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Association Between Time Spent in the Emergency Department and 30-Day Mortality: A Population-Level Observational
Hannah Aston1, Perrine Machuel1, Nina Mill1
1National Statistician's Analysis Unit, Office for National Statistics, Newport, UK.
Annals of Emergency Medicine
|July 7, 2026
Summary
Longer emergency department (ED) stays for non-urgent care are linked to higher 30-day mortality. This study highlights a concerning association between extended ED time and patient outcomes, emphasizing the need for further investigation into the causes.
Area of Science:
- Emergency Medicine
- Public Health
- Health Services Research
Background:
- Type 1 emergency departments (EDs) provide critical, consultant-led 24-hour care.
- Understanding factors influencing patient outcomes post-ED visit is crucial for improving healthcare.
- The association between ED length of stay and mortality requires further investigation.
Purpose of the Study:
- To investigate the association between time spent in Type 1 emergency departments (EDs) and all-cause mortality within 30 days.
- To analyze the risk of death for patients receiving non-immediate care based on their ED duration.
Main Methods:
- A cross-sectional, retrospective, observational study utilizing national linked data.
- Inclusion of individuals visiting a Type 1 ED between March 21, 2021, and March 31, 2022.
- Logistic regression analysis to assess the association between ED time and 30-day all-cause mortality.
Main Results:
- The study included over 6.7 million individuals, with 1.3% experiencing 30-day mortality.
- Compared to a 2-hour ED stay, spending 12 hours was associated with a 2.1 times higher adjusted odds of post-discharge death.
- Increased ED duration for non-immediate care showed a dose-response relationship with higher mortality risk.
Conclusions:
- Extended time in the ED for non-immediate care is associated with an increased risk of all-cause mortality within 30 days.
- The observed association may be influenced by residual confounding rather than a direct causal effect.
- Further research is necessary to elucidate the causal drivers of post-discharge mortality.
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