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Neurocritical Care
Published in: Neurocritical Care 3/2012

01-12-2012 | Original Article

Prolonged Emergency Department Length of Stay is not Associated with Worse Outcomes in Patients with Intracerebral Hemorrhage

Authors: Jonathan Elmer, Daniel J. Pallin, Shan Liu, Catherine Pearson, Yuchiao Chang, Carlos A. Camargo Jr, Steven M. Greenberg, Jonathan Rosand, Joshua N. Goldstein

Published in: Neurocritical Care | Issue 3/2012

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Abstract

Background

Prolonged emergency department length of stay (EDLOS) has been associated with worse patient outcomes, longer inpatient stays, and failure to meet quality measures in several acute medical conditions, but these findings have not been consistently reproduced. We performed this study to explore the hypothesis that longer EDLOS would be associated with worse outcomes in a large cohort of patients presenting with spontaneous intracerebral hemorrhage (ICH).

Methods

We performed a secondary analysis of a prospective cohort of consecutive patients with spontaneous ICH who presented to a single academic referral center from February 2005 to October 2009. The primary exposure variable was EDLOS, and our primary outcome was neurologic status at hospital discharge, measured with a modified Rankin scale (mRS). Secondary outcomes were ICU length of stay, total hospital length of stay, and total hospital costs.

Results

Our cohort included 616 visits of which 42 were excluded, leaving 574 patient encounters for analysis. Median age was 75 years (IQR 63–82), median EDLOS 5.1 h (IQR 3.7–7.1) and median discharge mRS 4 (IQR 3–6). Thirty percent of the subjects died in-hospital. Multivariable proportional odds logistic regression, controlling for age, initial Glasgow Coma Scale, initial hematoma volume, ED occupancy at registration, and the need for intubation or surgical intervention, demonstrated no association between EDLOS and outcome. Furthermore, multivariable analysis revealed no association of increased EDLOS with ICU or hospital length of stay or hospital costs.

Conclusion

We found no effect of EDLOS on neurologic outcome or resource utilization for patients presenting with spontaneous ICH.
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Metadata
Title
Prolonged Emergency Department Length of Stay is not Associated with Worse Outcomes in Patients with Intracerebral Hemorrhage
Authors
Jonathan Elmer
Daniel J. Pallin
Shan Liu
Catherine Pearson
Yuchiao Chang
Carlos A. Camargo Jr
Steven M. Greenberg
Jonathan Rosand
Joshua N. Goldstein
Publication date
01-12-2012
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 3/2012
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-011-9629-1

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