Citation

Alshahrani MS, Alfaraj D, AlHumaid J, Alshahrani K, Alsubaie A, Almulhim N, Althawadi D, Alam S, Alzahrani M, Alwosibai H, Alshahrani A, Makhdom R, Alkhadra F, Al-Faraj S, Al-Qahtani S, Alsulaibikh A, Jumaan MA, Asonto LP, Alahmadi S, Alghamdi M, Al-Mulhim M. Int. J. Environ. Res. Public Health 2022; 19(16): e9818.

Copyright

(Copyright © 2022, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph19169818

PMID

36011457

Abstract

OBJECTIVE: The coronavirus disease (COVID-19) pandemic has disrupted healthcare systems worldwide, resulting in decreased and delayed hospital visits of patients with non-COVID-19-related acute emergencies. We evaluated the impact of the COVID-19 pandemic on the presentation and outcomes of patients with non-COVID-19-related medical and surgical emergencies.

METHOD: All non-COVID-19-related patients hospitalized through emergency departments in three tertiary care hospitals in Saudi Arabia and Bahrain in June and July 2020 were enrolled and categorized into delayed and non-delayed groups (presentation ≥/=24 or <24 h after onset of symptom). Primary outcome was the prevalence and cause of delayed presentation; secondary outcomes included comparative 28-day clinical outcomes (i.e., 28-day mortality, intensive care unit (ICU) admission, invasive mechanical ventilation, and acute surgical interventions). Mean, median, and IQR were used to calculate the primary outcomes and inferential statistics including chi-square/Fisher exact test, t-test where appropriate were used for comparisons. Stepwise multivariate regression analysis was performed to identify the factors associated with delay in seeking medical attention.

RESULTS: In total, 24,129 patients visited emergency departments during the study period, compared to 48,734 patients in the year 2019. Of the 256 hospitalized patients with non-COVID-19-related diagnoses, 134 (52%) had delayed presentation. Fear of COVID-19 and curfew-related restrictions represented 46 (34%) and 25 (19%) of the reasons for delay. The 28-day mortality rates were significantly higher among delayed patients vs. non-delayed patients (n = 14, 10.4% vs. n = 3, 2.5%, OR: 4.628 (CI: 1.296-16.520), p = 0.038).

CONCLUSION: More than half of hospitalized patients with non-COVID-19-related diagnoses had delayed presentation to the ED where mortality was found to be significantly higher in this group. Fear of COVID-19 and curfew restrictions were the main reasons for delaying hospital visit.

Language: en

Keywords

emergency department; delayed presentation; non-COVID-19 emergencies