The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma patients.METHODS: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(<4 h, 4–12 h,12–24 h, and >24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital mortality.RESULTS: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(<4 h) and had higher level trauma team T1 activation(TTA-1), higher Injury Severity Score(ISS), higher shock index(SI), and more head injuries than the other groups(P=0.001). Patients with an EDLOS >24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.

The kinetics study of the reduction of Fast Green dye with cetylpyridinum chloride as cationic surfactant

The kinetics of the reaction of Fast Green dye(FG)with cetylpyridinum chloride was studied in alkaline medium by UV-Visible spectrophotometer.Reduction of Fast Green dye was carried out by varying the fast green dye concentration,cetylpyridinum chloride concentration and concentration of sodium hydroxide.In the present study the reduction of dye was carried out in order to reduce the color content.The interaction of dye was carried out with reducing analyte(cetylpyridinum chloride).The rate of the reaction was determined by varying the above parameters at different temperatures.It was observed that the reduction followed pseudo first-order kinetics with respect to dye,surfactant,OH–ion concentration according to the following reaction pathway.reaction like entropy of activation(ΔS)and free energy of activation(ΔG)showed the extremely solvated states of transient complex which was less disorderly arranged than the oxidized form of dye,whereas Ea values reflects a high amount of energy required for the reduction of dye with cetylpyridinum chloride.