute care beds, thus exacerbating 
      ED crowding.
FAU - Ackroyd-Stolarz, S
AU  - Ackroyd-Stolarz S
AD  - Department of Emergency Medicine, Dalhousie University, Queen Elizabeth II Health 
      Sciences Centre, Halifax, Nova Scotia, Canada. stacy.ackroyd@dal.ca
FAU - Read Guernsey, J
AU  - Read Guernsey J
FAU - Mackinnon, N J
AU  - Mackinnon NJ
FAU - Kovacs, G
AU  - Kovacs G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110105
PL  - England
TA  - BMJ Qual Saf
JT  - BMJ quality & safety
JID - 101546984
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Crowding
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Quality of Health Care/*statistics & numerical data
MH  - Retrospective Studies
MH  - Safety Management/*statistics & numerical data
EDAT- 2011/01/07 06:00
MHDA- 2012/08/22 06:00
CRDT- 2011/01/07 06:00
PHST- 2011/01/07 06:00 [entrez]
PHST- 2011/01/07 06:00 [pubmed]
PHST- 2012/08/22 06:00 [medline]
AID - bmjqs.2009.034926 [pii]
AID - 10.1136/bmjqs.2009.034926 [doi]
PST - ppublish
SO  - BMJ Qual Saf. 2011 Jul;20(7):564-9. doi: 10.1136/bmjqs.2009.034926. Epub 2011 Jan 
      5.