Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2018
Independent determinants of prolonged emergency department length of stay in a tertiary care centre: a prospective cohort study.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Optimizing efficiency in the acute care chain: a systematic review on the implementation and impact of interdisciplinary short-term monitoring in acute care units.Internal and emergency medicine · 2026Pooled it
- Prolonged length of stay and associated factors among emergency department patients in Ethiopia: systematic review and meta-analysis.BMC emergency medicine · 2024Pooled it
- Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Emergency Department length of stay: a mixed-methods study in four Ethiopian public hospitals.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Daily emergency department volume and in-hospital mortality: the importance of temporal alignment.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Patient-Physician Agreement on Diagnosis in the ED, Part of Diagnostic Excellence. A Prospective Multicenter Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Overcrowding Indicators in Emergency Departments Across Countries: Scoping Review.Interactive journal of medical research · 2026Review
- The association between emergency department length of stay and hospital length of stay: an observational multi-centre cohort study.Internal and emergency medicine · 2026Observational
- Enhancing patient participation in emergency department through patient-friendly clinical notes generated by large language models.Scientific reports · 2025Article
- Impact of Boarding Time on In-Hospital Mortality in Patients Presenting to an Oncologic Emergency Department of a Comprehensive Cancer Center.Journal of the American College of Emergency Physicians open · 2025Article
- Where Are the Greatest Risks for Choosing Unwisely? A Survey of Emergency Department Clinicians.Emergency medicine Australasia : EMA · 2025Article
- Streamlining emergency nursing care post-pandemic: A lean approach for reducing wait times and improving patient and staff satisfaction in the hospital.BMC nursing · 2025Article
- Comparison of Standardized Mortality Ratios in seven Dutch EDs based on presenting complaints.BMC emergency medicine · 2025Observational
- Article
- An Updated Scoping Review of Factors Associated with Length of Stay in Emergency Department.Journal of multidisciplinary healthcare · 2025Review
- Determinants of Length of Stay for Medical Inpatients Using Survival Analysis.International journal of environmental research and public health · 2024Article
- Influence of demographic factors on prolonged length of stay in an emergency department.PloS one · 2024Article
- Length of Stay in Emergency Department by ICD-10 Specific and Non-Specific Diagnoses: A Single-Centre Retrospective Study.Journal of clinical medicine · 2023Article
- Flow through the Emergency Department for Patients Presenting with Substance Use Disorder in Alberta, Canada.The western journal of emergency medicine · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency department (ED) overcrowding is a potential threat for patient safety. We searched for independent determinants of prolonged ED length of stay (LOS) with the aim to identify factors which can be targeted to reduce ED LOS, which may help in preventing overcrowding.
methodsThis prospective cohort study included consecutive ED patients in a Dutch tertiary care centre. Multivariable logistic regression analysis was used to identify independent determinants of ED LOS > 4 h, including patient characteristics (demographics, referral type, acuity, (number of) presenting complaints and comorbidity), treating specialty, diagnostic testing, consultations, number of patients in the ED and disposition. Furthermore, we quantified the absolute time delays (measured in real-time) associated with the most important independent determinants of prolonged ED LOS.
resultsIn 1434 included patients independent determinants of prolonged ED LOS were number and type of presenting complaints, specialty, laboratory/radiology testing and consultations, and ICU admission. Modifiable determinants with the largest impact were blood testing; Adjusted odds ratio (AOR (95%-CI)); 3.45 (1.95-6.11), urine testing; 1.79 (1.21-2.63), radiology imaging; 3.02 (2.13-4.30), and consultation; 5.90 (4.08-8.54). Combined with the laboratory/radiology testing and/or consultations (requested in 1123 (78%) patients) the decision-making and discharge process consumed between 74 (42%) and 117 (66%) minutes of the total ED LOS of 177 (IQR: 129-225) minutes.
conclusionsIn tertiary care EDs, ED LOS can be reduced if the process of laboratory/radiology testing and consulting is optimized and the decision-making and discharge procedures are accelerated.
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