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Acil Servisten İstenen Genel Cerrahi Konsültasyonları: Pandemi ve Pandemi Dışı Dönemin Analizi

Yıl 2021, Cilt: 13 Sayı: 1, 11 - 17, 11.03.2021
https://doi.org/10.18521/ktd.767493

Öz

Amaç: Pandemi döneminde toplumun gerekmedikçe evden çıkmama durumuna rağmen acil servise yapılan başvurular ve istenen genel cerrahi konsültasyonlarının acil tedavi gereksinimi incelemeyi amaçladık.

Gereç ve Yöntem: Acil servisine başvuran ve acil cerrahi tedavi gerektiği öngörüsüyle genel cerrahi konsültasyonu istenen hastaların dosyaları Covid 19 pandemi dönemi olan mart-mayıs 2020 ve normal sosyal hayatın devam ettiği bir zaman dilimi olarak seçilen mart-mayıs 2019 tarihleri arasında retrospektif olarak incelendi. Hastaların yaş, cinsiyet, başvuru şikayeti, mevcut ek hastalıklar, gerçekten acil cerrahi tedavi gerekme durumu ve sosyoekonomik durumları kayıt edilerek analiz edildi.

Bulgular: Konsültasyon isteme oranı pandemi döneminde %2.7 (n=170) iken pandemi dışı dönemde ise %3.1 (n=316) tespit edildi. Her iki dönemde de hastalara gereken müdahale şekillerine göre cinsiyetlerinin dağılımında istatistiksel olarak anlamlı farklılık saptanmamıştır (p>0.05). Hastaların başvuru şikayetleri her iki dönemde benzer olup en sık başvuru şikayeti bulantı-karın ağrısı-dışkılama güçlüğü idi. Her iki dönemde de ek hastalığı olmayan bireyler ağırlıklı olmakla birlikte, ek hastalığı olan bireylerin oranı pandemi döneminde daha yüksektir (p=0.001). Her iki dönemde acil müdahale gerekmeyen hastalar çoğunlukta idi. Acil müdahale gereken hastalarda ise pandemi döneminde yatırılarak tedavi edilen hasta oranı yüksek iken pandemi dışı dönemde ise ameliyat edilen hasta oranı daha yüksek tespit edildi (p=0.005). Her iki dönemde hastaların çoğunluğunun düşük ve az bir kısmının da orta sosyoekonomik düzeye sahip olduğu tespit edildi (p>0.05). Ayrıca 75 yaş ve üzeri olan düşük sosyoekonomik düzeye sahip hastaların acil tedavi gerektirmeyen başvuru oranları pandemi döneminde daha yüksekti (p=0.002).

Sonuç: Her ne kadar pandemi döneminde acil servis başvuru sayısı ve istenen genel cerrahi konsültasyon sayısında belirgin bir azalma olsa da konsültasyon istenen hastaların yarısından fazlasının acil cerrahi tedavi gerektirmemesi acil servislerin hala gereksiz kullanımını göstermektedir.

Destekleyen Kurum

Yok

Kaynakça

  • 1. İlhan B. Acil Servis Yoğunluğunu Değerlendirmede NEDOCS (National Emergency Department Overcrowding Study) Skoru Kullanımının Etkinliği, Ankara, Hacettepe Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı, Tıpta Uzmanlık Tezi, 2016.
  • 2. Atri D, Siddiqi HK, Lang J, Nauffal V, Morrow DA, Bohula EA. COVID-19 for the Cardiologist: A Current Review of the Virology, Clinical Epidemiology, Cardiac and Other Clinical Manifestations and Potential Therapeutic Strategies, ACC Basic Transl Sci. 2020;5(5):518-536.
  • 3. Gagliano A, Villani PG, Co MF, et al. COVID-19 Epidemic in the Middle Province of Northern Italy: Impact, Logistics, and Strategy in the First Line Hospital. Disaster Med Public Health Prep. 2020:24;1-5.
  • 4. Edirne T, Edirne Y, Atmaca B, Keskin S. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Acil Servis Hastalarının Özellikleri. Van Tıp Dergisi, 2008:15(4);107-111.
  • 5. Pines JM, Hilton JA, Weber EJ, et al. International perspectives on emergency department crowding. Acad Emerg Med. 2011;18(12):1358-70.
  • 6. Kabaroğlu K, Eroğlu SE, Onur Ö, Denizbaşı A, Akoğlu, H. Acil Serviste Hasta Memnuniyetini Etkileyen Faktörlerin Araştırılması. Marmara Medical Journal. 2013;26:82-89.
  • 7. Sanguinoa CG, Ausina B, Castellanosb M.A, et al. Mental health consequences during the initial stage of the 2020 Coronavirus pandemic in Spain, Brain, Behavior, and Immunity. 2020;87:172-176.
  • 8. Spoorthy MS, Pratapa SK, Mahant S. (2020), Mental Health Problems Faced by Healthcare Workers Due to the COVID-19 pandemic-A Review. Asian Journal of Psychiatr. 2020;22:102-119. 9. Kaya B. Effects of Pandemic on Mental Health. Klinik Psikiyatri Dergisi. 2020;23:123-124.
  • 10. Talevi D, Socci V, Carai M, et al. Mental health outcomes of the CoViD-19 pandemic, Rivista di Psichiatria. 2020;55(3):137-144.
  • 11. Hölzle P, Frank A, Förstl H. COVID-19 Crisis: Early Observations on a Pandemic's Psychiatric Problems, Dtsch Med Wochenschr. 2020;145(10):675-681.
  • 12. Pagliantini S, Nerattini M, Tomassini CR. The Logistics of the Path of the Emergency-Urgency: The Case of Siena Room Discharge, Ital Q Health Care Manag Econ Policy. 2009;70:23-30.
  • 13. Pines JM, Localio AR, Hollander JE. Racial Disparities in Emergency Department Length of Stay for Admitted Patients in the United States Acad Emerg Med. 2009;16(5):403-10.
  • 14. Baubeau B, Deville A, Joubart M. Emergency Department Visits in France From 1990 to 1998, A Growing Need For Non Urgent Visits, Etudes et Resultats. 2000; 72:1-8.

Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic

Yıl 2021, Cilt: 13 Sayı: 1, 11 - 17, 11.03.2021
https://doi.org/10.18521/ktd.767493

Öz

Objective: To investigate the emergency department admissions, the general surgery consultation request, and the necessity of immediate treatment of patients despite the fact that the society did not leave the house unless necessary during the pandemic period.


Methods: The files of patients who admitted to the emergency department and whose general surgery consultation was requested due to urgent surgical treatment were retrospectively scanned between March-May 2020, which is the Covid 19 pandemic period and March-May 2019, as a time period in which normal social life continues. Age, gender, complaints, comorbid diseases, the necessity of truly emergency surgical treatment as well as the socioeconomic level scale for each individual were recorded and analyzed.

Results: The rate of request for consultation was 2.7% (n = 170) in the pandemic period, and 3.1% (n = 316) in the non-pandemic period. In both periods, no statistically significant difference was found in the distribution of genders according to the treatment(p> 0.05). The complaints of the patients were similar in both periods, and the most common complaints were nausea-abdominal pain-difficulty defecation. Although individuals without comorbidities are predominant in both periods, the proportion of individuals with comorbid diseases was higher during the pandemic period (p = 0.001). Patients who did not require urgent treatment in both periods were in the majority. In patients requiring urgent treatment, the rate of the hospitalized patients was higher during the pandemic period, whereas the rate of the operated patients was higher in the non-pandemic period (p = 0.005). The majority of the patients had a low socioeconomic level and a small portion had a moderate socioeconomic level in both periods (p> 0.05). In addition, patients with a low socioeconomic level and 75 years of age or older who did not require urgent treatment were higher in the pandemic period (p = 0.002).


Conclusion: Although there is a significant decrease in the number of emergency department admissions and the number of general surgical consultations requested during the pandemic period, the fact that more than half of the patients who are consulted do not require emergency surgical treatment still shows the unnecessary use of emergency services.

Kaynakça

  • 1. İlhan B. Acil Servis Yoğunluğunu Değerlendirmede NEDOCS (National Emergency Department Overcrowding Study) Skoru Kullanımının Etkinliği, Ankara, Hacettepe Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı, Tıpta Uzmanlık Tezi, 2016.
  • 2. Atri D, Siddiqi HK, Lang J, Nauffal V, Morrow DA, Bohula EA. COVID-19 for the Cardiologist: A Current Review of the Virology, Clinical Epidemiology, Cardiac and Other Clinical Manifestations and Potential Therapeutic Strategies, ACC Basic Transl Sci. 2020;5(5):518-536.
  • 3. Gagliano A, Villani PG, Co MF, et al. COVID-19 Epidemic in the Middle Province of Northern Italy: Impact, Logistics, and Strategy in the First Line Hospital. Disaster Med Public Health Prep. 2020:24;1-5.
  • 4. Edirne T, Edirne Y, Atmaca B, Keskin S. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Acil Servis Hastalarının Özellikleri. Van Tıp Dergisi, 2008:15(4);107-111.
  • 5. Pines JM, Hilton JA, Weber EJ, et al. International perspectives on emergency department crowding. Acad Emerg Med. 2011;18(12):1358-70.
  • 6. Kabaroğlu K, Eroğlu SE, Onur Ö, Denizbaşı A, Akoğlu, H. Acil Serviste Hasta Memnuniyetini Etkileyen Faktörlerin Araştırılması. Marmara Medical Journal. 2013;26:82-89.
  • 7. Sanguinoa CG, Ausina B, Castellanosb M.A, et al. Mental health consequences during the initial stage of the 2020 Coronavirus pandemic in Spain, Brain, Behavior, and Immunity. 2020;87:172-176.
  • 8. Spoorthy MS, Pratapa SK, Mahant S. (2020), Mental Health Problems Faced by Healthcare Workers Due to the COVID-19 pandemic-A Review. Asian Journal of Psychiatr. 2020;22:102-119. 9. Kaya B. Effects of Pandemic on Mental Health. Klinik Psikiyatri Dergisi. 2020;23:123-124.
  • 10. Talevi D, Socci V, Carai M, et al. Mental health outcomes of the CoViD-19 pandemic, Rivista di Psichiatria. 2020;55(3):137-144.
  • 11. Hölzle P, Frank A, Förstl H. COVID-19 Crisis: Early Observations on a Pandemic's Psychiatric Problems, Dtsch Med Wochenschr. 2020;145(10):675-681.
  • 12. Pagliantini S, Nerattini M, Tomassini CR. The Logistics of the Path of the Emergency-Urgency: The Case of Siena Room Discharge, Ital Q Health Care Manag Econ Policy. 2009;70:23-30.
  • 13. Pines JM, Localio AR, Hollander JE. Racial Disparities in Emergency Department Length of Stay for Admitted Patients in the United States Acad Emerg Med. 2009;16(5):403-10.
  • 14. Baubeau B, Deville A, Joubart M. Emergency Department Visits in France From 1990 to 1998, A Growing Need For Non Urgent Visits, Etudes et Resultats. 2000; 72:1-8.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Server Sezgin Uludağ 0000-0002-0563-3769

Betül Güleryüz 0000-0002-9092-1705

Afşın İpekci 0000-0001-6125-4061

Abdullah Zengin Bu kişi benim 0000-0001-6706-2001

Mehmet Özçelik Bu kişi benim 0000-0002-5249-7106

Yayımlanma Tarihi 11 Mart 2021
Kabul Tarihi 28 Ocak 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 13 Sayı: 1

Kaynak Göster

APA Uludağ, S. S., Güleryüz, B., İpekci, A., Zengin, A., vd. (2021). Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic. Konuralp Medical Journal, 13(1), 11-17. https://doi.org/10.18521/ktd.767493
AMA Uludağ SS, Güleryüz B, İpekci A, Zengin A, Özçelik M. Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic. Konuralp Medical Journal. Mart 2021;13(1):11-17. doi:10.18521/ktd.767493
Chicago Uludağ, Server Sezgin, Betül Güleryüz, Afşın İpekci, Abdullah Zengin, ve Mehmet Özçelik. “Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic”. Konuralp Medical Journal 13, sy. 1 (Mart 2021): 11-17. https://doi.org/10.18521/ktd.767493.
EndNote Uludağ SS, Güleryüz B, İpekci A, Zengin A, Özçelik M (01 Mart 2021) Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic. Konuralp Medical Journal 13 1 11–17.
IEEE S. S. Uludağ, B. Güleryüz, A. İpekci, A. Zengin, ve M. Özçelik, “Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic”, Konuralp Medical Journal, c. 13, sy. 1, ss. 11–17, 2021, doi: 10.18521/ktd.767493.
ISNAD Uludağ, Server Sezgin vd. “Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic”. Konuralp Medical Journal 13/1 (Mart 2021), 11-17. https://doi.org/10.18521/ktd.767493.
JAMA Uludağ SS, Güleryüz B, İpekci A, Zengin A, Özçelik M. Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic. Konuralp Medical Journal. 2021;13:11–17.
MLA Uludağ, Server Sezgin vd. “Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic”. Konuralp Medical Journal, c. 13, sy. 1, 2021, ss. 11-17, doi:10.18521/ktd.767493.
Vancouver Uludağ SS, Güleryüz B, İpekci A, Zengin A, Özçelik M. Analysis of General Surgical Consultations Requested From The Emergency Department in the Period of Pandemic and Non-Pandemic. Konuralp Medical Journal. 2021;13(1):11-7.