Is Emergency Department length of stay associated with inpatient mortality?

Aims: To determine whether Emergency Department length of stay (EDLOS) greater than 8 hours (EDLOS > 8 hours) and less than 4 hours (EDLOS < 4 hours) were independently associated with inpatient mortality taking into account patient comorbidities and age; and to determine the impact of EDLOS on inpatient length of stay (IPLOS).

Methods: This was a retrospective data analysis of emergency presentations and inpatient admissions during 2007 at The Northern Hospital, Victoria.

Results: Taking into account age and disease states, EDLOS > 8 hours was not associated with inpatient mortality (odds ratio 1.1; 95% confidence interval (CI) 0.9-1.4, P = 0.4), nor was EDLOS < 4 hours (odds ratio 0.9; 95% CI 0.6-1.4, P = 0.6) associated with reduced mortality. EDLOS > 8 hours was significantly associated with longer inpatient length of stay (IPLOS) (P < 0.001) adjusting for medical comorbidities. Mean EDLOS and IPLOS were significantly longer for patients over 75 years of age.

Conclusion: EDLOS > 8 hours and EDLOS < 4 hours are not independently associated with mortality. A longer EDLOS is independently associated with longer IPLOS.