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4 "Length of stay"
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Original Articles
Analysis of Factors Related to Length of Stay Time in Patients with Back Pain at Emergency Department
Kwang Yong Choi, Byung Hak So, Hyung Min Kim, Kyung Man Cha, Won Jung Jeong
J Trauma Inj. 2017;30(4):173-178.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.173
  • 2,683 View
  • 21 Download
AbstractAbstract PDF
Purpose

Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER.

 Methods

We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups.

 Results

A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034).

 Conclusions

In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.

Summary
A Comparison of the Effectiveness of Before and After the Regional Trauma Center's Establishment
Bo Hyung Song, Sung Youl Hyun, Jin Joo Kim, Jin Seong Cho, Dae Sung Ma, Ha Kyung Kim, Geun Lee
J Trauma Inj. 2016;29(3):68-75.   Published online September 30, 2016
DOI: https://doi.org/10.20408/jti.2016.29.3.68
  • 2,105 View
  • 10 Download
  • 1 Citations
AbstractAbstract PDF
PURPOSE
The purpose of this study was to analyze the effectiveness of regional trauma center's management.
METHODS
Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality.
RESULTS
The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably.
CONCLUSION
Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.
Summary

Citations

Citations to this article as recorded by  
  • The Effects of a Trauma Team Approach on the Management of Open Extremity Fractures in Polytrauma Patients: A Retrospective Comparative Study
    Seungyeob Sakong, Eic Ju Lim, Jun-Min Cho, Nak-Jun Choi, Jae-Woo Cho, Jong-Keon Oh
    Journal of Trauma and Injury.2021; 34(2): 105.     CrossRef
A Comparison of the Effectiveness of Before and After the Trauma Team's Establishment: Treatment Outcomes and Lengths of Stay in the Emergency Department
Cheong Hoon Kwon, Chang Min Park, Young Tae Park
J Korean Soc Traumatol. 2011;24(2):75-81.
  • 1,007 View
  • 6 Download
AbstractAbstract PDF
PURPOSE
The aim of this study was to analyze the influence of a trauma team's management.
METHODS
A total of 181 patients with severe trauma were retrospectively divided into two groups. Of these 181 patients, 81 patients without a trauma team admitted between April and October 2008 were assigned to Group 1, and 100 patients with a Trauma team admitted between April and October 2009 were assigned to Group II. We compared general characteristics, the length of stay in the emergency department (ED) and treatment outcomes (24-h packed RBC transfusion, length of intensive care unit (ICU) stay, length of hospital stay, in-hospital mortality, 24-h mortality) between these two groups.
RESULTS
The length of stay in the ED was significantly reduced in Group II compared to Group I (p=0.025). No significant differences were found in mean arterial pressure, Glasgow Coma Scale, Revised Trauma Score, Injury Severity Score, in-hospital mortality and 24-h mortality between the two groups. However, Group II had a lower amount of 24-h packed RBC transfusion and a shorter length of ICU and hospital stay than Group I, although these differences were not statistically significant.
CONCLUSION
Through the establishment of a trauma team, the length of stay in the ED can be reduced remarkably. Furthermore, the need for 24-h packed RBC transfusions and the length of stay in the ICU and hospital were found to be decreased in patients managed by a trauma team.
Summary
Factors Affecting the Delay of a Decision to Admit Severe Trauma Patients and the Effect of a Multidisciplinary Department System: a Preliminary Study
Mun Ju Kang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Hyoung Gon Song
J Korean Soc Traumatol. 2010;23(2):113-118.
  • 952 View
  • 5 Download
AbstractAbstract PDF
PURPOSE
Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision.
METHODS
A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system.
RESULTS
A total of 89 patients were enrolled. The average time from triage to the admission decision was 5.2+/-7.1 hours and the average length of the ED stay was 9.0+/-11.5 hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was 2.1+/-1.5 hours.
CONCLUSION
In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.
Summary
J Trauma Inj : Journal of Trauma and Injury
© The Korean Society of Traumatology.