Document Type

Poster

Publication Date

4-2012

Comments

This poster was presented at the 15th Annual Conference of the Society of Trauma Nurses in Savannah, Georgia.

Abstract

Background & Purpose: Research on emergency department length of stay (EDLOS) suggests that increased LOS may result in worse patient outcomes and increased overall LOS. Additional research suggests that increased age may not only result in lower intensity of care for some patients but might also increase EDLOS. For geriatric trauma patients, intensity of care and EDLOS may be different from non-geriatric patients. Given the nature of geriatric traumatic injury, it is important to understand if improvements can be made in geriatric trauma services.

Study/Project Design: A retrospective descriptive study utilizing the hospital’s trauma registry data was completed, including patient demographics, injury information, EDLOS, post ED destination information, and consultations during ED stay. Patient aged 65 and older were compared to patients less than 65 years of age.

Setting: This study was conducted at a large urban hospital with a level I trauma center.

Sample: Five years of data (2006-2010) were culled from the hospital’s trauma registry. Preliminary data analysis was completed for two years of data (n= 1,997). Preliminary data analysis included descriptive statistics and independent samples Mann-Whitney U test.

Procedures: Patients were divided according to age (<65 years and 65+ years) to create two groups for comparative analysis. Preliminary data analysis included descriptive statistics and independent samples Mann-Whitney U test.

Findings/Results: Among trauma patients analyzed, nearly two-thirds (62.8%) were <64 years of age. The post-ED destination for patients also differed by age group with patients <64 years of age moving to step down/intermediate units (39%), followed by operating rooms (22.2%). For patients >65 years of age, patients moved to step down/intermediate units (51%), followed by ICU/critical care units (30.3%). The average EDLOS for patients <64 years of age 405.66 minutes compared to 495.79 for patients >65 years of age. Interestingly, average time from ED admission to ED Neurosurgery consult was longer by almost 10 minutes for patients <64 years of age, but time from ED admission to ED orthopedics consult was nearly 10 minutes longer for patients >65 years of age. An independent sample Mann-Whitney U Test was conducted only for patients who received a neurosurgery or orthopedics consult in the ED. Results indicated a significant difference across the age groups for average EDLOS.

Discussion/Conclusions/Implications: Preliminary analysis for two years of data indicates there may be significant differences in average EDLOS by age. Differences in EDLOS are important as they can affect patient outcomes, patient satisfaction, and patient flow management in the hospital.