Analysis On The Characteristics And Associated Factors Of Length Of Stay More Than6Hours Of Critically Ⅲ Patients In An Emergency Room

ObjectiveTo investigate the characteristics and associated factors of length of stay more than6hours of critically ill patients in an emergency room;Based on their clinical characteristics and the risk factors, we can provide basis for the emergency managers about the development of relevant measures.MethodsData of critically ill patients from the emergency room in a tertiary teaching hospital from January2010to June2011were retrospectively studied. A descriptive analysis was taken about clinical characteristics with patients who stay less than6hours and more than6hours. Binary Logistic regression analysis was used to determine possible factors associated with length of stay more than6hours and further draw survival curve about the main factors using Kalpan-Meier survival analysis. Log-Rank test was used to compare survival curve between patients.The data was analyzed with the statistic package for social science(SPSS)16.0.Results1From January2010to June2011a total of11,468patients were seen in the emergency department, the median ER length of stay was11h(3～23h). a number of6525(56.9%) patients stayed in ER more than6h. A number of3930(34.3%) patients stayed in ER between6h and24h. A number of1606(14.0%) patients stayed in ER between24h and48h. A number of600(5.2%) patients stayed in ER between48h and72h. A number of389(3.4%) patients stayed in ER more than72h.2Univariate Logistic regression analysis showed types of wards, green channel, treatment time, admitted to ICU, traffic, sent by120, the number of initial diagnosis, destinations of disposition, sex, holiday visit, visit month, age, occupation, residence.3Binary Logistic regression analysis showed that the main factors contributing to length of stay more than6hours were types of wards, green channel, treatment time, followed by admitted to ICU, traffic, sent by120, the number of initial diagnosis, destinations of disposition, sex, holiday visit, visit month. While age, occupation, residence were not factors.4Treatment time was an independent factor for patients who stayed more than6hours.The risk for patients who stayed more than6hours between17:00-23:59was2.328times more than8:00-16:59. The risk for patients who stayed more than6hours between0:00-7:59was3.019times more than8:00-16:59.5There were significant differences for patients who stayed more than6hours in ER among patients treated by different departments, with the highest retention rate in general internal medicine, followed by neurology department, neurosurgery department, orthopedics, emergency department, other departments,heart medicine.6Green channel was an independent factor for patients who stayed more than6hours.The risk for patients wasn't sent by green channel was9.17times stayed more than6hours more than patients was sent by green channel.7There were significant differences for patients who stayed more than6hours in ER among patients with different destinations of disposition. The retention rate for patients who were discharged by themselves and admitted to the hospital was higher than patients who requiring emergent operation and discharge.ConclusionThe patients in this hospital has a prolonged length of stay and a high proportion of patients with length of stay more than6hours. The associated factors included the main factors contributing to length of stay more than6hours were types of wards, green channel, treatment time, followed by admitted to ICU, traffic, sent by120, the number of initial diagnosis, destinations of disposition, sex, holiday visit, visit month. We should take effection nursing intervention to reduce the lenth of stay in emergency room.