Impact of COVID-19 pandemic on visits of an urban emergency department

Gülşah Çıkrıkçı Işık, Yunsur Çevik, Gülşah Çıkrıkçı Işık, Yunsur Çevik

Abstract

Objective: The aim of this study was to reveal how the pandemic process affected the number of ED visits and the reasons for application.

Methods: The daily number of ED visits during the pandemic were analyzed in 3 different periods; prepandemic period (February 1st to March 11th, declaration of the first COVID-19 case in Turkey), early pandemic period (March 12th to May 31th, period of strict measures), and late pandemic period (June 1st to July 31st, period of new norms). The pandemic periods were compared with the same timeframes in 2019 (comparison periods). Demographic variables and complaints of the patients on admission were investigated.

Results: The total number of ED visits in the study period in 2020 was 78,907, which was only the half of the applications in the same period in 2019 (n: 149,387). Data showed a sharp decrease at the number of daily visits to green and yellow zones after the announcement of the first case however red zone applications were more than twice that of the previous year. During pandemic nonspecific complaints was decreased and there was an increase at the percentages of respiratory, cardiac, and neurological complaints.

Conclusion: Number of ED visits during the pandemic were decreased by half when compared to the previous year. It was an advantage of the pandemic to decrease ED visits due to "nonemergent" complaints, and thus, unnecessary patient burden. However, on the other hand, patients avoided seeking medical attention, even for life-threatening conditions which led to increased mortality and morbidity.

Keywords: Application; COVID-19; Emergency; Pandemic; Visit.

Conflict of interest statement

Declaration of Competing Interest None.

Copyright © 2021 Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
Daily number of patients admitted to emergency department green zone and distribution of the complaints during admission in the study period as percent. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
Daily number of patients admitted to emergency department yellow zone and distribution of the complaints during admission in the study period as percent. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
Monthly number of patients admitted to emergency department red zone and distribution of the complaints during admission in the study period as percent. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

References

    1. Zhai P., Ding Y., Wu X., Long J., Zhong Y., Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. 2020;55(5):105955. doi: 10.1016/j.ijantimicag.2020.105955.
    1. Nuñez J.H., Sallent A., Lakhani K., et al. Impact of the COVID-19 pandemic on an emergency traumatology service: experience at a tertiary trauma Centre in Spain. Injury. 2020;51(7):1414–1418. doi: 10.1016/j.injury.2020.05.016.
    1. Pulia M.S., O’Brien T.P., Hou P.C., Schuman A., Sambursky R. Multi-tiered screening and diagnosis strategy for COVID-19: a model for sustainable testing capacity in response to pandemic. Ann Med. 2020;52(5):207–214. doi: 10.1080/07853890.2020.1763449.
    1. Çıkrıkçı Işık G., Tandoğan M., Şafak T., Çevik Y. Retrospective analyses of the frequent emergency department users. Eur J Emerg Med. 2020;19(2):89–93. doi: 10.4274/eajem.galenos.2019.07108.
    1. Timeline of the COVID-19 pandemic in Turkey. Accessed online: 03 Aug 2020.
    1. Bjørnsen L.P., Næss-Pleym L.E., Dale J., Laugsand L.E. Patient visits to an emergency department in anticipation of the COVID-19 pandemic. Tidsskr Nor Laegeforen. 2020;24:140(8). doi: 10.4045/tidsskr.20.0277.
    1. Boserup B., McKenney M., Elkbuli A. The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States. Am J Emerg Med. 2020;38(9):1732–1736. doi: 10.1016/j.ajem.2020.06.007.
    1. Bullrich M.B., Fridman S., Mandzia J.L., Mai L.M., Khaw A., Gonzalez J.C.V., et al. COVID-19: stroke admissions, emergency department visits, and prevention clinic referrals. Can J Neurol Sci. 2020;47(5):693–696. doi: 10.1017/cjn.2020.101.
    1. Lange S.J., Ritchey M.D., Goodman A.B., Dias T., Twentyman E., Fuld J., et al. Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions - United States, January–May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):795–800. doi: 10.15585/mmwr.mm6925e2.
    1. Kim H.S., Cruz D.S., Conrardy M.J., Gandhi K.R., Seltzer J.A., Loftus T.M., et al. Emergency department visits for serious diagnoses during the COVID-19 pandemic. Acad Emerg Med. 2020 doi: 10.1111/acem.14099. 10.1111/acem.14099.
    1. Jeffery M.M., D’Onofrio G., Paek H., Platts-Mills T.F., Soares W.E., 3rd, Hoppe J.A., et al. Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US. JAMA Intern Med. 2020;180(10):1328–1333. doi: 10.1001/jamainternmed.2020.3288.
    1. Göksoy B., Akça M.T., Inanç Ö.F. The impacts of the COVID-19 outbreak on emergency department visits of surgical patients. Ulus Travma Acil Cerrahi Derg. 2020;26(5):685–692. doi: 10.14744/etd.2020.67927.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner