Boarding of admitted patients in EDs for longer than five hours is linked to a higher risk of death in the following 30 days, a group of researchers found.1
Investigators analyzed ED visits in England that occurred from 2016 to 2018. There was one extra death for every 82 patients who waited between six and eight hours for an inpatient bed. This figure rose to one in 72 with delays between eight and 12 hours.
“Very long delays for patients awaiting admission to a hospital bed are now ubiquitous,” reports Chris Moulton, MBChB, DRCOG, DFSRH, MRCGP, FRCA, FCEM, a consultant in emergency medicine at the Royal Bolton Hospital in England and head of the National Health Service (NHS) Integrated Urgent and Emergency Care program.
Previous smaller studies conducted in Canada and Australia showed these delays may be associated with harm to patients.2,3 “But a larger study was required both to confirm and to quantify that association,” Moulton says.
Moulton and colleagues did not show a causal relationship between long ED stays and patient mortality. “To prove cause and effect is very difficult when so many other factors, both known and unknown, are involved,” Moulton says. “Nevertheless, there does seem to be good reasons for limiting a patient’s time in the ED to less than five to six hours.”
Long waits are inevitably responsible for unrecognized additional patient morbidity, and certainly contribute to poor patient experiences. “We must, therefore, strive to minimize those delays and to ensure that patients who do have to wait do so in the very best circumstances that we can provide,” Moulton says.
REFERENCES
- Jones S, Moulton C, Swift S, et al. Association between delays to patient admission from the emergency department and all-cause 30-day mortality. Emerg Med J 2022;39:168-173.
- Guttmann A, Schull MJ, Vermeulen MJ, Stukel TA. Association between waiting times and short term mortality and hospital admission after departure from emergency department: Population based cohort study from Ontario, Canada. BMJ 2011;342:d2983.
- Sprivulis PC, Da Silva JA, Jacobs IG, et al. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust 2006;184:208-212.
Boarding of admitted patients in EDs for longer than five hours is linked to a higher risk of death in the following 30 days, a group of researchers found.
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