• R García-Gigorro, F de la Cruz Vigo, E M Andrés-Esteban, S Chacón-Alves, G Morales Varas, J A Sánchez-Izquierdo, and J C Montejo González.
• Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041 Madrid, Spain. Electronic address: rennygg@hotmail.com.
• Med Intensiva. 2017 May 1; 41 (4): 201-208.

ObjectiveThe favorable evolution of critically ill patients is often dependent on time-sensitive care intervention. The timing of transfer to the intensive care unit (ICU) therefore may be an important determinant of outcomes in critically ill patients. The aim of this study was to analyze the impact upon patient outcome of the length of stay in the Emergency Care Department.DesignA single-center ambispective cohort study was carried out.SettingA general ICU and Emergency Care Department (ED) of a single University Hospital.PatientsWe included 269 patients consecutively transferred to the ICU from the ED over an 18-month period.InterventionsPatients were first grouped into different cohorts based on ED length of stay (LOS), and were then divided into two groups: (a) ED LOS ≤5h and (b) ED LOS >5h.VariablesDemographic, diagnostic, length of stay and mortality data were compared among the groups.ResultsMedian ED LOS was 277min (IQR 129-622). Patients who developed ICU complications had a longer ED LOS compared to those who did not (349min vs. 209min, p<0.01). A total of 129 patients (48%) had ED LOS >5h. The odds ratio of dying for patients with ED LOS >5h was 2.5 (95% CI 1.3-4.7). Age and sepsis diagnosis were the risk factors associated to prolongation of ED length of stay.ConclusionsA prolonged ED stay prior to ICU admission is related to the development of time-dependent complications and increased mortality. These findings suggest possible benefit from earlier ICU transfer and the prompt initiation of organ support.Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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