TY - JOUR
T1 - Factors associated with delays to emergency care for bowel obstruction
AU - Hwang, Ula
AU - Aufses, Arthur H.
AU - Bickell, Nina A.
N1 - Funding Information:
This study was funded by the Agency for Healthcare Research and Quality R0313464 (N.A.B.).
PY - 2011/7
Y1 - 2011/7
N2 - Background Our objective was to determine factors associated with delays to first treatment for emergency department (ED) patients diagnosed with small-bowel obstruction (SBO). Methods This was a retrospective study of ED patients with SBO. Data were collected from medical records, administrative databases, and staffing schedules at an urban, tertiary care medical center from June 1, 2001, to November 30, 2002. Patient-related characteristics and processes of ED and hospital care were evaluated. Outcomes studied were time to first treatment (nasogastric tube or surgery) and risk of surgical resection. Results A total of 193 patients were diagnosed with confirmed intestinal obstruction. Patients with longer times to first treatment arrived during ED clinician hand-offs (adjusted hazard ratio,.40; 95% confidence interval,.17-.98). Patients with longer times to surgery consult (ref. first quartile) had greater odds of surgical resection (second quartile adjusted odds ratio, 6.91; 95% confidence interval, 1.85-24.80). Conclusions Remediable ED and hospital factors were associated with longer times to treatment for patients with bowel obstruction.
AB - Background Our objective was to determine factors associated with delays to first treatment for emergency department (ED) patients diagnosed with small-bowel obstruction (SBO). Methods This was a retrospective study of ED patients with SBO. Data were collected from medical records, administrative databases, and staffing schedules at an urban, tertiary care medical center from June 1, 2001, to November 30, 2002. Patient-related characteristics and processes of ED and hospital care were evaluated. Outcomes studied were time to first treatment (nasogastric tube or surgery) and risk of surgical resection. Results A total of 193 patients were diagnosed with confirmed intestinal obstruction. Patients with longer times to first treatment arrived during ED clinician hand-offs (adjusted hazard ratio,.40; 95% confidence interval,.17-.98). Patients with longer times to surgery consult (ref. first quartile) had greater odds of surgical resection (second quartile adjusted odds ratio, 6.91; 95% confidence interval, 1.85-24.80). Conclusions Remediable ED and hospital factors were associated with longer times to treatment for patients with bowel obstruction.
KW - Bowel obstruction
KW - Delays
KW - Emergency department
KW - Hand-offs
UR - https://www.scopus.com/pages/publications/79960176259
U2 - 10.1016/j.amjsurg.2010.05.003
DO - 10.1016/j.amjsurg.2010.05.003
M3 - Article
AN - SCOPUS:79960176259
SN - 0002-9610
VL - 202
SP - 1
EP - 7
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 1
ER -