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Emergency medicine
Research
Is adequate pain relief and time to analgesia associated with emergency department length of stay? A retrospective study
  1. Catalina Sokoloff1,2,
  2. Raoul Daoust1,2,
  3. Jean Paquet1,3,
  4. Jean-Marc Chauny1,2
  1. 1Department of Emergency Medicine, Research Centre, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
  2. 2Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
  3. 3Department of Surgery, Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
  1. Correspondence to Dr Raoul Daoust; raoul.daoust{at}umontreal.ca

Abstract

Objectives Evaluate the association of adequate analgesia and time to analgesia with emergency department (ED) length of stay (LOS).

Setting and Design Post hoc analysis of real-time archived data.

Participants We included all consecutive ED patients ≥18 years with pain intensity >6 (verbal numerical scale from 0 to 10), assigned to an ED bed, and whose pain was re-evaluated less than 1 h after receiving analgesic treatment.

Outcome measures The main outcome was ED-LOS in patients who had adequate pain relief (AR=↓50% pain intensity) compared with those who did not have such relief (NR).

Results A total of 2033 patients (mean age 49.5 years; 51% men) met our inclusion criteria; 58.3% were discharged, and 41.7% were admitted. Among patients discharged or admitted, there was no significant difference in ED-LOS between those with AR (median (25th–75th centile): 9.6 h (6.3–14.8) and 18.2 h (11.6–25.7), respectively) and NR (median (25th–75th centile): 9.6 h (6.6–16.0) and 17.4 h (11.3–26.5), respectively). After controlling for confounding factors, rapid time to analgesia (not AR) was associated with shorter ED-LOS of discharged and admitted patients (p<0.001 and <0.05, respectively). When adjusting for confounding variables, ED-LOS is shortened by 2 h (95% CI 1.1 to 2.8) when delay to receive analgesic is <90 min compared with >90 min for discharged and by 2.3 h (95% CI 0.17 to 4.4) for admitted patients.

Conclusions In our study, AR was not linked with short ED-LOS. However, rapid administration of analgesia was associated with short ED-LOS.

  • Accident & Emergency Medicine

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bmjopen-2013-004288

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