Length of Stay as Quality Indicator in Emergency Department in Trauma Patient | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 20 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.429729.4234 | ||
| Authors | ||
| Moslem Mohamed El Lithy* 1; Tarek Ezzat Abdel Latif2; Emad Mohammed Salah3; Adel Hamed Elbaih4 | ||
| 1Emergency Medicine Department, Faculty of Medicine, Zagazig University | ||
| 2General surgery department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. | ||
| 3General Surgery and Head of Emergency Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. | ||
| 4Emergency Medicine department, Faculty of Medicine, Suez Canal University, Suez, Egypt. | ||
| Abstract | ||
| Background: Severe injuries are a major global cause of morbidity and mortality, particularly in young adults, with emergency department (ED) crowding and prolonged length of stay (LOS) worsening outcomes. ED LOS is a key quality indicator, as delays increase complications and mortality. This study aimed to evaluate the impact of LOS on trauma outcomes and ED performance. Methods: A prospective observational study was conducted at Zagazig University Hospital ED, including 254 adult polytrauma patients equally divided into two groups: Group A (LOS <4 hours, n=127) and Group B (LOS >4 hours, n=127). Inclusion required age ≥18 years, hemodynamic stability, and informed consent, while exclusions were minors, pregnancy, psychiatric illness, medicolegal cases, and need for immediate life-saving intervention. Injury severity was classified by the Abbreviated Injury Scale. Clinical assessment followed ATLS protocols with standard imaging, FAST, and selective CT. Results: Group B patients were older (36.4vs.30.6 years, P=0.0006), with more road traffic accidents (86.6%vs.66.9%), while falls predominated in Group A (33.1%vs.13.4%, P=0.0002). Group A had higher rates of pneumothorax (10.2%vs.3.2%), lung contusions (15.0%vs.0%), and splenic hematoma (3.2%vs.0%), whereas Group B showed more brain edema (16.5%vs.4.7%), contusions (21.3%vs.11.8%), vertebral (7.9%vs.0%) and limb fractures (31.5%vs.15.0%). ICU transfers were higher in Group B (51.2%vs.37.0%), but mortality was similar (24.4%vs.21.3%, P=0.5517). Conclusion: Shorter LOS improved workflow and manager satisfaction without increasing mortality, while longer LOS reflected more complex injuries requiring ICU care and was associated with higher patient satisfaction. LOS is a reliable quality indicator to guide triage and resource allocation in trauma care. | ||
| Keywords | ||
| Emergency Department; Trauma; Length of Stay; Quality Indicator | ||
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