engleski

Analysis of Emergency Department Patient Visits Over Two Weeks: a Prospective, Observational Study

Objective: To analyze demographic characteristics of the patients presenting to the Emergency Department (ED), determine the most frequent chief complaints and diagnoses, and to evaluate the efficacy of the work in the ED. Design and Method: A prospective, observational study, performed in the Emergency Room of the Department of Medicine, University Hospital Center Sisters of Charity (UHC SCh), Zagreb, Croatia, during 14 consecutive days in December 2018 and January 2019. All patients examined in the ED were enrolled consecutively in the study. Only the data available from the patient history, physical examination and ED diagnostic procedures were used. The study was approved by the Ethics Committee of the UHC SCh and was performed in accordance with the principles of the Declaration of Helsinki. Results: During the study, a total of 959 patients were examined in the ED; 502 (52.3%) were women, with no significant difference in sex distribution (P=0.146). Median age of all patients was 63 years (range 18-94); 62 for men (18-94) and 63 for women (18-94), P=0.350. The most frequent chief complaints were chest pain (145 patients), dyspnea (133) and abdominal pain (130) [figure1]. Following patient examination and diagnostic workup, the most frequent final diagnoses were unspecified chest pain (91 patients; 62.8% of those presenting with the chest pain) and unspecified abdominal pain (61; 46.9% of those presenting with the abdominal pain), followed by acute heart failure, pneumonia and arterial hypertension [figure2]. Of all the patients examined, 211 (22.0%) were admitted to the hospital. The majority was admitted to the Department of Medicine (145; 68.7%) and the Department of Cardiology (52; 24.6%), with 89 (45.2%) of these patients requiring treatment in one of the Intensive Care Units. Patients admitted to the hospital were significantly older (73 years, range 26-92) than patients discharged from the ED (P<0.001). Among hospitalized patients, leading diagnoses were acute heart failure, pneumonia, acute coronary syndrome, urinary tract infection and gastrointestinal bleeding [figure3]. Of all examined patients, 10 died in the ED (1.0%). Median length of stay in the ED was 4 hours (1-40) for all patients, compared to 6 hours (1-28) for hospitalized patients. Conclusions: The top 10 chief complaints represented 81.4% of all patients' complaints in the ED. Analysis of these symptoms and their derived diagnoses enables rationalization of workload in overcrowded EDs.

emergency department

nije evidentirano