• Chao-Jui Li, Yuan-Jhen Syue, Yan-Ren Lin, Hsien-Hung Cheng, Fu-Jen Cheng, Tsung-Cheng Tsai, Kuan-Fu Chen, and Chien-Hung Lee.
• Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
• BMJ Open. 2016 May 4; 6 (5): e010815.

ObjectiveCT, an important diagnostic tool in the emergency department (ED), might increase the ED length of stay (LOS). Considering the issue of ED overcrowding, it is important to evaluate whether CT use delays or facilitates patient disposition in the ED.DesignA retrospective 1-year cohort study.Setting5 EDs within the same healthcare system dispersed nationwide in Taiwan.ParticipantsAll adult non-trauma patients who visited the 5 EDs from 1 July 2011 to 30 June 2012.InterventionsPatients were grouped by whether or not they underwent a CT scan (CT and non-CT groups, respectively).Primary And Secondary Outcome MeasuresThe ED LOS and hospital LOS between patients who had and had not undergone CT scans were compared by stratifying different dispositions and diagnoses.ResultsCT use prolonged patient ED LOS among those who were directly discharged from the ED. Among patients admitted to the observation unit and then discharged, patients diagnosed with nervous system disease had shorter ED LOS if they underwent a CT scan. CT use facilitated patient admission to the general ward. CT use also accelerated patients' admission to the intensive care unit (ICU) for patients with nervous system disease, neoplasm and digestive disease. Finally, patients admitted to the general wards had shorter hospital LOS if they underwent CT scans in the ED.ConclusionsCT use did not seem to have delayed patient disposition in ED. While CT use facilitated patient disposition if they were finally hospitalised, it mildly prolonged ED LOS in cases of patients discharged from the ED.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

26 keywords...

hide…