在COVID-19大流行之前和期间的急诊科就诊和入院情况

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导言:COVID-19大流行对医疗保健系统造成了灾难性影响。急诊科是受影响最严重的地区之一。我们研究的目的是探讨大流行对患者急诊科就诊和入院的影响。方法:采用哈马德国王大学医院病案系统资料进行回顾性研究。我们在大流行之前和期间的两个12个月时间跨度内检查了急诊科就诊和住院情况。根据几个参数对每月就诊进行分类,并比较两个时间段内72小时内的ED就诊情况。结果:疫情期间急诊科总访问量总体下降11.05%。18岁以下儿科病例(49.54%)和65岁以上患者(1.41%)的就诊比例不成比例地下降。相反,成年人的访问量显著增加。大流行期间,从地方卫生中心转诊到急诊科的人数显著减少(23.92%),而救护车访问量增加了13.35%。分级为2级和3级的患者减少。总录取率下降8.39%。大多数专科的住院人数均出现下降,儿科住院人数下降幅度最大(51.81%),肿瘤科住院人数上升幅度最大(6.9%)。不遵医嘱出院率增加,急诊科72小时复诊率降低。结论:我们的研究显示,在COVID-19期间,儿科和老年患者的急诊科就诊和住院总次数明显下降。需要进一步的研究来解释和评估这些变化的影响。
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ED Visits and Admission Profile pre- and during COVID-19 Pandemic
Introduction: COVID-19 pandemic has had catastrophic effects on the healthcare system. Emergency departments (EDs) are among the most affected areas. The purpose of our study is to explore the pandemic’s effect on patients’ ED visits and admissions.Methods: This was a retrospective study using data from medical record system of King Hamad University Hospital. We examined ED visits and hospital admissions over two 12-month time spans before and during the pandemic. Monthly visits were classified according to several parameters, and ED revisits within 72 hours were also compared between both periods.Results: There was an overall decrease of 11.05% in total ED visits during the pandemic. Disproportionate decrease was seen in visits by pediatric cases under 18 years (49.54%) and patients older than 65 years (1.41%). Conversely, there was a significant increase in visits among adults. Referrals from local health centers to the ED during the pandemic decreased significantly (23.92%), while ambulance visits increased by 13.35%. Patients triaged as levels 2 and 3 decreased. Total admission rate decreased by 8.39%. The decline in admission was noted in most specialties, the greatest being in pediatrics (51.81%), while increased highest in oncology admissions (6.9%). There was an increase in discharge against medical advice rate and a reduction in the ED 72-hour revisit rate.Conclusion: Our study reveals a clear decline in the total number of ED visits and hospitalizations during COVID-19 for both pediatric and elderly patients. Further studies are needed to explain as well as evaluate the effect of such changes.
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