Factors associated with ED length of stay during a mass casualty incident

Am J Emerg Med. 2016 Aug;34(8):1462-6. doi: 10.1016/j.ajem.2016.04.056. Epub 2016 May 4.

Abstract

Background: The aim of this study was to examine the factors associated with emergency department (ED) length of stay (LOS) using the patient registry data from a medical burns center during a burn injury mass casualty incident (MCI) after a dust explosion in New Taipei City, Taiwan.

Methods: This was a retrospective cohort study conducted at an urban, tertiary care teaching hospital during an MCI event that occurred on June 27, 2015. A celebratory party was held at the Formosa Fun Water Park in New Taipei City, Taiwan. At 20:32, the was an explosion caused by an overheated spotlight accidentally igniting colored cornstarch powder that had been sprayed on the stage. Factors associated with ED LOS were compared.

Results: In total, 48 burn injury patients were enrolled for study analysis. The median total body surface area of second- to third-degree burns was 35.0% (interquartile range [IQR], 15.8%-55.0%). The median ED LOS was 121.5 minutes (IQR, 38.3-209.8 minutes). The output time interval accounted for the longest interval with a median time of 56.0 minutes (IQR, 15.3-117.3 minutes). In multivariate analysis of the variables, triage level (level III; hazard ratio, 0.06; 95% confidence interval, 0.01-0.52) and output time (hazard ratio, 0.97; 95% confidence interval, 0.96-0.98) were significant influential factors.

Conclusions: The triage level and output time intervals were significantly associated with ED LOS in a burn-related MCI. Time effectiveness analyses, using a patient flow model, might serve as an important indicator during a hospital MCI response.

MeSH terms

  • Adult
  • Burns / epidemiology*
  • Burns / therapy
  • Emergency Service, Hospital*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Length of Stay / trends*
  • Male
  • Mass Casualty Incidents / statistics & numerical data*
  • Retrospective Studies
  • Taiwan / epidemiology
  • Time Factors
  • Triage*
  • Young Adult