Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)

Objectives. To estimate the probability of adverse events based on the length of emergency department (ED) stay prior to hospitalization in patients aged > 65 treated in Spanish EDs. Method. All patients aged >= 65 years treated in 52 Spanish EDs during a 1-week period and included in the EDEN...

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Autores: Miro, O, Rodriguez-Cabrera, M, Alquézar-Arbé, A, Piñol, C, del Castillo, JG, Burillo-Putze, G
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p20774
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20774
Access Level:acceso abierto
Palabra clave:Geriatrics
Severity
Mortality
Hospitalization
Emergency department
Quality
Length of emergency department stay
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spelling Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)Miro, ORodriguez-Cabrera, MAlquézar-Arbé, APiñol, Cdel Castillo, JGBurillo-Putze, GGeriatricsSeverityMortalityHospitalizationEmergency departmentQualityLength of emergency department stayObjectives. To estimate the probability of adverse events based on the length of emergency department (ED) stay prior to hospitalization in patients aged > 65 treated in Spanish EDs. Method. All patients aged >= 65 years treated in 52 Spanish EDs during a 1-week period and included in the EDEN (Emergency Department and Elder Needs) Registry who were hospitalized and had available data on the length of ED stay were included in the study. Adverse events considered were in-hospital mortality and prolonged hospitalization (> 7 days) in patients discharged alive. Non-linear models using restricted cubic splines were applied to estimate the probability of adverse events as a function of the length of ED stay, and crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated, adjusting for 13 demographic, baseline health, and vital sign variables. First-order interactions with covariates were also examined. Results. A total of 6,333 patients were included. The length of ED stay ranged from 0 to 240 hours prior to hospital admission (median, 6 hours; and 12.6%, 3.5%, 1.5%, and 0.2% of patients remained in the ED for more than 1, 2, 3, and 7 days, respectively). A total of 683 patients (10.8%) died during hospitalization, and among survivors, 2,734 (46.9%) experienced prolonged hospitalization. Compared with patients with a 12-hour ED stay (reference), those with stays of 6 and 3 hours had adjusted ORs for in-hospital mortality of 1.11 (1.01-1.22) and 1.22 (1.03-1.44), and for prolonged hospitalization of 0.89 (0.84-0.95) and 0.83 (0.75-0.93), respectively. For ED stays of 1, 2, 3, and 7 days, the adjusted ORs for in-hospital mortality were 1.00 (0.94-1.06), 1.18 (0.97-1.43), 1.39 (0.98-1.97), and 2.70 (1.02-7.13), and for prolonged hospitalization, 1.14 (1.09-1.19), 1.39 (1.17-1.62), 1.66 (1.25-2.21), and 3.53 (1.60-7.76), respectively. Patients with functional limitation and hypotension showed a stronger association between the length of ED stay and in-hospital mortality, while those aged < 80 years and without prior falls showed a stronger association between the length of ED stay and prolonged hospitalization. Conclusions. Both short and long ED stays in patients who are subsequently hospitalized were associated with increased in-hospital mortality. However, shorter stays were associated with a lower likelihood of prolonged hospitalization, whereas longer stays were associated with a higher likelihood of prolonged hospitalization. These associations may be significantly stronger in certain patient subgroups.SANIDAD EDICIONES2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20774EMERGENCIASISSN: 11376821ISSNe: 23865857reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Españolinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p207742026-06-14T12:41:47Z
dc.title.none.fl_str_mv Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
title Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
spellingShingle Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
Miro, O
Geriatrics
Severity
Mortality
Hospitalization
Emergency department
Quality
Length of emergency department stay
title_short Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
title_full Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
title_fullStr Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
title_full_unstemmed Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
title_sort Emergency department length of stay of hospitalized patients and short-term outcomes (EDEN-18 Study)
dc.creator.none.fl_str_mv Miro, O
Rodriguez-Cabrera, M
Alquézar-Arbé, A
Piñol, C
del Castillo, JG
Burillo-Putze, G
author Miro, O
author_facet Miro, O
Rodriguez-Cabrera, M
Alquézar-Arbé, A
Piñol, C
del Castillo, JG
Burillo-Putze, G
author_role author
author2 Rodriguez-Cabrera, M
Alquézar-Arbé, A
Piñol, C
del Castillo, JG
Burillo-Putze, G
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Geriatrics
Severity
Mortality
Hospitalization
Emergency department
Quality
Length of emergency department stay
topic Geriatrics
Severity
Mortality
Hospitalization
Emergency department
Quality
Length of emergency department stay
description Objectives. To estimate the probability of adverse events based on the length of emergency department (ED) stay prior to hospitalization in patients aged > 65 treated in Spanish EDs. Method. All patients aged >= 65 years treated in 52 Spanish EDs during a 1-week period and included in the EDEN (Emergency Department and Elder Needs) Registry who were hospitalized and had available data on the length of ED stay were included in the study. Adverse events considered were in-hospital mortality and prolonged hospitalization (> 7 days) in patients discharged alive. Non-linear models using restricted cubic splines were applied to estimate the probability of adverse events as a function of the length of ED stay, and crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated, adjusting for 13 demographic, baseline health, and vital sign variables. First-order interactions with covariates were also examined. Results. A total of 6,333 patients were included. The length of ED stay ranged from 0 to 240 hours prior to hospital admission (median, 6 hours; and 12.6%, 3.5%, 1.5%, and 0.2% of patients remained in the ED for more than 1, 2, 3, and 7 days, respectively). A total of 683 patients (10.8%) died during hospitalization, and among survivors, 2,734 (46.9%) experienced prolonged hospitalization. Compared with patients with a 12-hour ED stay (reference), those with stays of 6 and 3 hours had adjusted ORs for in-hospital mortality of 1.11 (1.01-1.22) and 1.22 (1.03-1.44), and for prolonged hospitalization of 0.89 (0.84-0.95) and 0.83 (0.75-0.93), respectively. For ED stays of 1, 2, 3, and 7 days, the adjusted ORs for in-hospital mortality were 1.00 (0.94-1.06), 1.18 (0.97-1.43), 1.39 (0.98-1.97), and 2.70 (1.02-7.13), and for prolonged hospitalization, 1.14 (1.09-1.19), 1.39 (1.17-1.62), 1.66 (1.25-2.21), and 3.53 (1.60-7.76), respectively. Patients with functional limitation and hypotension showed a stronger association between the length of ED stay and in-hospital mortality, while those aged < 80 years and without prior falls showed a stronger association between the length of ED stay and prolonged hospitalization. Conclusions. Both short and long ED stays in patients who are subsequently hospitalized were associated with increased in-hospital mortality. However, shorter stays were associated with a lower likelihood of prolonged hospitalization, whereas longer stays were associated with a higher likelihood of prolonged hospitalization. These associations may be significantly stronger in certain patient subgroups.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20774
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20774
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SANIDAD EDICIONES
publisher.none.fl_str_mv SANIDAD EDICIONES
dc.source.none.fl_str_mv EMERGENCIAS
ISSN: 11376821
ISSNe: 23865857
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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