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Son Beş Yılda Acil Serviste Değerlendirilen Endokrinoloji Konsültasyonları: Tek Merkez Deneyimi

Year 2023, Volume: 62 Issue: 4, 549 - 555, 18.12.2023
https://doi.org/10.19161/etd.1231955

Abstract

Amaç:
Metabolik hastalıkların yıllar içinde artış eğiliminde olması acil servislerde gün geçtikçe daha sık endokrinolojik acillerle karşılaşılmasına neden olmakta; bu da acil servislerden istenen endokrinoloji konsültasyonların öneminin artmasını beraberinde getirmektedir. Bu konsültasyonların özelliklerinin incelenmesi, sürecin daha hızlı ve etkili şekilde sonuçlanabilmesine olanak sağlayacaktır.
Gereç ve Yöntem:
1 Mart 2017 – 1 Mart 2022 tarihleri arasında Manisa Celal Bayar Üniversitesi Hafsa Sultan Hastanesi Acil Servis kliniğine başvurup Endokrinoloji ve Metabolizma Hastalıkları bölümü ile konsülte edilen hastalar çalışmaya dahil edildi. Hastaların yaşı, cinsiyeti, konsültasyon günü, konsültasyon sonucu aldıkları tanı, konsültasyon gerçekleşme süresi ve konsültasyon sonuçları değerlendirildi.
Bulgular:
Çalışmaya dahil edilen 326 hastanın ortalama yaşı 51.56 ± 19.4 yıl saptandı. %53.4’ü (n=174) kadın, %46.6’sı (n=152) erkek idi. Hastaların %29.4’ü (n=96) diyabetik ketoasidoz, %21.5’i (n=70) hiperglisemi, %10.7’si (n=35) diyabetik ketoz, %7.4’ü (n=24) yeni tanı diyabet tanısı almıştı. Ortalama konsültasyon sonuçlandırma süresi 65.21 ± 46.23 dakika saptandı. Hastaların en sık olarak acil servisten taburcu oldukları (%32.2; n=105), bunu endokrinoloji ve metabolizma hastalıkları servisi yatışının (%23.9; n=78) ve yoğun bakım servisi yatışının (%17.8; n=58) izlediği görüldü.
Sonuç:
Cinsiyet ve yaş dağılımı homojen olan örneklem grubunda hastaların çoğunluğunun diyabete bağlı acil durumlar ile acil servise başvurmuş olduğu görüldü. En sık olarak acil servisten taburcu edilen hastaların tanı spektrumu oldukça geniş olup ortalama yaklaşık bir saat içinde konsültasyon sürecinin sonuçlandığı görüldü. Acil servis endokrinoloji konsültasyon sürecinin detaylı bir şekilde irdelenmesi, süreçteki aksaklıkların saptanması ve sürecin iyileştirilmesine katkıda bulunacaktır.

References

  • 1. Lee RS, Woods R, Bullard M, Holroyd BR, Rowe BH. Consultations in the emergency department: A systematic review of the literature. Vol. 25, Emergency Medicine Journal. 2008:4–9.
  • 2. Woods RA, Lee R, Ospina MB, Blitz S, Lari H, Bullard MJ, et al. Consultation outcomes in the emergency department: Exploring rates and complexity. Canadian Journal of Emergency Medicine. 2008;10(1):25–31.
  • 3. van der Veen D, Heringhaus C, de Groot B. Appropriateness, reasons and independent predictors of consultations in the Emergency Department (ED) of a Dutch Tertiary care center: A prospective cohort study. PLoS One. 2016 Feb 1;11(2).
  • 4. Idowu A, Adesegun O, Osonuga A, Osibowale B, Ajiro T, Ngubor T, et al. Patterns and Impact of Consultations to an Endocrinology Unit in a Tertiary Hospital in Southwestern Nigeria. Nigerian Medical Journal. 2018;59(3):28.
  • 5. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013 Feb;28(2):169–80.
  • 6. Anyanwu A, Fasanmade O, Mojeed A, Odeniyi I, Ohwovoriole A, Olofin K, et al. Endocrine-related diseases in the emergency unit of a Tertiary Health Care Center in Lagos: A study of the admission and mortality patterns. Nigerian Medical Journal. 2013;54(4):254.
  • 7. Umpierrez G, Korytkowski M. Diabetic emergencies-ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol [Internet]. 2016;12(4):222–32.
  • 8. Barranco RJ, Gomez-Peralta F, Abreu C, Delgado-Rodriguez M, Moreno-Carazo A, Romero F, et al. Incidence, recurrence and cost of hyperglycaemic crises requiring emergency treatment in Andalusia, Spain. Diabetic Medicine. 2017 Jul 1;34(7):966–72.
  • 9. Üzer B, ÜF& KS. Bir Devlet Hastanesi Acil Servisinden Göğüs Hastalıkları Servisine İstenen Konsültasyonların Değerlendirilmesi. Genel Tıp Dergisi. 2021;31(3):243–7.
  • 10. Dönmez SS, Durak VA, Torun G, Köksal Ö, Aydin Ş. Acil Serviste Gerçekleştirilen Konsültasyon Sürecinin İncelenmesi. Vol. 43, Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2017.
  • 11. Kearney T, Dang C. Diabetic and endocrine emergencies. Vol. 83, Postgraduate Medical Journal. 2007:79–86.

Endocrinology Consultations Evaluated in the Emergency Department over the Last Five Years: A Single Center Experience

Year 2023, Volume: 62 Issue: 4, 549 - 555, 18.12.2023
https://doi.org/10.19161/etd.1231955

Abstract

Purpose:
The increasing trend of metabolic diseases causes endocrine emergencies to be encountered more frequently in emergency services. This trend increases the importance of endocrinology consultations from emergency services. Examining the features of these consultations will allow the process to be concluded more quickly and effectively.
Materials and Method:
Patients who applied to Manisa Celal Bayar University Faculty of Medicine Emergency Department between March 1, 2017 and March 1, 2022, and were consulted with the Department of Endocrinology were included. The patients' age, gender, diagnoses, the day, the duration and the results of the consultations were evaluated.
Results:
The mean age of the 326 patients included in the study was 51.56 ± 19.4 years. 53.4% (n=174) were female, 46.6% (n=152) were male. Of the patients, 29.4% (n=96) were diagnosed as diabetic ketoacidosis, 21.5% (n=70) hyperglycemia, and 10.7% (n=35) diabetic ketosis. The mean consultation duration was 65.21 ± 46.23 minutes. 32.2% of the patients (n=105) were discharged from the emergency department. This was followed by endocrinology service admission (23.9%; n=78) and intensive care unit admission (17.8%; n=58).
Conclusion:
In the sample group with homogeneous gender and age distribution, it was observed that the majority of the patients applied to the emergency service with diabetes-related emergencies. The diagnosis spectrum of the patients was quite wide, and the consultations were concluded within an average of about one hour. A further investigation of the emergency department endocrinology consultations in detail will contribute to detecting the problems in this process and; therefore, its improvement.

References

  • 1. Lee RS, Woods R, Bullard M, Holroyd BR, Rowe BH. Consultations in the emergency department: A systematic review of the literature. Vol. 25, Emergency Medicine Journal. 2008:4–9.
  • 2. Woods RA, Lee R, Ospina MB, Blitz S, Lari H, Bullard MJ, et al. Consultation outcomes in the emergency department: Exploring rates and complexity. Canadian Journal of Emergency Medicine. 2008;10(1):25–31.
  • 3. van der Veen D, Heringhaus C, de Groot B. Appropriateness, reasons and independent predictors of consultations in the Emergency Department (ED) of a Dutch Tertiary care center: A prospective cohort study. PLoS One. 2016 Feb 1;11(2).
  • 4. Idowu A, Adesegun O, Osonuga A, Osibowale B, Ajiro T, Ngubor T, et al. Patterns and Impact of Consultations to an Endocrinology Unit in a Tertiary Hospital in Southwestern Nigeria. Nigerian Medical Journal. 2018;59(3):28.
  • 5. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013 Feb;28(2):169–80.
  • 6. Anyanwu A, Fasanmade O, Mojeed A, Odeniyi I, Ohwovoriole A, Olofin K, et al. Endocrine-related diseases in the emergency unit of a Tertiary Health Care Center in Lagos: A study of the admission and mortality patterns. Nigerian Medical Journal. 2013;54(4):254.
  • 7. Umpierrez G, Korytkowski M. Diabetic emergencies-ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol [Internet]. 2016;12(4):222–32.
  • 8. Barranco RJ, Gomez-Peralta F, Abreu C, Delgado-Rodriguez M, Moreno-Carazo A, Romero F, et al. Incidence, recurrence and cost of hyperglycaemic crises requiring emergency treatment in Andalusia, Spain. Diabetic Medicine. 2017 Jul 1;34(7):966–72.
  • 9. Üzer B, ÜF& KS. Bir Devlet Hastanesi Acil Servisinden Göğüs Hastalıkları Servisine İstenen Konsültasyonların Değerlendirilmesi. Genel Tıp Dergisi. 2021;31(3):243–7.
  • 10. Dönmez SS, Durak VA, Torun G, Köksal Ö, Aydin Ş. Acil Serviste Gerçekleştirilen Konsültasyon Sürecinin İncelenmesi. Vol. 43, Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2017.
  • 11. Kearney T, Dang C. Diabetic and endocrine emergencies. Vol. 83, Postgraduate Medical Journal. 2007:79–86.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Can AKÇURA 0000-0003-4182-9002

Samet ALKAN 0000-0003-3172-2770

Sedat Can GÜNEY 0000-0002-2035-6843

Nilüfer ÖZDEMİR 0000-0002-0719-988X

Zeliha HEKİMSOY 0000-0002-6003-0485

Publication Date December 18, 2023
Submission Date January 11, 2023
Published in Issue Year 2023Volume: 62 Issue: 4

Cite

Vancouver AKÇURA C, ALKAN S, GÜNEY SC, ÖZDEMİR N, HEKİMSOY Z. Endocrinology Consultations Evaluated in the Emergency Department over the Last Five Years: A Single Center Experience. EJM. 2023;62(4):549-55.