The longer you wait in an Ontario hospital emergency department, the
greater your chances of dying or becoming sick enough to return within a
week and require admission, new research shows.
The study, overseen by the Institute for Clinical Evaluative Sciences, focused on the 90 per cent of visitors to high-volume ER departments who do not end up getting admitted. Researchers looked for adverse outcomes among almost 14 million patients that occurred within a week of visiting Ontario ERs between 2003 and 2007.
“When we look at the odds increasing . . . every hour things get worse,” said lead author Dr. Astrid Guttmann, a pediatrician at Toronto’s Hospital for Sick Children.
Researchers compared outcomes of patients at similar levels of illness who waited more than six hours with those who had to wait less than an hour. For the sickest of patients, the risk of death was 79 per cent higher among those who waited more than six hours. And the risk of becoming so ill that you needed to return to hospital and be admitted were 95 per cent higher.
“I don’t want to be too alarmist,” Guttmann said, adding the province has made great strides in reducing ER wait times. She also noted that long waits are a problem in many countries.
If hours of stay were reduced by just one hour, the researchers calculated there would be 558 fewer deaths among these “high-acuity” patients.
“It’s not nothing, but it’s not tens of thousands either,” Guttman said.
High-acuity patients were defined as those who rated between 1 and 3 on the Canadian triage and acuity scale, meaning they were classified as needing resuscitation or being urgent or emergent.
The study was published recently in the BMJ (formerly known as the British Medical Journal).
It also looked at patients with ratings of 4 and 5 on the triage scale, meaning they were classified as less urgent. Again, it compared those who waited less than an hour with those who waited more than six hours. The latter group was found to have a 71 per cent greater risk of death and 66 per cent higher risk of returning within a week and needing admission.
If the wait was reduced by one hour for this group, there would be 261 fewer deaths.
Guttmann said it is unlikely that delayed treatment was the sole cause of the adverse outcomes and said a follow-up study is being planned to explore the reasons.
It’s possible the outcomes had something to do with a reluctance to order time-consuming tests or consultations, the study said. Shortened observation periods may be another reason. The findings could also be attributed to inadequate discharge planning.
Origin
Source: Healthzone (Toronto Star)
The study, overseen by the Institute for Clinical Evaluative Sciences, focused on the 90 per cent of visitors to high-volume ER departments who do not end up getting admitted. Researchers looked for adverse outcomes among almost 14 million patients that occurred within a week of visiting Ontario ERs between 2003 and 2007.
“When we look at the odds increasing . . . every hour things get worse,” said lead author Dr. Astrid Guttmann, a pediatrician at Toronto’s Hospital for Sick Children.
Researchers compared outcomes of patients at similar levels of illness who waited more than six hours with those who had to wait less than an hour. For the sickest of patients, the risk of death was 79 per cent higher among those who waited more than six hours. And the risk of becoming so ill that you needed to return to hospital and be admitted were 95 per cent higher.
“I don’t want to be too alarmist,” Guttmann said, adding the province has made great strides in reducing ER wait times. She also noted that long waits are a problem in many countries.
If hours of stay were reduced by just one hour, the researchers calculated there would be 558 fewer deaths among these “high-acuity” patients.
“It’s not nothing, but it’s not tens of thousands either,” Guttman said.
High-acuity patients were defined as those who rated between 1 and 3 on the Canadian triage and acuity scale, meaning they were classified as needing resuscitation or being urgent or emergent.
The study was published recently in the BMJ (formerly known as the British Medical Journal).
It also looked at patients with ratings of 4 and 5 on the triage scale, meaning they were classified as less urgent. Again, it compared those who waited less than an hour with those who waited more than six hours. The latter group was found to have a 71 per cent greater risk of death and 66 per cent higher risk of returning within a week and needing admission.
If the wait was reduced by one hour for this group, there would be 261 fewer deaths.
Guttmann said it is unlikely that delayed treatment was the sole cause of the adverse outcomes and said a follow-up study is being planned to explore the reasons.
It’s possible the outcomes had something to do with a reluctance to order time-consuming tests or consultations, the study said. Shortened observation periods may be another reason. The findings could also be attributed to inadequate discharge planning.
Origin
Source: Healthzone (Toronto Star)
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