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Simon EL, Shakya S, Liu L, et al. Comparison of critically ill patients from three freestanding ED's compared to a tertiary care hospital based ED. Am J Emerg Med. 2018;37(7):1307-1312doi: 10.1016/j.ajem.2018.10.006.
Simon, E. L., Shakya, S., Liu, L., Griffin, G., Smalley, C. M., Podolsky, S., & Engineer, R. (2019). Comparison of critically ill patients from three freestanding ED's compared to a tertiary care hospital based ED. The American journal of emergency medicine, 37(7), 1307-1312. https://doi.org/10.1016/j.ajem.2018.10.006
Simon, Erin L, et al. "Comparison of critically ill patients from three freestanding ED's compared to a tertiary care hospital based ED." The American journal of emergency medicine vol. 37,7 (2019): 1307-1312. doi: https://doi.org/10.1016/j.ajem.2018.10.006
Simon EL, Shakya S, Liu L, Griffin G, Smalley CM, Podolsky S, Engineer R. Comparison of critically ill patients from three freestanding ED's compared to a tertiary care hospital based ED. Am J Emerg Med. 2019 Jul;37(7):1307-1312. doi: 10.1016/j.ajem.2018.10.006. Epub 2018 Oct 11. PMID: 30348469.
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Am J Emerg Med. 2019 Jul;37(7):1307-1312. doi: 10.1016/j.ajem.2018.10.006. Epub 2018 Oct 11.

Comparison of critically ill patients from three freestanding ED's compared to a tertiary care hospital based ED.

The American journal of emergency medicine

Erin L Simon, Sunita Shakya, Louisa Liu, Greg Griffin, Courtney M Smalley, Seth Podolsky, Rakesh Engineer

Affiliations

  1. Cleveland Clinic Akron General, Department of Emergency Medicine, United States. Electronic address: [email protected].
  2. Cleveland Clinic Akron General, Department of Emergency Medicine, United States.
  3. Cleveland Clinic Emergency Services Institute, Department of Emergency Medicine, United States.

PMID: 30348469 DOI: 10.1016/j.ajem.2018.10.006

Abstract

BACKGROUND: Freestanding emergency departments (FEDs) care for all patients, including critically ill, 24/7/365. We characterized patients from three FEDs transferred to intensive care units (ICU) at a tertiary care hospital, and compared hospital length of stay(LOS) between patients admitted to ICUs from FEDs versus a hospital-based ED (HBED).

METHODS: We performed a retrospective, observational cohort study from January 2014 to December 2016. Demographic and clinical information was compared between FED and HBED patients with chi-square and fisher's exact tests for categorical variables and Student's t-test for continuous variables. The main outcome of interest was hospital LOS. Multi-variable linear regression was performed to estimate association between LOS and emergency facility type, while adjusting for potential confounders.

RESULTS: We included 500 critically ill patients (FED = 250 and HBED = 250). Patients did not differ by age, gender, or BMI. FED patients were more likely to be white (89.6% vs. 70.8%, p < 0.001) and have higher Charlson Co-morbidity Index scores (3.5 vs. 2.4, p < 0.001). Average LOS for FED patients was 5 days, compared to 7 days for HBED patients (p < 0.001). After adjusting for demographic and clinical confounders, there was significant correlation between ED facility type and LOS in hospital (p < 0.001).

CONCLUSION: Patients transferred from FEDs to an ICU were similar in age and gender, but more likely to be white with a higher Charlson Comorbidity Index score. FED patients experienced shorter hospital length of stay compared to patients admitted from a HBED.

Copyright © 2018 Elsevier Inc. All rights reserved.

Keywords: Critical care; Emergency department; Freestanding emergency department

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