Factors Associated with Prolonged Length of Stay in the Emergency Department Prior to Hospitalization

Objective: The aim of this study was to investigate the factors associated with prolonged emergency department (ED) length of stay (LOS) in inpatients.<br /> Methods: This was a retrospective and cross-sectional study conducted in the adult ED of a tertiary care hospital where approximately half a million patients are examined annually. Between August 1, 2022 and August 1, 2023, patients hospitalized from the adult ED were included in the study. Prolonged LOS was defined as patients who stayed in the ED for at least 8 hours. The relationship between prolonged LOS and patient-related and hospital-related factors was investigated. Mann-Whitney U and chi-square tests were performed statistically.<br /> Results: The median LOS of all patients in the ED was 4.4 h. Prolonged LOS (>8 hours) was independently significantly associated with older age (p=0.009), refugee status (p=0.004), non-urgent triage category (p<0.001), diagnostic tests and imaging (p<0.01), internal ward admission, and night shift arrival (p<0.01).<br /> Conclusion: Several factors were significantly associated with prolonged LOS in the ED. Prolonged LOS can be reduced through the implementation of these strategies designed to address these contributing factors.