{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:29:13Z","timestamp":1793608153472,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003621","name":"Ministry of Science, ICT and Future Planning","doi-asserted-by":"publisher","award":["2019R1G1A1100299"],"award-info":[{"award-number":["2019R1G1A1100299"]}],"id":[{"id":"10.13039\/501100003621","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emergency Medicine International"],"published-print":{"date-parts":[[2021,7,16]]},"abstract":"<jats:p>Background. This study aimed at investigating whether the length of stay (LOS) in the emergency department (ED) is associated with mortality in elderly patients with infections admitted to the intensive care unit (ICU). Delayed admission to the ICU may be associated with adverse clinical outcomes in elderly patients with infections. Methods. This was a retrospective study conducted with subjects over 65 years of age admitted to the ICU from 5 EDs. We recorded demographic data, clinical findings, initial laboratory results, and ED LOS. Outcomes were all-cause in-hospital mortality and hospital LOS. A multivariable regression model was applied to identify factors predictive of mortality. Results. A total of 439 patients admitted to the ICU via the ED were included in this study, 132 (30.1%) of whom died in the hospital. The median (IQR) age was 78 (73, 83) years. In multivariable analysis, a history of malignancy (OR: 3.76; 95% CI: 1.88\u20137.52; <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>), high lactate level (OR: 1.13; 95% CI: 1.01\u20131.27; <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.039<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), and ED LOS (OR: 1.01; 95% CI: 1.00\u20131.02; <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.039<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>) were independent risk factors for all-cause in-hospital admission. Elderly patients with an ED LOS &gt;12 hours had a longer hospital LOS (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.018<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), and those with an ED LOS\u2009&gt;\u200924 hours had a longer hospital LOS and higher mortality rate (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.044<\/i:mn>\n                        <i:mo>,<\/i:mo>\n                        <i:mtext>\u2009<\/i:mtext>\n                        <i:mi>p<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.008<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>). Conclusions. This study shows that prolonged ED LOS is independently associated with all-cause in-hospital mortality in elderly patients with infections requiring ICU admission. ED LOS should be considered in strategies to prevent adverse outcomes in elderly patients with infections who visit the ED.<\/jats:p>","DOI":"10.1155\/2021\/9952324","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T17:35:06Z","timestamp":1626716106000},"page":"1-6","source":"Crossref","is-referenced-by-count":14,"title":["Prolonged Length of Stay in the Emergency Department and Mortality in Critically Ill Elderly Patients with Infections: A Retrospective Multicenter Study"],"prefix":"10.1155","volume":"2021","author":[{"given":"Wonjin","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8914-1640","authenticated-orcid":true,"given":"Seon Hee","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woon Jeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sikyoung","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Daejeon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungman","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Song","family":"Youn","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yeouido St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0764-9"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-019-0236-3"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.09.011"},{"key":"4","first-page":"1","article-title":"Emergency department visits by persons aged 65 and over: United States, 2009-2010","volume":"130","author":"M. Albert","year":"2013","journal-title":"NCHS Data Brief"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2629-6"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0b013e318236f7b8"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.121523"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.04.015"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1998.tb02688.x"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1186\/cc9975"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000266585.74905.5a"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2018-208032"},{"issue":"5","key":"13","first-page":"509","article-title":"Impact of delay in admission on the outcome of critically ill patients presenting to the emergency department of a tertiary care hospital from low income country","volume":"66","author":"B. A. Khan","year":"2016","journal-title":"JPMA The Journal of the Pakistan Medical Association"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2019.34.e114"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827e83af"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2019.03.001"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.07.021"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2009.00456.x"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2012.03.028"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.15441\/ceem.17.261"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9072284"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2018.6.37295"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-019-03622-0"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2013-203541"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1186\/cc2893"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0b013e31819fcf68"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2011.12.019"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000132904.35713.a7"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.10.022"},{"issue":"3","key":"31","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock","volume":"43","author":"A. Rhodes","year":"2017","journal-title":"Intensive Care Medicine"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201609-1848OC"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.02.008"},{"key":"34","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.04.042"}],"container-title":["Emergency Medicine International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/emi\/2021\/9952324.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/emi\/2021\/9952324.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/emi\/2021\/9952324.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T17:35:14Z","timestamp":1626716114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/emi\/2021\/9952324\/"}},"subtitle":[],"editor":[{"given":"Bartlomiej","family":"Perek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,7,16]]},"references-count":34,"alternative-id":["9952324","9952324"],"URL":"https:\/\/doi.org\/10.1155\/2021\/9952324","relation":{},"ISSN":["2090-2859","2090-2840"],"issn-type":[{"value":"2090-2859","type":"electronic"},{"value":"2090-2840","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7,16]]}}}