Pandemi Hastanesinin Acil Servisine Başvuran Hastaların Analizi: Bir Retrospektif Türkiye Çalışması

Year 2022, Issue: 19, 76 - 85, 30.06.2022

Hakan Aydın , Attila Beştemir , Göksu Bozdereli Berikol , Halil Doğan

https://doi.org/10.46218/tshd.1106381

Cited By: 3

Abstract

Pandemi hastanesinin acil servisine başvuran hastaların analizi: Bir retrospektif Türkiye çalışması

Öz
Giriş: Tüm dünyada COVID-19 pandemisi ve uygulanan politikaların sağlık sistemi ve sağlık arama davranışı üzerinde doğrudan ve dolaylı etkileri olduğu gözlemlenmiştir. Bu çalışmanın amacı bir pandemi hastanesinin acil servisine başvuran vakaları analiz etmek ve pandemi döneminin sağlık hizmetlerine ve uygunsuz ambulans kullanımına etkisini araştırmaktır.
Metod: Bu tek merkezli, gözlemsel, retrospektif çalışmaya, Prof. Dr. Murat Dilmener Acil Durum Hastanesinin acil servisine (AS) 05 Ocak-05 Nisan 2021 tarihleri arasında başvuran COVID-19 hastaları alındı. Ambulans ile başvurun vakaların demografik özellikleri, yaşamsal belirtileri ve sonlanımları incelendi. Sonuçlar kendi imkanlarıyla başvuran vakaların (kontrol grubu) verileriyle karşılaştırıldı.
Bulgular: Çalışmaya 2958 vaka dahil edildi. Hastaların yaş ortancası 45 yıl ve %53’ü kadındı. Hastaların %45.3’ü ambulans ile AS’e başvurdu. Charlson Komorbidite Indeksi açısından kendi imkanıyla ve ambulans ile başvuran hastalar arasında istatistiksel bir ilişki saptanmadı (CKI=0, p=0.238; CKI=1-2, p=0.399; CKI≥ 3, P=0.124). Ambulansla gelen hastalarda nabız hızı 60-90/dk arasında olanların oranı %88.6, SpO2'si %95 ve üzerinde olanların oranı ise %66.1 idi. Ambulans ile başvuranları %62.3’ü kendi imkanlarıyla başvuranların %70.1’i AS’ten taburcu edildi (p<0.001).
Sonuç: COVID-19 pandemisinde uygulanan kısıtlama politikaları uygunsuz ambulans kullanımında artışa neden olabilir. Çalışmamız sonuçları itibariyle, sağlık politikaları ve kısıtlama önlemlerinde tibbi sosyal hizmet alanlarının göz önünde bulundurulmasına katkı sağlayacaktır.
Anahtar kelimeler: Acil Sağlık Hizmetleri, Acil servis, Uygunsuz Ambulans kullanımı, Pandemi hastanesi, Tibbi sosyal hizmetler

Analysis of patients visit to the emergency department of a pandemic hospital: A retrospective study from Turkey.
Abstract
Introduction: All over the world, it has been observed that the COVID-19 pandemic and the policies implemented have direct and indirect effects on the health system and health-seeking behaviour. The aim of this study is to analyze the cases visiting the emergency department of a pandemic hospital and to investigate the effect of the pandemic period on health services and inappropriate ambulance use.
Method: This single-center, observational, retrospective study included COVID-19 patients who visited the emergency department (ED) of Prof Dr Murat Dilmener Emergency Hospital between 05 January and 05 April 2021. The demographic characteristics, vital signs and outcomes of the ambulance admissions were examined. The results were compared with the data of those who visited with their own means (control group).
Result: The median age of the patients was 45 years and 53% were women. The rate of ED visits by ambulance was 45.3%. In terms of Charlson Comorbidity Index, there was no statistical relationship between patients visiting by their own means and by ambulance (CKI=0, p=0.238; CKI=1-2, p=0.399; CKI≥ 3, P=0.124). In patients visiting by ambulance, the rate of patients with a pulse rate of 60-90/min was 88.6%, and the rate of those with an SpO2 of 95% or more was 66.1%. The rate of discharge from ED was 62.3% for those who visited by ambulance, and 70.1% for those who visited on their own (p<0.001).
Conclusion: Restriction policies implemented during the COVID-19 pandemic may lead to an increase in inappropriate ambulance use. As a result of our study, it will contribute to the consideration of medical social work areas in health policies and restriction measures.
Keywords: Emergency Medical Services, Emergency department, Ambulance misuse, Pandemic hospital, Medical social services

Keywords

acil sağlık hizmetleri, acil servis, uygunsuz ambulans kullanımı, pandemi hastanesi, tıbbi sosyal hizmetler

Supporting Institution

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Project Number

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Thanks

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