The impact of overcrowding on the bacterial contamination of blood cultures in the ED

Ching Chi Lee, Nan-Yao Lee, Ming Che Chuang, Po-Lin Chen, Chia-Ming Chang, Wen-Chien Ko

研究成果: Article

32 引文 (Scopus)

摘要

Objectives: This study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED). Methods: Clinical variables and medical records of adults with bacterial growth of blood cultures in the ED as well as the degree of ED crowding, between August 2007 and July 2008, were prospectively collected. Results: Of the 11-491 adults who underwent blood culture sampling, the medical records of 558 (4.86%) eligible patients with bacterial growth in their blood cultures were analyzed. Most patients (366, or 3.19%) had true bacteremia, whereas 192 (1.67%) were regarded as contaminated. In multivariate analyses, ED overcrowding (scoring was based on a National Emergency Department Overcrowding Study [NEDOCS] score ≥100 points) was independently associated with blood culture contamination (odds ratio [OR], 1.58; P =.04). In contrast, other medical comorbidities, such as liver cirrhosis (OR, 0.31; P =.02), thrombocytopenia (<100000/mm 3; OR, 0.28; P =.002), or high serum levels of C-reactive protein (>100 mg/L; OR, 0.24; P <.001), were negatively associated with blood culture contamination. On further analysis of the 5 crowding categories as stratified by NEDOCS scores, which included not busy and busy (0-60 points), extremely busy but not overcrowded (60-100), overcrowded (100-140), severely overcrowded (140-180), and dangerously overcrowded (180-200), there was a strong correlation between blood culture contamination rates and the degrees of ED crowding (γ = 0.99, P <.001). Conclusions: Emergency department overcrowding may have an adverse impact on the quality of clinical care, including increasing the risk of blood culture contamination.

原文English
頁(從 - 到)839-845
頁數7
期刊American Journal of Emergency Medicine
30
發行號6
DOIs
出版狀態Published - 2012 七月 1

指紋

Hospital Emergency Service
Odds Ratio
Medical Records
Blood Culture
Quality of Health Care
Growth
Bacteremia
Liver Cirrhosis
Thrombocytopenia
Comorbidity
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

引用此文

@article{d94204234c1245f699d25b0a6cdacff6,
title = "The impact of overcrowding on the bacterial contamination of blood cultures in the ED",
abstract = "Objectives: This study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED). Methods: Clinical variables and medical records of adults with bacterial growth of blood cultures in the ED as well as the degree of ED crowding, between August 2007 and July 2008, were prospectively collected. Results: Of the 11-491 adults who underwent blood culture sampling, the medical records of 558 (4.86{\%}) eligible patients with bacterial growth in their blood cultures were analyzed. Most patients (366, or 3.19{\%}) had true bacteremia, whereas 192 (1.67{\%}) were regarded as contaminated. In multivariate analyses, ED overcrowding (scoring was based on a National Emergency Department Overcrowding Study [NEDOCS] score ≥100 points) was independently associated with blood culture contamination (odds ratio [OR], 1.58; P =.04). In contrast, other medical comorbidities, such as liver cirrhosis (OR, 0.31; P =.02), thrombocytopenia (<100000/mm 3; OR, 0.28; P =.002), or high serum levels of C-reactive protein (>100 mg/L; OR, 0.24; P <.001), were negatively associated with blood culture contamination. On further analysis of the 5 crowding categories as stratified by NEDOCS scores, which included not busy and busy (0-60 points), extremely busy but not overcrowded (60-100), overcrowded (100-140), severely overcrowded (140-180), and dangerously overcrowded (180-200), there was a strong correlation between blood culture contamination rates and the degrees of ED crowding (γ = 0.99, P <.001). Conclusions: Emergency department overcrowding may have an adverse impact on the quality of clinical care, including increasing the risk of blood culture contamination.",
author = "Lee, {Ching Chi} and Nan-Yao Lee and Chuang, {Ming Che} and Po-Lin Chen and Chia-Ming Chang and Wen-Chien Ko",
year = "2012",
month = "7",
day = "1",
doi = "10.1016/j.ajem.2011.05.026",
language = "English",
volume = "30",
pages = "839--845",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - The impact of overcrowding on the bacterial contamination of blood cultures in the ED

AU - Lee, Ching Chi

AU - Lee, Nan-Yao

AU - Chuang, Ming Che

AU - Chen, Po-Lin

AU - Chang, Chia-Ming

AU - Ko, Wen-Chien

PY - 2012/7/1

Y1 - 2012/7/1

N2 - Objectives: This study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED). Methods: Clinical variables and medical records of adults with bacterial growth of blood cultures in the ED as well as the degree of ED crowding, between August 2007 and July 2008, were prospectively collected. Results: Of the 11-491 adults who underwent blood culture sampling, the medical records of 558 (4.86%) eligible patients with bacterial growth in their blood cultures were analyzed. Most patients (366, or 3.19%) had true bacteremia, whereas 192 (1.67%) were regarded as contaminated. In multivariate analyses, ED overcrowding (scoring was based on a National Emergency Department Overcrowding Study [NEDOCS] score ≥100 points) was independently associated with blood culture contamination (odds ratio [OR], 1.58; P =.04). In contrast, other medical comorbidities, such as liver cirrhosis (OR, 0.31; P =.02), thrombocytopenia (<100000/mm 3; OR, 0.28; P =.002), or high serum levels of C-reactive protein (>100 mg/L; OR, 0.24; P <.001), were negatively associated with blood culture contamination. On further analysis of the 5 crowding categories as stratified by NEDOCS scores, which included not busy and busy (0-60 points), extremely busy but not overcrowded (60-100), overcrowded (100-140), severely overcrowded (140-180), and dangerously overcrowded (180-200), there was a strong correlation between blood culture contamination rates and the degrees of ED crowding (γ = 0.99, P <.001). Conclusions: Emergency department overcrowding may have an adverse impact on the quality of clinical care, including increasing the risk of blood culture contamination.

AB - Objectives: This study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED). Methods: Clinical variables and medical records of adults with bacterial growth of blood cultures in the ED as well as the degree of ED crowding, between August 2007 and July 2008, were prospectively collected. Results: Of the 11-491 adults who underwent blood culture sampling, the medical records of 558 (4.86%) eligible patients with bacterial growth in their blood cultures were analyzed. Most patients (366, or 3.19%) had true bacteremia, whereas 192 (1.67%) were regarded as contaminated. In multivariate analyses, ED overcrowding (scoring was based on a National Emergency Department Overcrowding Study [NEDOCS] score ≥100 points) was independently associated with blood culture contamination (odds ratio [OR], 1.58; P =.04). In contrast, other medical comorbidities, such as liver cirrhosis (OR, 0.31; P =.02), thrombocytopenia (<100000/mm 3; OR, 0.28; P =.002), or high serum levels of C-reactive protein (>100 mg/L; OR, 0.24; P <.001), were negatively associated with blood culture contamination. On further analysis of the 5 crowding categories as stratified by NEDOCS scores, which included not busy and busy (0-60 points), extremely busy but not overcrowded (60-100), overcrowded (100-140), severely overcrowded (140-180), and dangerously overcrowded (180-200), there was a strong correlation between blood culture contamination rates and the degrees of ED crowding (γ = 0.99, P <.001). Conclusions: Emergency department overcrowding may have an adverse impact on the quality of clinical care, including increasing the risk of blood culture contamination.

UR - http://www.scopus.com/inward/record.url?scp=84863194235&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863194235&partnerID=8YFLogxK

U2 - 10.1016/j.ajem.2011.05.026

DO - 10.1016/j.ajem.2011.05.026

M3 - Article

C2 - 22169577

AN - SCOPUS:84863194235

VL - 30

SP - 839

EP - 845

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

IS - 6

ER -