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International Journal of Emergency Medicine

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Open Access 01-12-2023 | COVID-19 | Research

Outcomes of critically ill COVID-19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study

Authors: Tharwat El Zahran, Sally Al Hassan, Victoria Al Karaki, Lina Hammoud, Christelle El Helou, Malak Khalifeh, Moustafa Al Hariri, Hani Tamim, Imad El Majzoub

Published in: International Journal of Emergency Medicine | Issue 1/2023

Abstract

Background

Boarding of critically ill patients in the emergency department (ED) has long been known to compromise patient care and affect outcomes. During the COVID-19 pandemic, multiple hospitals worldwide experienced overcrowded emergency rooms. Large influx of patients outnumbered hospital beds and required prolonged length of stay (LOS) in the ED. Our aim was to assess the ED LOS effect on mortality and morbidity, in addition to the predictors of in-hospital mortality, intubation, and complications of critically ill COVID-19 ED boarder patients.

Methods

This was a retrospective cohort study, investigating 145 COVID-19-positive adult patients who were critically ill, required intensive care unit (ICU), and boarded in the ED of a tertiary care center in Lebanon. Data on patients who boarded in the emergency from January 1, 2020, till January 31, 2021, was gathered and studied.

Results

Overall, 66% of patients died, 60% required intubation, and 88% developed complications. Multiple risk factors were associated with mortality naming age above 65 years, vasopressor use, severe COVID pneumonia findings on CT chest, chemotherapy treatment in the previous year, cardiovascular diseases, chronic kidney diseases, prolonged ED LOS, and low SaO₂ < 95% on triage. In addition, our study showed that staying long hours in the ED increased the risk of developing complications.

Conclusion

To conclude, all efforts need to be drawn to re-establish mitigation strategies and models of critical care delivery in the ED to alleviate the burden of critical boarders during pandemics, thus decreasing morbidity and mortality rates. Lessons from this pandemic should raise concern for complications seen in ED ICU boarders and allow the promotion of health measures optimizing resource allocation in future pandemic crises.

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Title: Outcomes of critically ill COVID-19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study
Authors: Tharwat El Zahran
Sally Al Hassan
Victoria Al Karaki
Lina Hammoud
Christelle El Helou
Malak Khalifeh
Moustafa Al Hariri
Hani Tamim
Imad El Majzoub
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: COVID-19
Care
Triage
Published in: International Journal of Emergency Medicine / Issue 1/2023
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI: https://doi.org/10.1186/s12245-023-00551-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcomes of critically ill COVID-19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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