Volume 14, Issue 4 (9-2026)
J Surg Trauma 2026, 14(4): 208-214 |
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Choobi Anzali B, Soltanpour B, Mehryar H R. Factors Contributing to Prolonged Length of Stay in the Emergency Department: A 2023 Study from Imam Khomeini Hospital, Urmia, Iran. J Surg Trauma 2026; 14 (4) :208-214
URL: http://jsurgery.bums.ac.ir/article-1-542-en.html
URL: http://jsurgery.bums.ac.ir/article-1-542-en.html
Department of Emergency Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
Abstract: (405 Views)
Abstract
Introduction: Prolonged length of stay (LOS) in the emergency department (ED) is a major operational challenge, contributing to delays in diagnosis and treatment, increased morbidity, inefficient resource utilization, reduced quality of care, and higher hospital costs. This study aimed to determine the characteristics and factors associated with prolonged LOS in the ED of Imam Khomeini Hospital (RA), Urmia, Iran, in 2023.
Methods: This cross-sectional study was conducted throughout 2023. A LOS exceeding 6 h was defined as prolonged. Data were extracted from medical records using a structured researcher-designed checklist, including demographic characteristics, triage level, presentation time, prehospital emergency report, diagnostic procedures, specialist consultation, and final ED disposition. Data were analyzed using the Chi-square test, independent t-test, one-way ANOVA, and Kruskal–Wallis test in SPSS version 18.
Results: Among 21,301 ED visits, 203 patients with LOS >6 h were included. Mean age was 47.3 years, and 59.6% were male. The 41–60-year age group was most frequent (P=0.013). Triage level 2 accounted for 80.3% and was significantly associated with prolonged stay (P=0.001). Prolonged stays were more frequent during the night shift (42.9%; P=0.008), whereas day-of-week distribution was not significant (P=0.080). Diagnostic or laboratory procedures were performed in 93.1% of patients and specialist consultations in 16.2% (P=0.001). Overall, 50.2% were admitted and 30% discharged, with no significant association between disposition and prolonged stay (P=0.492).
Conclusion: Prolonged ED LOS was associated with nighttime workload, higher triage acuity, and extensive diagnostic and management processes. Improving access to specialist consultation, diagnostic resources, and patient flow systems may reduce prolonged ED stays and enhance the quality and efficiency of emergency care.
Introduction: Prolonged length of stay (LOS) in the emergency department (ED) is a major operational challenge, contributing to delays in diagnosis and treatment, increased morbidity, inefficient resource utilization, reduced quality of care, and higher hospital costs. This study aimed to determine the characteristics and factors associated with prolonged LOS in the ED of Imam Khomeini Hospital (RA), Urmia, Iran, in 2023.
Methods: This cross-sectional study was conducted throughout 2023. A LOS exceeding 6 h was defined as prolonged. Data were extracted from medical records using a structured researcher-designed checklist, including demographic characteristics, triage level, presentation time, prehospital emergency report, diagnostic procedures, specialist consultation, and final ED disposition. Data were analyzed using the Chi-square test, independent t-test, one-way ANOVA, and Kruskal–Wallis test in SPSS version 18.
Results: Among 21,301 ED visits, 203 patients with LOS >6 h were included. Mean age was 47.3 years, and 59.6% were male. The 41–60-year age group was most frequent (P=0.013). Triage level 2 accounted for 80.3% and was significantly associated with prolonged stay (P=0.001). Prolonged stays were more frequent during the night shift (42.9%; P=0.008), whereas day-of-week distribution was not significant (P=0.080). Diagnostic or laboratory procedures were performed in 93.1% of patients and specialist consultations in 16.2% (P=0.001). Overall, 50.2% were admitted and 30% discharged, with no significant association between disposition and prolonged stay (P=0.492).
Conclusion: Prolonged ED LOS was associated with nighttime workload, higher triage acuity, and extensive diagnostic and management processes. Improving access to specialist consultation, diagnostic resources, and patient flow systems may reduce prolonged ED stays and enhance the quality and efficiency of emergency care.
Type of Study: Research |
Subject:
General
Received: 2026/02/14 | Accepted: 2026/06/22 | ePublished ahead of print: 2026/07/13 | Published: 2026/09/1
Received: 2026/02/14 | Accepted: 2026/06/22 | ePublished ahead of print: 2026/07/13 | Published: 2026/09/1
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