Impact of patient isolation on emergency department length of stay: A retrospective cohort study using the Registry for Emergency Care.
Australia
/ epidemiology
COVID-19
Coronavirus Infections
/ epidemiology
Emergency Service, Hospital
/ statistics & numerical data
Female
Humans
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Pandemics
Patient Isolation
/ statistics & numerical data
Pneumonia, Viral
/ epidemiology
Registries
Retrospective Studies
COVID-19
emergency
isolation
quality improvement
registry
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
03
08
2020
accepted:
04
08
2020
pubmed:
15
8
2020
medline:
27
11
2020
entrez:
15
8
2020
Statut:
ppublish
Résumé
The number of patients with suspected COVID-19 presenting to Australian EDs continues to impose a burden on healthcare services. Isolation is an important aspect of infection prevention and control, but has been associated with undesirable consequences among hospital inpatients. The aim of the present study was to determine if isolation is associated with an increased length of stay (LOS) in the ED. The Registry for Emergency Care Project is a prospective cohort study with a series of nested sub-studies. The present study was a retrospective analysis of adult patients allocated an Australasian Triage Scale category of 1 or 2 who presented to a tertiary ED between 18 and 31 May 2020. The primary outcome was ED LOS. Regression methods were used to determine the independent association between ED isolation and LOS. There were 447 patients who met inclusion criteria, of which 123 (28%) were managed in isolation. The median (interquartile range) ED LOS was 259 (210-377) min for the isolation group and 204 (126-297) min for the non-isolation group, a difference in median ED LOS of 55 min (P < 0.001). Isolation was independently associated with a 23% increase in ED LOS (P = 0.002) and doubled the odds of an ED stay of more than 4 h (adjusted odds ratio 2.2 [1.4-3.4], P = 0.001). Consistent with the anecdotal experience of Australian ED clinicians, the present study demonstrated an increased ED LOS for patients managed in isolation. Enhanced infection prevention and control precautions will be required during and beyond the current pandemic, creating significant ongoing challenges for emergency care systems.
Identifiants
pubmed: 32794298
doi: 10.1111/1742-6723.13607
pmc: PMC7461400
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1034-1039Subventions
Organisme : National Health and Medical Research Council
ID : APP1142691
Pays : International
Informations de copyright
© 2020 Australasian College for Emergency Medicine.
Références
Med J Aust. 2010 Mar 15;192(6):354
pubmed: 20230356
Med J Aust. 2006 Mar 6;184(5):208-12
pubmed: 16515429
Med J Aust. 2012 Feb 6;196:122-6
pubmed: 22304606
Emerg Med Australas. 2020 Aug;32(4):687-691
pubmed: 32462732
BMJ Open. 2020 Feb 18;10(2):e030371
pubmed: 32075820
Emerg Med J. 2020 Aug;37(8):458-459
pubmed: 32665424
Emerg Med Australas. 2017 Jun;29(3):260-261
pubmed: 28544345
BMJ. 2020 May 6;369:m1848
pubmed: 32376614
Med J Aust. 2006 Mar 6;184(5):203-4
pubmed: 16515426
Med J Aust. 2016 May 16;204(9):354
pubmed: 27169971
Emerg Med Australas. 2020 Oct;32(5):880-882
pubmed: 32484307
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Aust Health Rev. 2016 Jun;40(3):319-323
pubmed: 26433943
PLoS One. 2018 Aug 30;13(8):e0203316
pubmed: 30161242
Emerg Med Australas. 2020 Oct;32(5):814-822
pubmed: 32533613
J Health Serv Res Policy. 2016 Jul;21(3):147-55
pubmed: 26811373
Emerg Med Australas. 2020 Jun;32(3):511-514
pubmed: 32255567
BMJ. 2020 Apr 24;369:m1607
pubmed: 32332059
Med J Aust. 2006 Mar 6;184(5):213-6
pubmed: 16515430