Length-of-Stay in the Emergency Department and In-Hospital Mortality: A Systematic Review and Meta-Analysis
The effect of emergency department (ED) length of stay (EDLOS) on in-hospital mortality (IHM) remains unclear. The aim of this systematic review and meta-analysis was to determine the association between EDLOS and IHM. We searched the PubMed, Medline, Embase, Web of Science, Cochrane Controlled Register of Trials, CINAHL, PsycInfo, and Scopus databases from their inception until 14-15 January 2022. We included studies reporting the association between EDLOS and IHM. A total of 11,337 references were identified, and 52 studies (total of 1,718,518 ED patients) were included in the systematic review and 33 in the meta-analysis. A statistically significant association between EDLOS and IHM was observed for EDLOS over 24 h in patients admitted to an intensive care unit (ICU) (OR = 1.396, 95% confidence interval [CI]: 1.147 to 1.701; p < 0.001, I2 = 0%) and for low EDLOS in non-ICU-admitted patients (OR = 0.583, 95% CI: 0.453 to 0.745; p < 0.001, I2 = 0%). No associations were detected for the other cut-offs. Our findings suggest that there is an association between IHM low EDLOS and EDLOS exceeding 24 h and IHM. Long stays in the ED should not be allowed and special attention should be given to patients admitted after a short stay in the ED.
Keywords: emergency department; in-hospital mortality; intensive care unit; length-of-stay; meta-analysis; systematic review.
Lauque D, Khalemsky A, Boudi Z, Östlundh L, Xu C, Alsabri M, Onyeji C, Cellini J, Intas G, Soni KD, Junhasavasdikul D, Cabello JJT, Rathlev NK, Liu SW, Camargo CA Jr, Slagman A, Christ M, Singer AJ, Houze-Cerfon CH, Aburawi EH, Tazarourte K, Kurland L, Levy PD, Paxton JH, Tsilimingras D, Kumar VA, Schwartz DG, Lang E, Bates DW, Savioli G, Grossman SA, Bellou A. Length-of-Stay in the Emergency Department and In-Hospital Mortality: A Systematic Review and Meta-Analysis. J Clin Med. 2022 Dec 21;12(1):32. doi: 10.3390/jcm12010032.