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The effect of emergency department delay on outcome in critically ill medical patients: evaluation using hospital mortality and quality of life at 6 months.
J Intern Med. 2006 Dec; 260(6):586-91.JI

Abstract

OBJECTIVE

To assess the impact of delay in emergency department (ED) on outcome of critically ill patients admitted to the medical intensive care unit (MICU). Outcome was defined as hospital mortality and as health-related quality of life (HRQoL) at 6 months after intensive care assessed by the 15D measure. The 15D is a generic, 15-dimensional, standardized measure of HRQoL. We hypothesized that prolonged stay in the ED is related to worse outcome.

DESIGN AND SETTING

A prospective follow-up cohort study in university hospital.

SUBJECTS

All consecutive 1675 patients admitted to the MICU between July 2002 and June 2004.

RESULTS

The 15D questionnaire was mailed to all patients alive at 6 months after admission. Of all MICU patients, 64% were admitted from ED. The mean length of stay in the ED was 6.2 h (95%CI 5.9-6.5 h). The hospital mortality rate was 24.4% (20.0% in the ED vs. 33.0% in the non-ED cohort, P < 0.001) and it was associated with higher age and degree of physiological derangement at admission. Neither the length of ED stay was associated with hospital mortality (P = 0.82) nor with HRQoL at 6 months after MICU admission (P = 0.34). Altogether, HRQoL at 6 months was significantly lower compared with the age- and sex-matched general population (P < 0.001).

CONCLUSIONS

In a university hospital, the length of ED stay was not associated with the outcome of critically ill medical patients. However, we feel that the effect of ED treatment and delay on outcome and outcome prediction in the critically ill patients deserves further evaluation.

Authors+Show Affiliations

Emergency Care, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. katri.saukkonen@helsinki.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17116010

Citation

Saukkonen, K A., et al. "The Effect of Emergency Department Delay On Outcome in Critically Ill Medical Patients: Evaluation Using Hospital Mortality and Quality of Life at 6 Months." Journal of Internal Medicine, vol. 260, no. 6, 2006, pp. 586-91.
Saukkonen KA, Varpula M, Räsänen P, et al. The effect of emergency department delay on outcome in critically ill medical patients: evaluation using hospital mortality and quality of life at 6 months. J Intern Med. 2006;260(6):586-91.
Saukkonen, K. A., Varpula, M., Räsänen, P., Roine, R. P., Voipio-Pulkki, L. M., & Pettilä, V. (2006). The effect of emergency department delay on outcome in critically ill medical patients: evaluation using hospital mortality and quality of life at 6 months. Journal of Internal Medicine, 260(6), 586-91.
Saukkonen KA, et al. The Effect of Emergency Department Delay On Outcome in Critically Ill Medical Patients: Evaluation Using Hospital Mortality and Quality of Life at 6 Months. J Intern Med. 2006;260(6):586-91. PubMed PMID: 17116010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of emergency department delay on outcome in critically ill medical patients: evaluation using hospital mortality and quality of life at 6 months. AU - Saukkonen,K A, AU - Varpula,M, AU - Räsänen,P, AU - Roine,R P, AU - Voipio-Pulkki,L-M, AU - Pettilä,V, PY - 2006/11/23/pubmed PY - 2007/1/4/medline PY - 2006/11/23/entrez SP - 586 EP - 91 JF - Journal of internal medicine JO - J Intern Med VL - 260 IS - 6 N2 - OBJECTIVE: To assess the impact of delay in emergency department (ED) on outcome of critically ill patients admitted to the medical intensive care unit (MICU). Outcome was defined as hospital mortality and as health-related quality of life (HRQoL) at 6 months after intensive care assessed by the 15D measure. The 15D is a generic, 15-dimensional, standardized measure of HRQoL. We hypothesized that prolonged stay in the ED is related to worse outcome. DESIGN AND SETTING: A prospective follow-up cohort study in university hospital. SUBJECTS: All consecutive 1675 patients admitted to the MICU between July 2002 and June 2004. RESULTS: The 15D questionnaire was mailed to all patients alive at 6 months after admission. Of all MICU patients, 64% were admitted from ED. The mean length of stay in the ED was 6.2 h (95%CI 5.9-6.5 h). The hospital mortality rate was 24.4% (20.0% in the ED vs. 33.0% in the non-ED cohort, P < 0.001) and it was associated with higher age and degree of physiological derangement at admission. Neither the length of ED stay was associated with hospital mortality (P = 0.82) nor with HRQoL at 6 months after MICU admission (P = 0.34). Altogether, HRQoL at 6 months was significantly lower compared with the age- and sex-matched general population (P < 0.001). CONCLUSIONS: In a university hospital, the length of ED stay was not associated with the outcome of critically ill medical patients. However, we feel that the effect of ED treatment and delay on outcome and outcome prediction in the critically ill patients deserves further evaluation. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/17116010/The_effect_of_emergency_department_delay_on_outcome_in_critically_ill_medical_patients:_evaluation_using_hospital_mortality_and_quality_of_life_at_6_months_ L2 - https://doi.org/10.1111/j.1365-2796.2006.01716.x DB - PRIME DP - Unbound Medicine ER -