Delay in Hospital Discharge of Trauma Patients: A Prospective Observational Study

Abstract

Background: "Delayed discharge" is defined as patients who remain hospitalized beyond the time of being fit for discharge. There is no standardized amount of time defining delayed discharge documented in the literature, and there is a lack of evidence about this topic in Egypt. This study aims to identify the factors associated with discharge delays.Methods: A prospective observational study included all trauma patients admitted to a University Hospital in Egypt over two months. The time of the decision of discharge and actual discharge time were recorded by reviewing patients' medical records. The patients and their caregivers were asked to fill in a questionnaire about the reasons for delayed discharge. Potential reasons for the delayed discharge were classified into system-related, medical and family-related factors. Results: The study included 498 patients with a median age of 41 years (9 – 72). The median time until the actual discharge was three hours. System-related factors were documented in 48.8% of cases, followed by medical factors (36.3%), and family-related factors (28.1%). When controlling for age, gender and injury severity score using a logistic regression analysis, longer time to discharge (≥ 3 hours) showed a stronger association with medical factors [adjusted OR (95% CI) = 5.44 (2.73-10.85)] and family-related factors [adjusted OR (95% CI) = 7.94 (3.40-18.54)] compared to system-related factors [adjusted OR (95% CI) = 2.20 (1.12-4.29)].Conclusion: Although system-related factors were more prevalent, medical and family-related factors appear to be associated with longer discharge delays compared to system-related factors.