NDLI: Determinants of time-to-disposition in patients who underwent CT for pulmonary embolism: a retrospective study

Content Provider	Springer Nature : BioMed Central
Author	Hassan, Ali Al Dandan, Omran Awary, Khaled Bukhamsin, Besma Bukhamseen, Reema Alzaki, Alaa Al-Sulaibeekh, Amal Alsaif, Hind S.
Abstract	Background Pulmonary embolism (PE) is a common life-threatening medical emergency that needs prompt diagnosis and management. Providing urgent care is a key determinant of quality in the emergency department (ED) and time-based targets have been implemented to reduce length of stay and overcrowding. The study aimed to determine factors that are associated with having a time-to-disposition of less than 4 h in patients with suspected PE who underwent computed tomography pulmonary angiography (CT-PA) to confirm the diagnosis. Methods After obtaining approval from the ethics committee, we conducted a retrospective observational study by examining CT-PA scans that was performed to rule out PE in all adult patients presenting at the ED between January 2018 and December 2019. Demographic information and clinical information, as well as arrival and disposition times were collected from electronic health records. Multivariable regression analysis was used to identify the independent factors associated with meeting the 4-h target in the ED. Results In total, the study involved 232 patients (76 men and 156 women). The median length of stay in the ED was 5.2 h and the 4-h target was achieved in 37% of patients. Multivariable logistic regression analysis revealed that a positive CT-PA scan for PE was independently associated with meeting the four-hour target in the ED (odds ratio [OR]: 2.2; 95% CI: 1.1–4.8). Furthermore, Hemoptysis was the only clinical symptom that served as an independent factor associated with meeting the 4-h target in the ED (OR: 10.4; 95% CI: 1.2–90.8). Conclusion Despite the lower number of staff and higher volume of patients on weekends, patients who presented on weekends had shorter stays and were more likely to meet the 4-h target. Careful clinical assessment, prior to requesting a CT-PA scan, is crucial, since negative CT-PA scans may be associated with failure to meet the 4-h target.
Related Links	https://bmcemergmed.biomedcentral.com/counter/pdf/10.1186/s12873-021-00510-7.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s12873-021-00510-7
Journal	BMC Emergency Medicine
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-10-12
Access Restriction	Open
Subject Keyword	Emergency Medicine Medicine Public Health Pulmonary embolism Emergency department Length of stay 4-h target Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine
Journal Impact Factor	2.3/2023
5-Year Journal Impact Factor	2.5/2023

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