کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3478805 1233415 2014 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Why do general medical patients have a lengthy wait in the emergency department before admission?
ترجمه فارسی عنوان
چرا بیماران عمومی پزشکی قبل از پذیرش در اداره اورژانس صبر زیادی دارند؟
کلمات کلیدی
شاخص بارتل، شاخص همبودگی چارلز، رضایت بدون رعایت، بخش اورژانس ماندن
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی

Background/PurposeEmergency department (ED) overcrowding is a universal problem, especially with the shortage of hospital beds. We studied the characteristics and outcomes of patients with prolonged ED stays, which has rarely been studied before.MethodsWe conducted a retrospective study at a tertiary medical center in Taiwan. Prolonged stay in the ED was defined as a stay of more than 72 hours in the ED before admission. The medical records were reviewed for data analysis.ResultsFrom November 1, 2009 to January 31, 2010, a total of 1364 general medical patients were enrolled. The mean age was 66.4 ± 17.8 years, with 53.4% male. The mean Charlson Comorbidity Index (CCI) was 3.0 ± 3.1. The mean length of ED stay was 43.9 ± 41.0 hours. The CCI (4.1 ± 3.5 vs. 2.8 ± 3.0, p < 0.001) and do-not-resuscitate (DNR) rates (18.8% vs. 10.3%, p = 0.001) of the patients with prolonged ED stays were higher than those of the patients with shorter stays. For patients with high CCI (≥3) and DNR consent, the odds ratio of prolonged ED stay was 1.73 and 1.60, respectively. Patients with prolonged ED stays also had a lower Barthel index (60.3 ± 34.8 vs. 66.4, p = 0.011) and higher in-hospital mortality (11.6% vs. 6.0%, p = 0.006).ConclusionComplex comorbidities and terminal conditions with DNR consent were associated with the prolonged ED stay for general medical patients. The hospital manager should pay attention to general medical patients with multiple comorbidities as well as those who require palliative care.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the Formosan Medical Association - Volume 113, Issue 8, August 2014, Pages 557–561
نویسندگان
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