scholarly journals Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035951
Author(s):  
Saja S Al-Otmy ◽  
Abeer Z Abduljabbar ◽  
Rajaa M Al-Raddadi ◽  
Fayssal Farahat

ObjectivesTo explore magnitude and factors associated with non-urgent visits to the emergency department (ED) in a tertiary care centre, western Saudi Arabia.DesignA cross-sectional study.SettingED of a tertiary care hospital in western Saudi Arabia.Participants400 patients, both men and women.InterventionsAn interview-based questionnaire was administered to a consecutive sample of patients who visited the ED during morning shifts, where primary healthcare centres (PHCs) and outpatient clinics were available.Primary outcome measureED visits classified as non-urgent versus urgent (excluding life-threatening conditions) based on the Canadian Triage and Acuity Scale (CTAS). Levels IV and V were classified as non-urgent.ResultsMajority of the cases were adult (97.3%) and half of them were women (54.8%). Non-urgent visits represented 78.5% among non-life-threatening cases. One-third of the patients (33.8%) had three visits or more to the ED during the past year. Main reasons for visiting the ED were perception that the condition was urgent (42.0%), easy access (25.5%) and limited resources and services at the PHCs (17.8%). Patients 40–50 years old were more likely to have non-urgent visits (OR=3.21, 95% CI 1.15 to 8.98). However, likelihood of non-urgent visits was significantly lower among patients with cancer (OR=0.37, 95% CI 0.19 to 0.72) and cardiovascular disease (OR=0.43, 95% CI 0.23 to 0.83), and those who live near the hospital (OR=0.49, 95% CI 0.28 to 0.88).ConclusionsThe current study reported overuse of the ED. Enhancement of the primary care services, in concordance with community awareness, is an important component to reduce burden due to non-urgent use of the ED.

2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.


2019 ◽  
Vol 6 (17) ◽  
pp. 1300-1305
Author(s):  
Mansi Singh ◽  
Ajay Kumar ◽  
Sanjay Mehrotra ◽  
Virendra Atam ◽  
Ravi Mishra ◽  
...  

2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Rahul Pathak ◽  
Pukar Ghimire ◽  
Sabin Thapaliya ◽  
Sashi Sharma ◽  
Prem Khadga

Introduction: Among patients with Hepatic Encephalopathy, prevalence of Minimal HE variesbetween 30-50%. Identifying patients with MHE has been shown to improve with medications anddelay development of Overt HE, however only limited clinicians screen for MHE in patients due totime consuming neuropsychological and neurophysiological tests. The Number Connection Test isan easy way to evaluate patients to diagnose MHE. The aim of this study is to find out the prevalenceof covert hepatic encephalopathy. Methods: The descriptive cross-sectional study was done to find out the prevalence of covert hepaticencephalopathy among patients with chronic liver disease. To diagnose Covert HE which includedMHE as well, NCT was used in Devanagari script. Results: The prevalence of covert hepatic encephalopathy is found to be 56 (58.3%) at 90% confidenceinterval (58.23-58.37%). A total of 96 patients (71.9% male) were diagnosed as HE, with mean age of49.6+11.8 years. The cause of CLD in 85 (88.5%) of these patients was alcohol, of which 76 (79.2%)consumed locally brewed alcohol. Of these 96 patients with HE, only 40 (41.7%) had overt HE.Among all these, maximum patients had MHE (37.5%). Conclusions: Our study showed that although the prevalence of minimal HE is quite high amongcirrhotics, they are usually missed in clinical practice due to absence of symptoms. Active screeningwith easy-to-administer tests, like Number Connection tests, can help identify patients with minimalHE and hence treat them early.


Sign in / Sign up

Export Citation Format

Share Document