Critical Care and Shock

Impact of length of stay in emergency department on the outcome in patients with severe sepsis


Objective: The impact of emergency department length of stay (EDLOS) on outcome in critically ill patients is debatable. The factors that impact on mortality and the measures to improve survival have been widely studied. However, the association between EDLOS and outcome in the group of critically ill patients with severe sepsis requiring intensive care has not been investigated.

Methods: We performed a retrospective observational study over a 3-year period in a metropolitan 360-bed teaching hospital that has a 10-bed general intensive care unit (ICU). Adult patients presenting to emergency department during the study period with severe sepsis requiring ICU admission were included. The effect of EDLOS on in-hospital mortality, intensive care unit length of stay (ICULOS) and hospital length of stay (HLOS) was investigated.

Results: During the study period 117 patients were admitted to ICU from the emergency department (ED) with severe sepsis. The mean age of the patients was 64.7 years and the sex ratio was comparable (51% male patients). The mean APACHE II score was 18.3. The median EDLOS was 8.3 hours. The median ICULOS and HLOS were 3 and 12 days respectively. The hospital mortality was 21.3%. There was no association between EDLOS and in-hospital mortality, ICULOS or HLOS.

Conclusion: Our study revealed that in patients with severe sepsis, the duration of EDLOS had no effect on in-hospital mortality, ICULOS or HLOS.