Critically ill patients boarding in the emergency department and the association with intensive care unit length of stay and hospital mortality during the COVID-19 pandemic.

Boarding of critically ill patients in the emergency department (ED) has been associated with mortality and intensive care unit (ICU) length of stay (LOS). This study evaluated whether boarding time in the ED was associated with those outcomes. A retrospective analysis of patients admitted through the ED to the ICU was performed. Information on demographics, severity score, and diagnoses was collected. The continuous primary endpoint of ICU LOS was fitted by a log normal model on covariates, including ED LOS. A multivariate log normal model was also used to model covariates toward ICU LOS. The binary patient expiration status was modeled by univariate and multivariate logistic regressions to evaluate the association of mortality with covariates. ED LOS was not associated with ICU LOS (correlation with an estimate of -0.02 ± 0.06 [SE], P = 0.76). ED LOS was not associated with hospital mortality (estimate correlation of -0.07 ± 0.07 [SE], P = 0.33). Body mass index, APACHE IV score, mechanical ventilation, and diagnosis of COVID-19 were associated with LOS. Age, APACHE IV score, mechanical ventilation, sepsis, and COVID-19 were associated with mortality. In conclusion, ED LOS is not associated with ICU LOS or hospital mortality. These findings may be related to early therapeutic interventions applied in the ED.