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Cited by 12COVID-19 and healthcare impactsCOVID-19 Clinical Research StudiesEmergency and Acute Care Studies

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

Impact of COVID-19 pandemic on emergency department length of stay and clinical outcomes of patients with severe pneumonia: A single-center observational study

Open access
Ha, Jun Young, Sung, Won Young·2022·Medicine
DOI 10.1097/md.0000000000030633PMC PMC9508957
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Abstract

We examined the impact of COVID-19 pandemic on the emergency department length of stay (EDLOS) and clinical outcomes of patients with severe pneumonia admitted to the intensive care unit (ICU) through the emergency department (ED). This single-center retrospective observational study included adult patients with pneumonia admitted to the ICU through the ED between January and December 2019 (pre-pandemic) and between March 2020 and February 2021 (during-pandemic). We compared and analyzed the EDLOS by dividing it into pre-, mid-, and post-EDLOS and in-hospital mortality of patients with pneumonia admitted to the ICU according to the time of ED visits before and during the COVID-19 pandemic. Risk factors for in-hospital mortality according to the time of ED visits were analyzed using multiple logistic regression analysis. In total, 227 patients (73 patients pre-pandemic and 154 patients during the pandemic) with pneumonia admitted to the ICU through the ED were analyzed. During the COVID-19 pandemic, pre-, mid-, and post-EDLOS increased (P < .05), and the in-hospital mortality rate increased by 10.4%; however, this was not significant (P = .155). Multivariate logistic regression analysis revealed post-EDLOS (ED waiting time after making ICU admission decision) as an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU, pre-pandemic (odds ratio [OR] = 2.282, 95% confidence interval [CI]: 1.367–3.807, P = .002) and during the pandemic (OR = 1.126, 95% CI: 1.002–1.266, P = .047). Mid-EDLOS (ED time to assess, care, and ICU admission decision) was an independent risk factor for in-hospital mortality of patients with pneumonia admitted to the ICU during the COVID-19 pandemic (OR = 1.835, 95% CI: 1.089–3.092, P = .023). During the pandemic of emerging respiratory infectious diseases, to reduce in-hospital mortality of severe pneumonia patients, it is necessary to shorten the ED waiting time for admission by increasing the number of isolation ICU beds. It is also necessary to accelerate the assessment and care process in the ED, and make prompt decisions regarding admission to the ICU.

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Figure 1. Flow chart of study patients. ED = emergency department, ICU = intensive care unit.
Figure 1. Flow chart of study patients. ED = emergency department, ICU = intensive care unit.CC BY-NC · PubMed Central

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Metadata

Authors
Ha, J. Y., & Sung, W. Y.
Affiliations
Daejeon Eulji Medical Center, Eulji University (KR)
Corresponding author
Sung, Won Young
ORCID
Sung, Won Young
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-09-23
Volume
101
Issue
38
Pages
e30633
ISSN
  • 0025-7974 (ISSN-L)
  • 1536-5964
DOI
10.1097/md.0000000000030633
PMC
PMC9508957
OpenAlex
W4297018274
Cited by
12
References
31
Citations by year
2026: 1 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 1
FWCI
1.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
Keywords
COVID-19 pandemic, emergency department length of stay, severe pneumonia, intensive care unit admission, in-hospital mortality, emergency department waiting times, mortality risk factors, emergency department throughput, pre-pandemic vs pandemic comparison, respiratory infections
MeSH terms
COVID-19, Adult, Emergency Service, Hospital, Humans, Intensive Care Units, Length of Stay, Patient Admission, Retrospective Studies, Hospital Mortality, Pandemics

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