중증응급환자의 응급의료센터 재실시간에 따른 중증도 표준화 생존 분석Association between the emergency department length of stay and severity-standardized survival among severe emergency patients
- Other Titles
- Association between the emergency department length of stay and severity-standardized survival among severe emergency patients
- Authors
- 강사율; 최유리; 이성우; 한갑수; 김수진; 김원영; 강형구; 홍은석; 정진우
- Issue Date
- Feb-2022
- Publisher
- 대한응급의학회
- Keywords
- Program evaluation; Quality improvement; Emergency service; hospital; Length of stay; Survival
- Citation
- 대한응급의학회지, v.33, no.1, pp.69 - 83
- Indexed
- KCI
- Journal Title
- 대한응급의학회지
- Volume
- 33
- Number
- 1
- Start Page
- 69
- End Page
- 83
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/139418
- ISSN
- 1226-4334
- Abstract
- Objective: The length of stay in the emergency department (ED) is a major contributor to ED overcrowding, which in turn negatively affects the quality of emergency care. Several efforts have been made to reduce the ED length of stay (EDLOS), including a mandatory target to limit ED-LOS within certain parameters. However, the association between EDLOS and treatment results is yet to be clarified. The authors investigated the influence of ED-LOS on patient survival by comparing severity-adjusted survival.
Methods: This study was a retrospective analysis of data registered in 2018 in the National Emergency Department Information System (NEDIS). Cases registered by the regional and local emergency centers were included for analysis.
The standardized W scores (Ws) based on the Emergency Department Initial Evaluation Score were used to assess treatment outcomes represented by severity-standardized survival, and the correlation between the Ws and the ED-LOS was analyzed.
Results: A total of 2,281,526 cases were included for analysis. The overall mortality comprised 52,284 cases (2.3%) and the median ED-LOS was 165 minutes (interquartile range, 96-301). Although a longer ED-LOS was associated with poorer outcomes overall, the association was not apparent when an analysis of cases eligible for ED-LOS evaluation in the national evaluation program was carried out. Moreover, in the analysis of severe cases with a predicted survival probability of less than 0.9, an ED-LOS shorter than 6 hours was associated with significantly poorer severity-adjusted survival.
Conclusion: The study revealed that the current ED-LOS criteria used in the national evaluation program were not associated with better survival.
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