34 Chapter 2 About three quarters of all patients were presented during weekdays (n=1,536; 77%). Almost half of the patients presented in the afternoon (n=980; 49%). The mean number of consultations per patient was 0.47 (SD 0.74) and mean number of diagnostics per patient was 2.2 (SD 1.4). Patients were most frequently admitted by the general practitioner (n=760; 38%). Most patients arrived at the ED by self-transport (n=1,171; 59%). Patients were mainly treated by residents (n=1,678; 84%). About 44% of all patients were triaged as U1-U2 (n= 876). Of the 2,000 patients that visited the ED, almost two-thirds (n=1,251; 63%) were admitted to the hospital. Fourteen patients (0.7%) died at the ED. Fourteen percent of the patients (n=272) revisited the ED within a month after ED discharge. Most patients had a presenting complaint (n=1,032; 52%) in the field of internal medicine. Final diagnosis was only in 32% of the patients (n=642) in the field of internal medicine. This discrepancy could be explained by the fact that some patients with a presenting complaint in the field of internal medicine, had a diagnosis in the field of another specialism (e.g., a patient with upper abdominal pain with a diagnosis of acute coronary syndrome or pneumonia). About one third of all patients (n=729; 36%) were treated by the emergency physician (table 3). Demographical factors related to a prolonged LOS The median length of stay of our study cohort was 216 minutes (SD 116 minutes). A quarter of the patients (n=505, 25%) had a prolonged length of stay. Polypharmacy was significantly associated with a prolonged ED LOS (p < 0.001) in the bivariate analysis (table 4). However, polypharmacy was not independently related to a prolonged stay at the ED in the multivariable analysis (p = 0.56; table 5). Organizational factors independently related to a prolonged LOS Day of presentation (p = 0.036), time of presentation (p = 0.022), number of consultations (p < 0.001), number of diagnostic interventions (p < 0.001), mode of presentation (p < 0.001), method of transport (p = 0.021), seniority of physician (p = 0.015), assigned urgency (p < 0.001), and destination after ED visit (p < 0.001) were significantly univariately associated with ED LOS (table 4). In multivariable analysis; risk of prolonged ED LOS was higher for patients with a higher number of consultations (OR 2.4, CI 2.0-2.91) or with diagnostic interventions (OR 1.5, CI 1.4-1.7). Patients with an urgency category of U1 – U2 (OR 4.8, CI 2.2-10), U3 – U4 (OR 6.3, CI 2.9-14), or U5/missing (OR 2.9, CI 1.2-6.8) were more likely to have a prolonged ED LOS than patients with an urgency category of U0 (table 5).
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