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Original Research

Open Access

Factors associated with prolonged emergency department length of stay in a resource-constrained setting

  • Ahmad M. Zamzami1,*,
  • Ahyad A. Felimban2
  • Imad Khojah1
  • Abdullah A. Bakhsh1

1Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University Hospital, 21589 Jeddah, Saudi Arabia

2Department of Emergency Medicine, King Faisal Specialist Hospital and Research Center, 21499 Jeddah, Saudi Arabia

DOI: 10.22514/sv.2024.019 Vol.20,Issue 2,February 2024 pp.96-101

Submitted: 04 June 2023 Accepted: 17 July 2023

Published: 08 February 2024

*Corresponding Author(s): Ahmad M. Zamzami E-mail:


Prolonged length of stay (LOS) in the emergency department (ED) is a key factor in measuring ED crowding worldwide. This study aimed to identify factors associated with prolonged LOS in the ED to better understand these factors at our institution. This was a retrospective record review examining factors associated with prolonged emergency department length of stay (>6-hours). Data were collected from electronic medical records, including patient demographics, chief complaints, triage acuity level, medication administration, diagnostic testing, consultations and patient disposition. In 2019, we recorded a total of 36,068 patient visits at our ED. Of these, 6439 (17.9%) patients met our definition of prolonged ED LOS (more than 6-hours) and were included in our analysis. Using multivariate analysis, we found that consulting services carried the highest predictor for prolonged ED LOS, with an adjusted odds ratio (aOR) of 23.0 and 95% confidence interval (CI) of 20.4–25.8. Followed by medication administration (aOR 2.0, CI 1.8–2.3), laboratory investigations (aOR 1.7, CI 1.5–2.0), radiological studies (aOR 1.8, CI 1.6–2.0), and non-Saudi nationality (aOR 1.3, CI 1.2–1.4), all p < 0.01. ED LOS may be reduced by optimizing the process of laboratory/radiology testing and medication administration. More importantly however, implementing a timeframe monitoring system for consultations while emphasizing accelerated decision-making and disposition for patients can reduce ED LOS.


Length of stay; Emergency department; Prolonged ED LOS; Factors

Cite and Share

Ahmad M. Zamzami,Ahyad A. Felimban,Imad Khojah,Abdullah A. Bakhsh. Factors associated with prolonged emergency department length of stay in a resource-constrained setting. Signa Vitae. 2024. 20(2);96-101.


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