The impact of the COVID-19 pandemic on emergency department length of stay and outcomes of pneumonia patients

Ha, Ji Sung; Seo, Sang Won; Lee, Jang Young; Lee, Won Suk; Sung, Won Young; Lee, Keun Taek

J Korean Soc Emerg Med > Volume 33(1); 2022 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2022;33(1): 84-93.

코로나19 대유행 이후 폐렴 환자의 응급실 체류시간과 예후 변화

하지성

을지대학교 의과대학 응급의학교실

The impact of the COVID-19 pandemic on emergency department length of stay and outcomes of pneumonia patients

Department of Emergency Medicine, Eulji University, College of Medicine, Daejeon, Korea

Correspondence

Sang Won Seo ,Tel: 042-611-3256, Fax: 042-611-3880, Email: dockpung@eulji.ac.kr,

Received: April 19, 2021; Revised: August 12, 2021 Accepted: September 9, 2021. Published online: February 28, 2022.

ABSTRACT

Objective:
This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) outbreak on the emergency department length of stay (ED-LOS) and outcomes of patients admitted with pneumonia.
Method:
This was a retrospective observational study that included adult pneumonia patients admitted to the emergency department during the period from February to July 2019 and the corresponding period in 2020. After the COVID-19 outbreak, many changes occurred in medical systems, causing prolonged ED-LOS. We divided ED-LOS into pre-, mid-, and post-ED-LOS and compared ED-LOS, hospital LOS and in-hospital mortality rates of pneumonia patients during the above-mentioned periods. In addition, a multivariable logistic regression analysis was performed to identify the risk factors leading to in-hospital mortality in 2020.
Results:
A total of 365 patients were included in the study. Pre-ED-LOS, mid-ED-LOS, post-ED-LOS, and in-hospital mortality in the 2020 group were significantly higher than those of the 2019 group (P<0.05). Mid-ED-LOS (odds ratio [OR], 1.474; P=0.001) and post-ED-LOS (OR, 1.098; P=0.024) were identified as being independently associated with an increased risk of in-hospital mortality in 2020.
Conclusion:
Our study shows that ED-LOS and in-hospital mortality increased after the COVID-19 pandemic. Mid-ED-LOS and post-ED-LOS were independently associated with an increased risk of in-hospital mortality in patients with pneumonia in 2020.

Key words: COVID-19; Pneumonia; Emergency department; Length of stay; Mortality