Involuntary patient length-of-stay at a suburban emergency department

Michael J. Maniaci, Christian Lachner, Tyler F. Vadeboncoeur, David O. Hodge, Nancy L. Dawson, Teresa A. Rummans, Archana Roy, M. Caroline Burton

Research output: Contribution to journalArticle

Abstract

Background: Patients who may be a danger to themselves or others often are placed on involuntary hold status in the Emergency Department (ED). Our primary objective was to determine if there are demographic and/or clinical variables of involuntary hold patients which were associated with an increased ED LOS. Methods: Records of ED patients evaluated while on involuntary hold from January 1, 2014 through November 30, 2015 at a suburban acute-care hospital ED were reviewed. Data collected included demographics information, LOS, suicidal or homicidal ideation, suicide attempt, blood alcohol concentration (BAC), urine drug test (UDT), psychiatric disorder, substance use, medical illness, violence in the ED, and hospital admission. Linear regression based on the log of LOS was used to identify factors associated with increased LOS. Results: Two-hundred and fifty-one patients were included in the study. ED LOS (median)was 6 h (1, 49). Linear regression analysis showed increased LOS was associated with BAC (p = 0.05), urine drug test (UDT)(p = 0.05)and UDT positive for barbiturates (p = 0.01). There was no significant difference in ED LOS with respect to age, gender, housing, psychiatric diagnosis, suicidal or homicidal ideation, suicide attempt, violence, medical diagnosis, or admission status. Conclusions: Involuntary hold patients had an increased ED LOS associated with alcohol use, urine drug test screening, and barbiturate use. Protocol development to help stream-line ED evaluation of alcohol and drug use may improve ED LOS in this patient population.

Original languageEnglish (US)
JournalAmerican Journal of Emergency Medicine
DOIs
StatePublished - Jan 1 2019

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Hospital Emergency Service
Length of Stay
Urine
Violence
Suicide
Linear Models
Alcohols
Demography
Pharmaceutical Preparations
Preclinical Drug Evaluations
Drug Evaluation
Barbiturates
Hospital Departments
Mental Disorders
Substance-Related Disorders
Psychiatry
Regression Analysis
Population

Keywords

  • Alcohol intoxication
  • Emergency department
  • Involuntary hold
  • Length of stay

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Involuntary patient length-of-stay at a suburban emergency department. / Maniaci, Michael J.; Lachner, Christian; Vadeboncoeur, Tyler F.; Hodge, David O.; Dawson, Nancy L.; Rummans, Teresa A.; Roy, Archana; Burton, M. Caroline.

In: American Journal of Emergency Medicine, 01.01.2019.

Research output: Contribution to journalArticle

Maniaci, Michael J. ; Lachner, Christian ; Vadeboncoeur, Tyler F. ; Hodge, David O. ; Dawson, Nancy L. ; Rummans, Teresa A. ; Roy, Archana ; Burton, M. Caroline. / Involuntary patient length-of-stay at a suburban emergency department. In: American Journal of Emergency Medicine. 2019.
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