title: Admission delays' magnitude of traumatized patients in the emergency department of a hospital in Egypt: a cross-sectional study.
abstract: BACKGROUND
  Injury is an escalating public health problem, representing about 9% of global mortality, which disproportionately impacts lower- and middle-income countries. There are approximately 12,000 annual fatalities from road traffic injuries in Egypt, but a little information about delays in seeking emergent care is available.
  
  
  OBJECTIVE
  To measure the time interval between sustaining an injury and presentation to the emergency department of Ain Shams University Surgery Hospital and to identify possible causes of these delays.
  
  
  METHODS
  We conducted a cross-sectional, facilitated survey of a convenience sample of trauma patients presenting to the emergency department of Ain Shams University Surgery Hospital from 1 February to 31 May 2014. Data obtained included: demographic information, trauma incident details, and injury assessment.
  
  
  RESULTS
  The average reported transport time for patients from injury to hospital arrival was 3.8 h, while the mean ambulance response time was 45 min. Referral from other hospitals was revealed to be a significant cause of delay (P = 0.004), while ignorance of the local ambulance phone number could not be confirmed as a cause (P = 0.2).
  
  
  CONCLUSIONS
  This study demonstrated that trauma patients at our hospital experience more than 3 h of delay until they reach the ED. It also identified the possible causes accounting for that delay. However, additional nationwide research is needed to establish the clear causation or association of these causes with the delay intervals.
authors.affiliation: Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, 11566, Egypt. haitham.m.saleh@gmail.com.
authors.forename: H M
authors.initials: HM
authors.lastname: Saleh
authors.affiliation: Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, 11566, Egypt.
authors.forename: A E
authors.initials: AE
authors.lastname: Elsabagh
authors.affiliation: Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, 11566, Egypt.
authors.forename: M G
authors.initials: MG
authors.lastname: Elewa
authors.affiliation: Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, 11566, Egypt.
authors.forename: A A
authors.initials: AA
authors.lastname: Fawzy
authors.affiliation: Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, 11566, Egypt.
authors.forename: O M
authors.initials: OM
authors.lastname: Hassan
authors.affiliation: Charles McC. Mathias, Jr. National Study Center for Trauma and EMS, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Comer
authors.affiliation: Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, 11566, Egypt.
authors.forename: I M
authors.initials: IM
authors.lastname: Abdelmonem
authors.affiliation: Charles McC. Mathias, Jr. National Study Center for Trauma and EMS, University of Maryland School of Medicine, Baltimore, USA.|Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA.|Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Hirshon
authors.affiliation: Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: El-Shinawi
mesh_terms: D000552:Ambulances / Q000592:standards / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007407:Interviews as Topic; D008297:Male; D009104:Multiple Trauma; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Ambulance; Delays; Emergency care; Referral; Trauma