Impact of Different COVID-19 Pandemic Phases on Emergency Department Length of Stay and Intensive Care Unit Admission Risk: Single-Center Retrospective Cohort Study.
Postpandemic era associated with increased intensive care unit admission risk after emergency department visits
Impact of Different COVID-19 Pandemic Phases on Emergency Department Length of Stay and Intensive Care Unit Admission Risk: Single-Center Retrospective Cohort Study.
COVID-19 profoundly affected emergency department (emergency department) services and patient outcomes.
We investigated and compared emergency department LOS and intensive care unit admission risk among patients in the emergency department resuscitation area in 2019, 2021, and 2023, respectively before, during, and after the pandemic.
This single-center retrospective cohort study enrolled patients in the emergency department resuscitation area of a regional emergency center in central China.
postpandemic patients had higher intensive care unit admission risk than prepandemic
Among discharged patients, median emergency department LOS increased from a prepandemic 248 (IQR 149-404.8) minutes to a midpandemic 262.0 (IQR 153-423.8) minutes (P=.047) and remained elevated in the postpandemic phase (median 258, IQR 152-451 minutes; P<.001).
Among patients admitted to general wards, median emergency department LOS nearly doubled during the pandemic (from 186, IQR 96-431 to 350, IQR 188-610 minutes) and partially decreased to a postpandemic 293 (IQR 113-840) minutes (all P<.001).
The overall intensive care unit admission rate was 15.8% (6982/44,161).
The COVID-19 pandemic exerted differential effects on emergency department LOS across disposition groups.
The postpandemic period was associated with an increased risk of intensive care unit admission, especially among female patients, whereas no significant change was observed during the pandemic.
As a novel gender-stratified analysis covering the full pandemic timeline, this study distinguishes itself from prior research by revealing the sustained impacts of pandemic control policies on emergency care.