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Original Research

Open Access

Prolonged boarding in emergency department with neurologist coverage does not worse the outcomes for patients with acute ischemic stroke

  • Xin Huang1,†
  • Qun-feng Yu2,†
  • Hui-Jie Yu3,†
  • De-sheng Pan1
  • Bu-wen Yu4,*,

1Department of neurosurgery, the 1st affiliated hospital, Zhejiang University School of Medicine, 311121 Hangzhou, Zhejiang, China

2Department of Critical Care Medicine, Sir Run Run Shaw Hospital Longyou campus & Longyou People’s hospital, 324499 Longyou, Zhejiang, China

3Department of Emergency Medicine, the 1st hospital of Jiaxing & affiliated hospital of Jiaxing University, 314001 Jiaxing, Zhejiang, China

4Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310016 Hangzhou, Zhejiang, China

DOI: 10.22514/sv.2023.062 Vol.19,Issue 4,July 2023 pp.180-186

Submitted: 08 February 2023 Accepted: 23 March 2023

Published: 08 July 2023

*Corresponding Author(s): Bu-wen Yu E-mail:

† These authors contributed equally.


Shortage of hospital beds is a common phenomenon and some acute ischemic stroke patients have to be cared for in emergency department with their staffs. However, boarding acute stroke patients in emergency department for hospital ward beds has been associated with worse outcomes. Whether an additional coverage of neurologist for them would benefit was not elucidated. All acute ischemic stroke patients admitted to our hospital between January 2016 and December 2018 were retrospectively analyzed. Patients were classified according to the various emergency department length of stay. A binary Logistic regression was used to explore the relationship of coverage of neurologist for acute ischemic stroke patients admitted but boarded in emergency department to their hospital outcomes by adjusting for age, patient gender, comorbidities, triage urgency, initial National Institute of Health Stroke Scale (NIHSS) score, whether underwent thrombosis, admitted to Intensive care unit (ICU) and complications. A total of 1150 acute ischemic stroke patients were evaluated. 24.1% of them were admitted within 4 hours, 10.3% within 4–8 hours while 65.6% patients boarded in emergency department more than 8 hours although they were admitted, due to the shortage ward beds. However, with the neurologist coverage, their prolonged waiting hours in emergency department was not associated with poor patients’ outcomes including Modified Rankin Scale (mRS) ≥4 at discharge, long hospital length of stay and high hospital cost. In summary, with additional neurologist coverage for acute ischemic stroke patients who were admitted but boarded in emergency department, prolonged waiting hours in emergency department was not associated with worse patients’ outcomes including mRS ≥4 at discharge, long hospital length of stay and high hospital cost.


Acute ischemic stroke; Emergency department; Neurocritical care; Survival

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Xin Huang,Qun-feng Yu,Hui-Jie Yu,De-sheng Pan,Bu-wen Yu. Prolonged boarding in emergency department with neurologist coverage does not worse the outcomes for patients with acute ischemic stroke. Signa Vitae. 2023. 19(4);180-186.


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