The relationship between emergency department crowding and outcome of referred critical patients from other hospitals

Introduction: Emergency department overcrowding can affect the process of seeking help for critically ill patients in the emergency department. The aim of this study was to investigate the relationship between crowding and clinical outcome of referred critical patients from other hospitals. Methods: This was a retrospective cross-sectional study performed on 583 critically ill patients (triage levels one and two) referred to the emergency department of Imam Reza Hospital, Tabriz, Iran, between 22 September 2016 and 22 March 2017. Clinical outcome was considered as death rate and the crowd was measured in terms of the number of patients per hour. Statistical analysis was performed using SPSS. Results: The mean ± standard deviation (SD) of age was 49.5 ± 25.0 years old with 56.4% frequency of men and 43.2% women. About 53.5% of people were referred during peak hour. Evaluating the final outcome, 21.6% of patients died in the emergency department, while 41.5% and 36.9% were cured and discharged or hospitalized respectively. The mean ± SD duration of staying in the emergency department was 239.6 ± 233.0 minutes. A significant percentage of death was during the peak hour of emergency referrals. The final outcome got worse with an increased number of patients admitted to the emergency room. Conclusion: Crowding in the emergency department deteriorated the treatment process of patients with a critical condition. Thus, the final outcome of the disease or the mortality rate of patients admitted to emergency worsened. Constructive measures to reduce the crowding in the emergency department should be considered.