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{
    "pk": 14412,
    "title": "Increased Emergency Department Hallway Length of Stay is Associated with Development of Delirium",
    "subtitle": null,
    "abstract": "Introduction:\n Our study aimed to determine 1) the association between time spent in the emergency department (ED) hallway and the development of delirium and 2) the hospital location of delirium development.\nMethods:\n This single-center, retrospective chart review included patients 18+ years old admitted to the hospital after presenting, without baseline cognitive impairment, to the ED in 2018. We identified the Delirium group by the following: key words describing delirium; orders for psychotropics, special observation, and restraints; or documented positive Confusion Assessment Method (CAM) screen. The Control group included patients not meeting delirium criteria. We used a multivariable logistic regression model, while adjusting for confounders, to assess the odds of delirium development associated with percentage of ED LOS spent in the hallway.\nResults:\n A total of 25,156 patients met inclusion criteria with 1920 (7.6%) meeting delirium criteria. Delirium group vs. Control group patients spent a greater percentage of time in the ED hallway (median 50.5% vs 10.8%, P<0.001); had longer ED LOS (median 11.94 vs 8.12 hours, P<0.001); had more ED room transfers (median 5 vs 4, P<0.001); and had longer hospital LOS (median 5.0 vs 4.6 days, P<0.001). Patients more frequently developed delirium in the ED (77.5%) than on inpatient units (22.5%). The relative odds of a patient developing delirium increased by 3.31 times for each percent increase in ED hallway time (95% confidence interval, 2.85, 3.83).\nConclusion: \nPatients with delirium had more ED hallway exposure, longer ED LOS, and more ED room transfers. Understanding delirium in the ED has substantial implications for improving patient safety.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Delirium, Hallway, Length of Stay"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9jq9q26v",
    "frozenauthors": [
        {
            "first_name": "Kate",
            "middle_name": "",
            "last_name": "van Loveren",
            "name_suffix": "",
            "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Arnav",
            "middle_name": "",
            "last_name": "Singla",
            "name_suffix": "",
            "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Liron",
            "middle_name": "",
            "last_name": "Sinvani",
            "name_suffix": "",
            "institution": "Center for Health Innovations and Outcomes Research, Feinstein Institutes of Medical Research, Northwell Health, Manhasset, New York\nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Medicine, Division of Hospital Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Christopher",
            "middle_name": "",
            "last_name": "Calandrella",
            "name_suffix": "",
            "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York \nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Thomas",
            "middle_name": "",
            "last_name": "Perera",
            "name_suffix": "",
            "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York \nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Martina",
            "middle_name": "",
            "last_name": "Brave",
            "name_suffix": "",
            "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Lance",
            "middle_name": "",
            "last_name": "Becker",
            "name_suffix": "",
            "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York \nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        },
        {
            "first_name": "Timmy",
            "middle_name": "",
            "last_name": "Li",
            "name_suffix": "",
            "institution": "Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York",
            "department": "None"
        }
    ],
    "date_submitted": "2020-07-30T22:53:09+01:00",
    "date_accepted": "2020-07-30T22:53:09+01:00",
    "date_published": "2021-04-10T00:24:23+01:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14412/galley/7397/download/"
        }
    ]
}