The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study
The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study
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DOI：
10.1136/bmjqs.2009.034926
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发表时间：
2011-07-01
影响因子：
5.4
通讯作者：
Kovacs, G.
中科院分区：
文献类型：
--
作者：
Ackroyd-Stolarz, S.;Guernsey, J. Read;Kovacs, G.
目的：患者安全性研究已将老年人确定为不良事件（AE）的高风险人群。作为急诊科（艾德）的频繁使用者，他们容易受到艾德拥挤的负面后果的影响。该研究的目的是确定是否延长艾德停留与老年患者入院hospital.Methods的发生AE的风险增加：这项回顾性队列研究进行了最大的成人三级保健设施在加拿大大西洋（2005年7月1日至2006年3月31日）。所有从艾德入住急性住院部的65岁及以上社区居民均符合资格。关注的暴露是ED的总住院时间（LOS）。主要结局是院内AE的发生率。使用以前验证的筛选critics.Results：从行政诊断数据中确定AE：982名合格参与者的平均年龄为77.8岁（SD 7.8）。大多数（75.0%）经历了国家指南定义的长期艾德LOS。在140份（14.3%）记录中有至少1起AE的证据。校正后，在艾德每待1小时，院内发生AE的几率增加3%（OR 1.03，95% CI 1.004 - 1.05）。发生不良事件的患者住院时间是住院时间的两倍（20.2 vs 9.8天，p
Objective: Patient safety studies have identified older adults as a high-risk group for adverse events (AEs). As frequent users of the emergency department (ED), they are vulnerable to the negative consequences of ED crowding. The study objective was to determine whether a prolonged ED stay is associated with an increased risk for the occurrence of AEs for older patients admitted to hospital.Methods: This retrospective cohort study was conducted at the largest adult tertiary care facility in Atlantic Canada (1 July 2005-31 March 2006). All community-dwelling persons 65 years and older admitted to an acute inpatient unit from the ED were eligible. The exposure of interest was total length of stay (LOS) in the ED. The primary outcome was the occurrence of an AE in-hospital. AEs were identified from administrative diagnostic data using previously validated screening criteria.Results: The average age of 982 eligible participants was 77.8 years (SD 7.8). The majority (75.0%) experienced a prolonged ED LOS as defined by national guidelines. There was evidence of at least one AE in 140 (14.3%) records. After adjustment, for every hour spent in the ED, the odds of experiencing an AE in-hospital increased 3% (OR 1.03, 95% CI 1.004 to 1.05). Those with an AE had twice the hospital LOS (20.2 vs 9.8 days, p