急诊科住院时间的预测因素:分析全国急诊科数据。

IF 1.9 Q2 EMERGENCY MEDICINE Clinical and Experimental Emergency Medicine Pub Date : 2024-10-16 DOI:10.15441/ceem.24.309
Minha Kim, Sujeong Lee, Minyoung Choi, Doyeop Kim, Junsang Yoo, Tae Gun Shin, Jin-Hee Lee, Seongjung Kim, Hansol Chang, Eunsil Ko
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引用次数: 0

摘要

研究目的本研究旨在利用全国性数据库识别和分析影响急诊科住院时间(ED LOS)的因素,以提高急诊护理效率:这项回顾性研究利用了韩国国家急诊科信息系统(NEDIS)的数据,涵盖了2018年至2022年期间的25,578,263次急诊科就诊。研究考察了患者人口统计学特征、临床特征和急诊室运行变量。研究采用单变量和多变量逻辑回归分析来评估这些因素与 ED LOS(定义为 6 小时或以上)延长之间的关联:在纳入的 25,578,263 名患者中,急诊室 LOS 中位数为 2.1 小时(四分位数间距 [IQR],1.050 - 3.830 小时),12.6% 的患者经历了急诊室 LOS 延长。老年患者(年龄≥ 65 岁)更容易出现 ED LOS 延长的情况(调整后的几率比 [aOR]:1.415,95% 置信区间 [CI]:1.411-1.419)。从其他医院转来的患者(aOR:1.469,95% 置信区间:1.463-1.474)和乘坐 119 救护车到达的患者(aOR:1.093,95% 置信区间:1.077-1.108)的 LOS 延长几率也较高。相反,儿科患者延长住院时间的几率较低(aOR:0.682,95% CI:0.678-0.686)。包括败血症(aOR:1.324,95% CI:1.311-1.340)和 COVID-19 感染(aOR:1.413,95% CI:1.399-1.427)在内的严重疾病与 LOS 延长密切相关:ED LOS 的延长受患者人口统计学、临床严重程度和系统性因素的综合影响。针对老年人、重症患者以及转院等操作效率低下的情况采取有针对性的干预措施,对于缩短急诊室的生命周期和改善整体急诊服务至关重要。
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Predictive Factors of Emergency Department Length of Stay: Analyzing National Emergency Department Data.

Objective: This study aimed to identify and analyze the factors influencing Emergency Department Length of Stay (ED LOS) using a nationwide database to improve emergency care efficiency.

Methods: This retrospective study utilized data from the National Emergency Department Information System (NEDIS) in South Korea, covering 25,578,263 ED visits from 2018 to 2022. Patient demographics, clinical characteristics, and ED operational variables were examined. The study employed univariate and multivariate logistic regression analyses to assess the association between these factors and prolonged ED LOS, defined as six hours or more.

Results: Among the 25,578,263 patients included, median ED LOS was 2.1 hours (interquartile range [IQR], 1.050 - 3.830 hours), with 12.6% experienced a prolonged ED LOS. Elderly patients (aged ≥ 65 years) were significantly more likely to experience prolonged ED LOS (adjusted odds ratio [aOR]: 1.415, 95% confidence interval [CI]: 1.411-1.419). Patients transferred from other hospitals (aOR: 1.469, 95% CI: 1.463-1.474) and those arriving by 119 ambulances (aOR: 1.093, 95% CI: 1.077-1.108) also had higher odds of prolonged LOS. Conversely, pediatric patients had a lower likelihood of extended stays (aOR: 0.682, 95% CI: 0.678-0.686). Severe illness, including sepsis (aOR: 1.324, 95% CI: 1.311-1.340) and COVID-19 infection (aOR: 1.413, 95% CI: 1.399-1.427), were strongly associated with prolonged LOS.

Conclusion: Prolonged ED LOS is influenced by a combination of patient demographics, clinical severity, and systemic factors. Targeted interventions focusing on older adults, severe illness, and operational inefficiencies, such as hospital transfers, are essential for reducing ED LOS and improving overall emergency care delivery.

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CiteScore
2.80
自引率
10.50%
发文量
59
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