The following is a summary of “Impact of COVID-19 on emergency department boarding and in-hospital mortality,” published in the May 2023 issue of Emergency Medicine by Griffin, et al.

For a retrospective cohort study, researchers sought to evaluate changes in emergency departments (EDs) boarding and in-hospital mortality rates before and during the COVID-19 pandemic within a large integrated healthcare system.

All patients aged 18 and above who presented to one of the 17 EDs (11 hospital-based and 6 freestanding) within the healthcare system were included in this study. The study period was divided into two periods: pre-pandemic (March 1, 2019 – February 29, 2020) and during the pandemic (March 1, 2020 – August 31, 2021). Categorical variables were analyzed using frequencies and percentages. The significance of differences was assessed using Pearson chi-squared or Fisher’s exact tests where appropriate. Multiple regression analyses compared ED boarding and in-hospital mortality rates between the two periods.

A total of 1,374,790 patient encounters were included in the study. During the COVID-19 pandemic, there was a 16% increase in in-hospital mortality (adjusted odds ratio [AOR] = 1.16, 95% CI: 1.09-1.23, P < 0.0001). ED boarding also increased by 22% during the pandemic (AOR = 1.22, 95% CI: 1.20-1.23, P < 0.0001). The proportion of patients admitted during the pandemic was higher than in the pre-pandemic period (26.02% vs. 24.97%, P < 0.0001). Notably, the initial acuity level of patients presenting to the ED increased for both high acuity (13.95% vs. 13.18%, P < 0.0001) and moderate acuity (60.98% vs. 59.95%, P < 0.0001) during the COVID-19 pandemic.

The COVID-19 pandemic significantly impacted ED operations and patient outcomes, as evidenced by increased rates of ED boarding and in-hospital mortality. The findings underscored the importance of understanding and addressing the challenges faced by healthcare systems during pandemics and call for effective strategies to mitigate the adverse effects on ED functioning and patient care.

Source: sciencedirect.com/science/article/pii/S0735675723000529