TY - JOUR
T1 - Association between boarding in the emergency department and in-hospital mortality
T2 - A systematic review
AU - Boudi, Zoubir
AU - Lauque, Dominique
AU - Alsabri, Mohamed
AU - Östlundh, Linda
AU - Oneyji, Churchill
AU - Khalemsky, Anna
AU - Rial, Carlos Lojo
AU - Liu, Shan W.
AU - Camargo, Carlos A.
AU - Aburawi, Elhadi
AU - Moeckel, Martin
AU - Slagman, Anna
AU - Christ, Michael
AU - Singer, Adam
AU - Tazarourte, Karim
AU - Rathlev, Niels K.
AU - Grossman, Shamai A.
AU - Bellou, Abdelouahab
N1 - Publisher Copyright:
Copyright: © 2020 Boudi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/4
Y1 - 2020/4
N2 - Importance Boarding in the emergency department (ED) is a critical indicator of quality of care for hospitals. It is defined as the time between the admission decision and departure from the ED. As a result of boarding, patients stay in the ED until inpatient beds are available; moreover, boarding is associated with various adverse events. Study objective The objective of our systematic review was to determine whether ED boarding (EDB) time is associated with in-hospital mortality (IHM). Methods A systematic search was conducted in academic databases to identify relevant studies. Medline, PubMed, Scopus, Embase, Cochrane, Web of Science, Cochrane, CINAHL and PsychInfo were searched. We included all peer-reviewed published studies from all previous years until November 2018. Studies performed in the ED and focused on the association between EDB and IHM as the primary objective were included. Extracted data included study characteristics, prognostic factors, outcomes, and IHM. A search update in PubMed was performed in May 2019 to ensure the inclusion of recent studies before publishing. Results From the initial 4,321 references found through the systematic search, the manual screening of reference lists and the updated search in PubMed, a total of 12 studies were identified as eligible for a descriptive analysis. Overall, six studies found an association between EDB and IHM, while five studies showed no association. The last remaining study included both ICU and non-ICU subgroups and showed conflicting results, with a positive association for non-ICU patients but no association for ICU patients. Overall, a tendency toward an association between EDB and IHM using the pool random effect was observed. Conclusion Our systematic review did not find a strong evidence for the association between ED boarding and IHM but there is a tendency toward this association. Further well-controlled, international multicenter studies are needed to demonstrate whether this association exists and whether there is a specific EDB time cut-off that results in increased IHM.
AB - Importance Boarding in the emergency department (ED) is a critical indicator of quality of care for hospitals. It is defined as the time between the admission decision and departure from the ED. As a result of boarding, patients stay in the ED until inpatient beds are available; moreover, boarding is associated with various adverse events. Study objective The objective of our systematic review was to determine whether ED boarding (EDB) time is associated with in-hospital mortality (IHM). Methods A systematic search was conducted in academic databases to identify relevant studies. Medline, PubMed, Scopus, Embase, Cochrane, Web of Science, Cochrane, CINAHL and PsychInfo were searched. We included all peer-reviewed published studies from all previous years until November 2018. Studies performed in the ED and focused on the association between EDB and IHM as the primary objective were included. Extracted data included study characteristics, prognostic factors, outcomes, and IHM. A search update in PubMed was performed in May 2019 to ensure the inclusion of recent studies before publishing. Results From the initial 4,321 references found through the systematic search, the manual screening of reference lists and the updated search in PubMed, a total of 12 studies were identified as eligible for a descriptive analysis. Overall, six studies found an association between EDB and IHM, while five studies showed no association. The last remaining study included both ICU and non-ICU subgroups and showed conflicting results, with a positive association for non-ICU patients but no association for ICU patients. Overall, a tendency toward an association between EDB and IHM using the pool random effect was observed. Conclusion Our systematic review did not find a strong evidence for the association between ED boarding and IHM but there is a tendency toward this association. Further well-controlled, international multicenter studies are needed to demonstrate whether this association exists and whether there is a specific EDB time cut-off that results in increased IHM.
UR - http://www.scopus.com/inward/record.url?scp=85083332736&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0231253
DO - 10.1371/journal.pone.0231253
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.systematicreview???
C2 - 32294111
AN - SCOPUS:85083332736
SN - 1932-6203
VL - 15
JO - PLoS ONE
JF - PLoS ONE
IS - 4
M1 - e0231253
ER -