Determinants of Severely Prolonged Emergency Department Stays Among Older Adults: A Retrospective Comparative Analysis

IF 4 2区医学 Q2 MANAGEMENT

Journal of Nursing Management Pub Date : 2025-10-19 DOI:10.1155/jonm/5173443

Zhongxiang Wang, Lan Lai, Xiaping Zhang, Yajun Sun

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Abstract

Objective

Prolonged emergency department (ED) stays are linked to adverse outcomes in older adults. This study examined the clinical characteristics and determinants of severely prolonged ED stays in a large tertiary hospital in China.

Methods

A retrospective cohort study was conducted at a tertiary hospital in Zhejiang Province, including 652 adult patients with ED boarding ≥ 72 h between January 1 and December 31, 2024. Patients were stratified into geriatric (≥ 60 years) and nongeriatric groups for descriptive comparison. Logistic regression analyses were performed to identify independent predictors of severely prolonged stays (> 96 h) among geriatric patients.

Results

Among all included patients, 73.3% were geriatric. Compared with nongeriatric patients, older adults had significantly higher rates of multimorbidity and nutritional risk and were less likely to arrive at night. Multivariate analysis showed that advanced age, nighttime arrival, nutritional risk, and infection were independent risk factors for severely prolonged ED stays, while multidisciplinary consultation significantly reduced risk.

Conclusion

Severely prolonged ED stays among older adults are driven by both patient-level vulnerabilities and system-level constraints. Early nutritional screening, timely infection management, and multidisciplinary collaboration may help reduce boarding time and optimize care for aging populations.

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老年人严重延长急诊时间的决定因素：回顾性比较分析

目的延长急诊科（ED）住院时间与老年人不良预后相关。本研究调查了中国一家大型三级医院严重延长ED住院时间的临床特征和决定因素。方法对浙江省某三级医院2024年1月1日至12月31日期间ED住院≥72 h的成人患者652例进行回顾性队列研究。将患者分为老年组（≥60岁）和非老年组进行描述性比较。进行Logistic回归分析以确定老年患者严重延长住院时间（96小时）的独立预测因素。结果73.3%的患者为老年人。与非老年患者相比，老年人的多病发病率和营养风险明显更高，夜间就诊的可能性也更小。多因素分析显示，高龄、夜间入住、营养风险和感染是严重延长ED住院时间的独立危险因素，而多学科会诊可显著降低风险。结论老年人严重延长ED住院时间是由患者层面的脆弱性和系统层面的制约因素共同驱动的。早期营养筛查、及时感染管理和多学科合作可能有助于减少登机时间并优化对老年人的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nursing Management NURSING-

CiteScore

9.40

自引率

14.50%

发文量

377

审稿时长

4-8 weeks

期刊介绍： The Journal of Nursing Management is an international forum which informs and advances the discipline of nursing management and leadership. The Journal encourages scholarly debate and critical analysis resulting in a rich source of evidence which underpins and illuminates the practice of management, innovation and leadership in nursing and health care. It publishes current issues and developments in practice in the form of research papers, in-depth commentaries and analyses. The complex and rapidly changing nature of global health care is constantly generating new challenges and questions. The Journal of Nursing Management welcomes papers from researchers, academics, practitioners, managers, and policy makers from a range of countries and backgrounds which examine these issues and contribute to the body of knowledge in international nursing management and leadership worldwide. The Journal of Nursing Management aims to: -Inform practitioners and researchers in nursing management and leadership -Explore and debate current issues in nursing management and leadership -Assess the evidence for current practice -Develop best practice in nursing management and leadership -Examine the impact of policy developments -Address issues in governance, quality and safety