Utilization of Renal Replacement Therapy and Its Impact on the Emergency Department Length of Stay in South Korean Emergency Medical Centers
Abstract
Background: The utilization of renal replacement therapy (RRT) is crucial for the management of patients with acute kidney injury (AKI) in emergency departments (EDs). The prompt initiation of RRT, encompassing both intermittent hemodialysis (HD) and continuous renal replacement therapy (CRRT), is acknowledged as beneficial for critically ill patients. The purpose of this study is to investigate the implementation of RRT within EDs and its impact on ED length of stay (EDLOS) in South Korea. Methods: This retrospective study utilized data from the National Emergency Department Information System (NEDIS) for the year 2019 to assess the utilization of RRT in emergency medical centers (EMCs) across South Korea. The analysis focused on RRT, which includes intermittent HD and CRRT, as identified through insurance billing codes for patients treated during ED visits and subsequent admissions. EMCs were categorized into three groups based on the frequency of RRT sessions, and the median EDLOS was evaluated. Results: Among 5,937,569 ED visits to Level I and II emergency medical centers (EMCs), 40,130 cases (0.68%) received RRT. Of the 162 EMCs, 58 centers (35.8%) did not perform intermittent HD in the ED and 106 centers (65.4%) did not perform CRRT in the ED during the study period. Centers that frequently performed CRRT in the ED showed significantly longer EDLOS compared with centers that seldom or never performed CRRT (588 min [IQR 286-767] vs. 270 min [IQR 147-337] and 205 min…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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