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  • Title: The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis.
    Author: Hong YC, Chou MH, Liu EH, Hsiao CT, Kuan JT, Lin JC, Chen IC.
    Journal: Am J Emerg Med; 2009 May; 27(4):385-90. PubMed ID: 19555606.
    Abstract:
    OBJECTIVE: Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated. METHODS: This was a retrospective study. A total of 195 patients were enrolled and analyzed. The sample was divided into 2 groups: nonmortality and mortality. A stepwise logistic regression model was developed to investigate 3 factors of clinical relevance predicting patient mortality. RESULT: The results of the stepwise logistic regression analysis revealed that hypotension (odds ratio [OR], 32.9; 95% confidence interval [CI], 6.9-156.0) and prolonged ED boarding stay (OR, 3.4; 95% CI 1.3-8.6) were both associated with higher mortality. Early operation (OR: 0.16; 95% CI: 0.06-0.45) was associated with lower mortality. CONCLUSION: Prolonged ED boarding stay was associated with increased mortality in patients with necrotizing fasciitis. Early operation (within 24 hours of ED arrival) was associated with decreased mortality.
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