Epidemiological and clinical features of eye-related emergency department visits involving an ophthalmology consultation in geriatrics

Abstract

ABSTRACT Objective: This study aimed to examine the epidemiological and clinical characteristics of geriatric patients who presented to the emergency department (ED) with ocular complaints and were referred for an ophthalmology consultation and to evaluate the efficacy of visual acuity (VA) as an indicator of urgency of care. Material and Methods: The data of 730 patients were retrospectively analyzed. Age, gender, presentation complaints, presentation time, pre-diagnoses made by the ED physician, definitive diagnosis, VA (logMAR) measurements and urgency of care were recorded. Results: The mean age of the patients was 72.7 ± 7.1 years. The percentage of patients presenting to ED during evening shift hours was 60.3%, and the rate of presentation on weekdays was 75.8% (p<0.05). The agreement rate between the pre-diagnosis of the ED physicians and the final diagnosis of the ophthalmologists was 65.2%. The most common reasons for presenting to ED were infection (21%) and trauma (19.9%). No pathological finding was present in 10.1%. According to the classification of urgency of care, 52.6% of the cases were evaluated as urgent, 24.3% as semi-urgent, and 23.1% as non-urgent. VA was the lowest (1.49 ± 1.06 logMAR) in the urgent group (p<0.01). Conclusion: We consider that low VA can be of great help in evaluating the urgency of geriatric patients presenting to ED. In addition, rather than ED, geriatric patients applying to health institutions where they can receive outpatient clinic service for non-emergency ocular diseases may allow ED to provide better service to other patients with more serious problems. Key Words: Geriatrics, Emergency department, Eye-related emergency, Ocular emergency

Keywords

• Geriatrics
• Emergency department
• Eye-related emergency
• Ocular emergency

Acil servise başvuran ve oftalmoloji konsültasyonu istenen geriatrik hastaların epidemiyolojik ve klinik özelliklerinin belirlenmesi

Öz

ÖZ Giriş: Oküler şikayetle acil servise (AS) başvuran ve oftalmoloji konsültasyonu istenen geriatrik hastaların epidemiyolojik ve klinik özelliklerinin incelenmesi; görme keskinliğinin aciliyet göstergesi olarak etkinliğinin değerlendirilmesi. Gereç ve Yöntemler: Yedi yüz otuz hastanın verileri retrospektif olarak incelendi. Yaş, cinsiyet, başvuru şikayetleri, başvuru zamanı, AS hekimi tarafından konulan ön tanıları, kesin tanıları, görme keskinlikleri (logMAR), aciliyet durumları kaydedildi. Bulgular: Hastaların yaş ortalaması 72,7 ± 7,1 idi. Saat olarak akşam vardiyasında AS başvuru oranı %60,3; gün dağılımda da hafta içi başvuru oranları da %75,8 idi (p<0.05). Acil hekimlerin ön tanısı ile oftalmologların kesin tanı uyum oranı %65,2 idi. Hastaların en sık başvuru nedeninin enfeksiyon (%21) ve travma (%19,9) olduğu görüldü. Hastaların %10,1’inde patolojik bulgu izlenmedi. Aciliyet sınıflamasına baktığımız zaman ise %52,6 hasta acil, %24,3 hasta yarıacil ve %23,1 hasta acil olmayan olarak değerlendirildi. Görme keskinliğinin acil grupta en düşük (1,49±1,06 logMAR), acil olmayan grupta (72,82±7,3 logMAR) en yüksekti (p<0.01). Sonuç: Özellikle AS başvuran geriatrik hastaların aciliyet durumlarının değerlendirilmesinde düşük görme keskinliğinin bize oldukça yardımcı olabileceğini düşünmekteyiz. Ayrıca hastaları acil olmayan oküler hastalıklar için AS başvurmak yerine, poliklinik hizmeti alabilecekleri sağlık kuruluşlarına başvurmaları AS daha ciddi sorunları olan hastalara daha iyi hizmet vermesine olanak sağlayabileceğini düşünmekteyiz. Anahtar Sözcükler: Geriatrik, Acil servis, Gözle ilişkili aciller, Oküler aciller

Anahtar Kelimeler

• Geriatrik
• Acil servis
• Gözle ilişkili aciller
• Oküler aciller

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