Rapid influenza diagnostic test at triage can decrease emergency department length of stay

Abstract Objective Even if performing rapid influenza diagnostic tests test will not change clinical decision making, we sometimes perform at triage to reduce length of stay in Japan. Whether performing rapid influenza diagnostic tests at triage may shorten emergency department (ED) length of stay (...

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Main Authors: Tsutomu Iwasaki, Toru Hifumi, Kuniyoshi Hayashi, Norio Otani, Shinichi Ishimatsu
Format: Article
Language:English
Published: Elsevier 2020-08-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12125
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author Tsutomu Iwasaki
Toru Hifumi
Kuniyoshi Hayashi
Norio Otani
Shinichi Ishimatsu
author_facet Tsutomu Iwasaki
Toru Hifumi
Kuniyoshi Hayashi
Norio Otani
Shinichi Ishimatsu
author_sort Tsutomu Iwasaki
collection DOAJ
description Abstract Objective Even if performing rapid influenza diagnostic tests test will not change clinical decision making, we sometimes perform at triage to reduce length of stay in Japan. Whether performing rapid influenza diagnostic tests at triage may shorten emergency department (ED) length of stay (LOS) is remains unclear. We aimed to determine the utility of rapid influenza diagnostic tests at triage in shortening ED length of stay LOS. Methods We retrospectively reviewed medical records of patients discharged from our ED after receiving results from rapid influenza diagnostic tests during the influenza season from December, 2013 to March, 2019. Eligibility criteria were a walk‐in visit, age ≥15 years, triage performed, rapid influenza diagnostic test administered, and no admission. The triage group received rapid influenza diagnostic tests at triage. The after‐examination group received their tests only after examination by a doctor. The primary outcome was ED LOS after propensity score matching to adjust for several covariates. Results Of 2,768 eligible patients, 2,554 patients were enrolled in the triage group (n = 363) or after examination group (n = 2,191). There were 329 matched pairs after propensity score matching. Median ED LOS was significantly shorter in the triage group than in the after‐examination group after propensity score matching (81 min (interquartile range [IQR] 60 to 111) vs 106 min (IQR 80–142); median difference 24 min (95% confidence interval 17–30)). Conclusions Performing rapid influenza diagnostic tests at triage was associated with shorter ED LOS during the influenza season.
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spelling doaj-art-81f00d9578b04699bc68d44a39a6ef402025-08-20T02:09:05ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522020-08-011449450110.1002/emp2.12125Rapid influenza diagnostic test at triage can decrease emergency department length of stayTsutomu Iwasaki0Toru Hifumi1Kuniyoshi Hayashi2Norio Otani3Shinichi Ishimatsu4Emergency and Critical Care medicine St. Luke's International Hospital Tokyo JapanEmergency and Critical Care medicine St. Luke's International Hospital Tokyo JapanGraduate School of Public Health St. Luke's International University Tokyo JapanEmergency and Critical Care medicine St. Luke's International Hospital Tokyo JapanEmergency and Critical Care medicine St. Luke's International Hospital Tokyo JapanAbstract Objective Even if performing rapid influenza diagnostic tests test will not change clinical decision making, we sometimes perform at triage to reduce length of stay in Japan. Whether performing rapid influenza diagnostic tests at triage may shorten emergency department (ED) length of stay (LOS) is remains unclear. We aimed to determine the utility of rapid influenza diagnostic tests at triage in shortening ED length of stay LOS. Methods We retrospectively reviewed medical records of patients discharged from our ED after receiving results from rapid influenza diagnostic tests during the influenza season from December, 2013 to March, 2019. Eligibility criteria were a walk‐in visit, age ≥15 years, triage performed, rapid influenza diagnostic test administered, and no admission. The triage group received rapid influenza diagnostic tests at triage. The after‐examination group received their tests only after examination by a doctor. The primary outcome was ED LOS after propensity score matching to adjust for several covariates. Results Of 2,768 eligible patients, 2,554 patients were enrolled in the triage group (n = 363) or after examination group (n = 2,191). There were 329 matched pairs after propensity score matching. Median ED LOS was significantly shorter in the triage group than in the after‐examination group after propensity score matching (81 min (interquartile range [IQR] 60 to 111) vs 106 min (IQR 80–142); median difference 24 min (95% confidence interval 17–30)). Conclusions Performing rapid influenza diagnostic tests at triage was associated with shorter ED LOS during the influenza season.https://doi.org/10.1002/emp2.12125crowdingemergency departmentinfluenzalength of staypoint‐of‐care testingpropensity score
spellingShingle Tsutomu Iwasaki
Toru Hifumi
Kuniyoshi Hayashi
Norio Otani
Shinichi Ishimatsu
Rapid influenza diagnostic test at triage can decrease emergency department length of stay
Journal of the American College of Emergency Physicians Open
crowding
emergency department
influenza
length of stay
point‐of‐care testing
propensity score
title Rapid influenza diagnostic test at triage can decrease emergency department length of stay
title_full Rapid influenza diagnostic test at triage can decrease emergency department length of stay
title_fullStr Rapid influenza diagnostic test at triage can decrease emergency department length of stay
title_full_unstemmed Rapid influenza diagnostic test at triage can decrease emergency department length of stay
title_short Rapid influenza diagnostic test at triage can decrease emergency department length of stay
title_sort rapid influenza diagnostic test at triage can decrease emergency department length of stay
topic crowding
emergency department
influenza
length of stay
point‐of‐care testing
propensity score
url https://doi.org/10.1002/emp2.12125
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AT toruhifumi rapidinfluenzadiagnostictestattriagecandecreaseemergencydepartmentlengthofstay
AT kuniyoshihayashi rapidinfluenzadiagnostictestattriagecandecreaseemergencydepartmentlengthofstay
AT noriootani rapidinfluenzadiagnostictestattriagecandecreaseemergencydepartmentlengthofstay
AT shinichiishimatsu rapidinfluenzadiagnostictestattriagecandecreaseemergencydepartmentlengthofstay