• Andreas Asheim, Sara Marie Nilsen, Fredrik Carlsen, Lars Eide Næss-Pleym, Oddvar Uleberg, Jostein Dale, Lars P Bache-Wiig Bjørnsen, and Johan Håkon Bjørngaard.
• Center for Health Care Improvement, St. Olav's hospital HF.
• Eur J Emerg Med. 2019 Dec 1; 26 (6): 446-452.

ObjectiveTo assess whether prolonged length of stay in the emergency department was associated with risk of death.MethodsWe analysed data from 165,183 arrivals at St. Olav's University Hospital's emergency department from 2011 to 2018, using an instrumental variable method. As instruments for prolonged length of emergency department stay, we used indicators measured before arrival of the patient. These indicators were used to study the association between prolonged length of emergency department stay and risk of death, being discharged from the emergency department and length of hospitalisation for those who were hospitalised.ResultsMean length of stay in the emergency department was 2.9 hours, and 30-day risk of death was 3.4%. Per hour prolonged length of stay in the emergency department, the overall change in risk of death was close to zero, with a narrow 95% confidence interval of -0.5 to 0.7 percentage points. Prolonged emergency department stay was associated with a higher probability of being discharged from the emergency department without admission to the hospital. We found no substantial differences in length of hospitalisation for patients who were admitted.ConclusionIn this study, prolonged emergency department stay was not associated with increased risk of death.

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