Impact of Prolonged Emergency Department Stays Due to ICU Bed Shortage on Patient Outcomes

Abstract

Background: The rising demand for intensive care unit (ICU) beds has led to frequent delays in ICU admissions, extending patient stays in emergency departments (EDs) and potentially worsening outcomes. Understanding the clinical impact of these delays is vital for healthcare improvement. Objective: This study investigates the impact of prolonged ED stays due to ICU bed shortages on patient outcomes, including mortality and complications, at Esenyurt Necmi Kadıoğlu State Hospital. Methods: This retrospective analytical study was conducted on 1000 adult patients (≥18 years) who were managed in the ED between September 1, 2022, and August 31, 2024, while awaiting ICU admission. Inclusion criteria involved a minimum ED stay of 24 hours and complete clinical data. Data were collected from hospital records and included demographic, clinical, and laboratory information. Statistical analyses included descriptive statistics, chi-square tests for associations, and binary logistic regression to determine predictors of prolonged ED stay-related outcomes. Results: The mean patient age was 53.2 years, with cardiac issues being the most common condition. Patients with longer ED stays had significantly higher rates of mortality and complications (p < 0.05). Regression analysis confirmed that prolonged ED stay and delayed ICU admission were independent predictors of poor outcomes, including increased sepsis risk and mortality. Conclusion: Delays in ICU admission due to bed shortages contribute to extended ED stays, leading to worse clinical outcomes. The findings underscore the need for increased ICU capacity and improved patient flow strategies. Multicenter studies are recommended to generalize the findings and guide policy development.