The length of stay and the percentage of patients leaving were also increased with increased number of P1 and P2 patients (meantime Figure 1). LWBS percentages

seem to vary with time of the day and were more than 20% in the night shift (11 pm to 7 am) compared to about 4% in the morning shift (7am to 3pm). This inhibitor Y-27632 finding was found to persist in the regression analysis, which revealed a 2.6 times higher odds of an LWBS visit if the patient presented to the ED in the night shift compared to the morning hours. Another Inhibitors,research,lifescience,medical important predictor of LWBS visit is the diversion status of the ED at the time of presentation. Patients visiting during the ED diversion hours are 1.5 times more likely to have a LWBS visit than when Inhibitors,research,lifescience,medical diversion status is off (19.8% vs. 9.8% during off-diversion). Sex and day of the week on which the patient presented showed an association with LWBS visits at the univariate level, but this relationship was not found after adjustment with other factors in the multivariable model (Tables 2 &3). Percentage of LWBS is more in female (13.75) patients as compared to male (12.58). Inhibitors,research,lifescience,medical Table 1 Basic demographic characteristics of patients Table 2 Percentages of LWBS in patient groups Table 3 Patient characteristics of ED visits by Whether or not the patient left without being seen

Figure 1 Relationship of length of stay, triage category and LWBS patients. We also observed a difference in percentage of LWBS over the total study duration, being lowest in April (6.4%) and highest in the September Inhibitors,research,lifescience,medical to October period (up to 19%) (Table 2). This pattern was consistent in the regression model which showed higher odds of LWBS visits in October (marginally significant), November and December (Table 3). Median waiting time for pediatric patients was

154 minutes and 171 minutes for adults who left. Patients with a waiting time of over 180 minutes had 26 times higher odds of leaving compared to those who waited for less than 30 minutes. This relationship is consistent in the adjusted Inhibitors,research,lifescience,medical multivariable model (Table 3). Relationship of wait time with age, triage category diversion status and shift of the day had been shown in Figure 2. Figure 2 Relationship between Age, Diversion Status, shift of day and LWBS with respect to waiting time. The top seven presenting complaints of patients with LWBS visits are shown in Figure 3. Most of the cases were of fever, non-specific complaints, abdominal pain, and vomiting/ diarrhea. Co-morbid was identified AV-951 in 12.6% of patients with LWBS visits. Total patients who returned to hospital within 48 hours were 181 in LWBS group vs. 251 among the patients who were discharge; which means overall 3.6% of the LWBS patients vs. 1.11% of discharged patients needed to revisit in ED for medical care. Among the LWBS, 77 (1.5%) and 6(0.26%) in the discharge group required admission to the inpatient units (Table 4). Figure 3 Top Seven Complaints of patients who left without being seen.