Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit

Şükriye Miray Kılınçer Bozgül; İlkçe Akgün Kurtulmuş; Figen Yargucu; Mümtaz Yilmaz; Funda Karbek Akarca; Deniz Can Aydogan; Barış Özkılıç; Karya İslamoğlu; Güneş Ak; Fatma Feriha Çilli; Devrim Bozkurt

doi:10.19161/etd.1345563

EN TR

Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit

Abstract

Aim: During the COVID-19 pandemic, a large number of intensive care unit beds have been organized for critically ill COVID-19 patients. However, the need for intensive care for non-COVID-19 critical patients continues. In our study, we aimed to compare non-COVID-19 critically ill patients admitted to the internal medicine intensive care unit from the emergency department before and during the pandemic period. Materials and Methods: Patients who were admitted to the internal medicine intensive care unit from the emergency department were grouped as pre-pandemic (March 2018-March 2020) and during the pandemic (March 2020-March 2022) and compared retrospectively in terms of the number of hospitalisations, demographic characteristics, length of intensive care unit stay and mortality. Results: The number of emergency department patient admissions other than surgical reasons was 579.657 during the study period. 63.33 % of these patients were admitted before the pandemic and 36.67% during the pandemic period. The number of patients included in our study was 493 before the pandemic and 460 during the pandemic period. Median age was 61 (30) in the pre-pandemic period and 64 (26.8) in the pandemic period, p=0.022. There was no significant difference in terms of comorbidities. The main reason for hospitalisation was similar and sepsis was the leading reason for hospitalisation. The frequency of acute renal failure in intensive care unit was significantly higher during the pandemic period. Mortality was 25.2% before the pandemic and 24.3% during the pandemic period, p=0.760. Conclusion: Although emergency department admissions decreased, the number of non-COVID-19 internal medicine intensive care unit hospitalisations did not decrease. This situation reveals the importance of organising intensive care beds for hospitalisation for non-COVID-19 reasons in order not to disrupt health services during the pandemic period.

Keywords

Pandemi öncesi ve pandemi döneminde acil servisten iç hastalıkları yoğun bakım ünitesine yatan COVID-19 dışı kritik hastaların karşılaştırılması

Öz

Amaç: COVID-19 pandemisi boyunca birçok yoğun bakım ünitesi yatağı kritik COVID-19 hastaları için ayrılmıştır. Ancak COVID-19 dışı kritik hastalar için yoğun bakım ihtiyacı devam etmektedir. Bu çalışmada pandemic öncesi ve pandemic dönemi boyunca acil servisten iç hastalıkları yoğun bakım ünitesine yatan COVID-19 dışı kritik hastaların karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Acil servisten iç hastalıkları yoğun bakım ünitesine yatırılan hastalar pandemi öncesi (Mart 2018-Mart 2020) ve pandemi boyunca (Mart 2020-Mart 2022) olarak gruplanıp hasta yatış sayısı, demografik özellikler, yoğun bakım yatış süresi ve mortalite oranı açısından retrospektif olarak karşılaştırıldı. Bulgular: Çalışma dönemi boyunca cerrahi neden dışı acil servis hasta başvuru sayısı 579.657 olup bu hastaların %63.33’ü pandemic öncesi, %36.67’si pandemic dönemi boyunca başvurmuştur. İç hastalıkları yoğun bakım ünitesine yatan ve çalışmaya dahil edilen hasta sayısı pandemi öncesinde 493 ve pandemi döneminde 460’tır. Medyan yaş, pandemi öncesi dönemindeki hastalarda 61 (30), pandemi döneminde ise 64 (26.8) olarak saptandı, p=0.022. Komorbiditeler açısından anlamlı fark saptanmadı. Başlıca yatış nedeni benzer olup sepsisin önde gelen yatış sebebi olduğu görüldü. Yoğun bakımda akut böbrek yetmezliği görülme sıklığı pandemi döneminde anlamlı yüksek saptandı. Yoğun bakımda kalış süresi iki grupta benzer saptandı. Mortalite pandemi öncesinde %25.2 ve pandemi döneminde %24.3 saptandı, p=0.760. Sonuç: Acil servis başvuruları azalmasına rağmen COVID-19 dışı iç hastalıkları yoğun bakım hasta yatış sayısı azalmamıştır. Bu durum pandemi döneminde sağlık hizmetlerinin aksamaması için yoğun bakım alanlarının COVID-19 dışı nedenlerle yatış için de organize edilmesinin önemini ortaya koymaktadır.

Anahtar Kelimeler

Ethical Statement

The study was approved by the Ege University Ethics Committee, number 23-5.1T/15

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Details

Primary Language

English

Subjects

Emergency Medicine , Internal Diseases , Intensive Care

Journal Section

Research Article

Authors

Şükriye Miray Kılınçer Bozgül ^*
0000-0002-3995-5096
Türkiye

İlkçe Akgün Kurtulmuş
0000-0002-2661-8525
Türkiye

Figen Yargucu
0000-0001-7479-3582
Türkiye

Mümtaz Yilmaz
0000-0002-8585-0770
Türkiye

Funda Karbek Akarca
0000-0003-2455-8044
Türkiye

Deniz Can Aydogan
0009-0001-4330-0682
Türkiye

Barış Özkılıç
0000-0001-5904-7522
Türkiye

Karya İslamoğlu
0000-0002-0941-6235
Türkiye

Güneş Ak
0000-0001-6780-1812
Türkiye

Fatma Feriha Çilli
0000-0003-3993-3396
Türkiye

Devrim Bozkurt
0000-0003-4557-3390
Türkiye

Publication Date

March 19, 2024

Submission Date

September 4, 2023

Acceptance Date

November 30, 2023

Published in Issue

Year 2024 Volume: 63 Number: 1

DOI

https://doi.org/10.19161/etd.1345563

IZ

https://izlik.org/JA93KY89XD

Cite

RIS / Bibtex

Vancouver

1.Şükriye Miray Kılınçer Bozgül, İlkçe Akgün Kurtulmuş, Figen Yargucu, Mümtaz Yilmaz, Funda Karbek Akarca, Deniz Can Aydogan, Barış Özkılıç, Karya İslamoğlu, Güneş Ak, Fatma Feriha Çilli, Devrim Bozkurt. Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit. EJM. 2024 Mar. 1;63(1):106-14. doi:10.19161/etd.1345563