FACTORS ASSOCIATED WITH PROLONGED HOSPITAL STAY OF PATIENTS TREATED IN THE EMERGENCY DEPARTMENT

Prolonged length of stay (LOS) in the emergency department (ED) is a common issue that can strain hospital resources and affect patient outcomes. Identifying the factors contributing to prolonged hospital stays is essential for improving patient flow and care quality. Objective: To assess the factors associated with prolonged hospital stays in patients admitted to the emergency department. Methods: A cross-sectional study was conducted in the Emergency Department of Shifa International Hospital from July 2023 to June 2024. A total of 150 patients with a prolonged LOS of more than 6 hours were included in the study through convenience sampling. Data were collected using a modified questionnaire comprising three sections: sociodemographic characteristics, indices of timely care, and determinants of prolonged hospital stays. Medical records were reviewed to complete the first section, and in-depth interviews with on-call physicians and nurses were conducted to identify potential causes of prolonged stays. Statistical analysis included univariate and multivariate analyses, with odds ratios (OR) and 95% confidence intervals (CI) calculated to determine significant predictors of prolonged LOS. Results: Univariate analysis identified several important predictors of prolonged LOS, including female sex (OR: 1.50, 95% CI: 1.09-1.82), old age (OR: 1.11, 95% CI: 0.9-1.10), evening admission (OR: 3.9, 95% CI: 1.77-8.71), level I triage (OR: 1.84, 95% CI: 1.18-2.60), disposition order after 6 hours (OR: 0.15), and a high number of clinical and lab tests (OR: 1.19, 95% CI: 1.08-1.42). Multivariate analysis revealed that old age (p=0.020), disposition after 6 hours (p=0.005), and a high number of tests (p=0.033) were significantly associated with prolonged LOS. Conclusion: Factors such as female sex, old age, evening admission, level I triage, disposition order after 6 hours, and a high number of clinical and lab tests are significant predictors of prolonged LOS in the emergency department. These findings highlight the need for targeted interventions to reduce prolonged stays and improve ED efficiency.