Evaluation of The Relevance of Urgency in Dermatological Patients Admitted to The Emergency Department with The Relationship Between Anxiety, Depression Levels and Dermatological Quality of Life: A Prospective Observational Study

Year 2019, , 407 - 415, 28.06.2019

Hatice Kaya Onur Karakayali

https://doi.org/10.17098/amj.576971

Cited By: 1

Abstract

Objectives: In this
study, it was aimed to define the demographic data of the patients admitted to
the emergency clinics with dermatological complaints, to determine the rate of
the true dermatologic emergency cases, the dermatology life quality index, and
to define the reasons why patients without dermatological emergencies admitted
to Emergency clinics, their psycho-social backgrounds with Beck Anxiety and
Depression Inventory.



Materials and Methods: It was a
single-center prospective observational and questionnaire-based study. The
patients older than 18 years of age who admitted to the emergency department
due to dermatological emergencies were included in the study. In this study,
the patients who were admitted to the emergency department were consulted by
the dermatology specialist after their initial diagnosis and treatment was done
by the emergency physicians. Demographic data, dermatology life quality index,
scores of Beck Anxiety and Depression Inventory were recorded.



Results: The average age of 200
patients was 40.5 (16.39) and 116 of the patients (58%) were female. The
duration of the most frequent complaint was 1 month and over (n = 58, 29%). The
true dermatological patient group was 29.5% of all patients. The most common
reason for the hospital admission was that the patients thought that their
condition was urgent (47.50%). The most common complaint for hospital admission
was urticaria (24%). According to dermatology life quality index, 79 (39.5%)
patients were affected moderately. The mean value of all patients was 15.22
+12.56 according to the Beck anxiety inventory, while the mean value was
12.88.9 according to the Beck depression inventory. When the patients were
divided into two groups according to Beck depression-anxiety inventory and
dermatology life quality index, there was no statistically significant
difference between the two groups in terms of gender, age, marital status,
education level, income level, duration of complaint, and the reason for
admission. However, there was a statistically significant difference between
groups in terms of gender according to Beck anxiety inventory (p = 0.029).

Conclusion: In our study, the
patients coming from the emergency department were evaluated by dermatology
physician in a short time, so more accurate diagnosis and rapid treatment
opportunities were provided and unnecessary medical approaches and costs were
prevented. We believe that increased anxiety levels are an important factor in
patients admitting to the emergency department. Therefore, awareness-raising
campaigns should be beneficial in preventing frequent admission by social media
and hospital-based studies focusing on this issue.

Keywords

Dermatologic emergency, emergency department, anxiety, depression

Acil Servise Başvuran Dermatolojik Hastaların Aciliyet Uygunluğunun; Anksiyete, Depresyon Düzeyleri Ve Dermatolojik Yaşam Kalitesi Arasındaki İlişki İle Değerlendirilmesi: Prospektif Gözlemsel Bir Çalışma

Abstract

Amaç: Çalışmamızda dermatolojik şikayetlerle acil kliniğine başvuran hastaların
demografik verilerinin tanımlanması, gerçek dermatolojik acil vakaların
oranının belirlenmesi ve beck anksiete ve depresyon ölçekleri ile başvuru
nedenlerinin psiko-sosyal zemininin ve acil servise acil olmayan hastaların
başvuru gerekçelerinin tanımlanması amaçlanmıştır.

Materyal ve Metot: Prospektif
gözlemsel ve anket çalışma araştırma tek merkez olarak 3 aylık dönemde acil tıp
kliniğine dermatolojik aciller nedeniyle başvuran 18 yaşından büyük hastalar
dahil edilerek yapıldı. Çalışmada acil servise başvuran bu hastalar ilk tanı ve
tedavileri acil tıp hekimleri tarafından yapıldıktan sonra dermatoloji uzmanına
konsulte edildi. Hastaların demografik verileri, dermatolojik yaşam indeksi,
beck anksiete ve depresyon ölçeği kayıt altına alındı. 

Bulgular: 200 hastanın ortalama yaşı
40,5 (16,39), 116’ sı (%58) kadındı. En sık başvuru grubunun şikayetleri 1 ay
ve üzerinde (n=58, %29) idi. Gerçek dermatolojik hasta grubu tüm hastaların
%29,5’ i idi. En sık başvuru nedeni hastaların durumlarının acil olduğunu
düşünmeleri (%47,50) ve klinik tanıları en sık ürtiker (%24) idi. Hastalar
dermatolojik yaşam kalite indeksine göre; 79’ unun (%39,5) orta derecede
etkilendiği gözlendi. Beck anksiete puan ölçeğine göre tüm hastaların ortalama
değeri 15,22 12,56’ idi. Beck depresyon sınıflamasına göre hastaların
ortalaması 12,8 +8,9’ idi. Hastalar beck depresyon-anksiete ölçeği ve
dermatolojik yaşam indeksine göre hafif ve orta-şiddetli olarak 2 gruba
ayrıldığında her iki grup arasında cinsiyet, yaş, medeni durum, eğitim durumu,
gelir düzeyi, şikayet başvuru süresi, başvuru sebebi arasında istatistiksel
olarak anlamlı fark tespit edilmedi, sadece beck anksiete depresyon ölçeğine
göre cinsiyet farklılıklarına göre istatistiksel olarak anlamlı fark tespit
edildi (p=0,029).

Sonuç: Çalışmamız acilden gelen
hastaların kısa sürede dermatoloji hekimi tarafından değerlendirilmesi ile daha
doğru tanı, hızlı tedavi imkanı sağlaması yanısıra gereksiz tıbbi yaklaşımların
ve masrafların önlenmesinde fayda sağlamıştır. Hastaların acile başvurularında
anksiyete düzeylerinin yüksek olmasının önemli bir faktör olduğu, bu nedenle
bilinçlendirme çalışmalarının gerek sosyal medya gerek hastane temelli çalışmalarla
bu noktaya değinilerek artırılması sık başvurunun önlenmesinde fayda
sağlayacaktır kanaatindeyiz.

Keywords

dermatolojik aciller, acil servis, anksiete, depresyon

References

• Grillo S, Vano-Galvan N, Jiménez-Gómez A, Ballester A, Muñoz-Zato E, Jaén P . Dermatologic Emergencies:Descriptive Analysis of 861 Patients in a Tertiary Care Teaching Hospital. Actas Dermosifiliogr 2013;104:316-24.
• Jack AR, Spence AA, Nichols BJ, Chong S, Williams DT, Swadron SP, et al. Cutaneous Conditions Leading to Dermatology Consultations in the Emergency Department. West J Emerg Med 2011;12:551-5.
• Erdogan HK, Altunay IK, Koslu A. Evaluation of dermatologic emergency patients: a unicentral prospective clinical study. Arch Turkish Dermatol Venereol. 2009; 43: 144-8.
• Ozkur E, Altunay IK, Sekerlisoy G, Erdem Y. Dermatology consultations in a tertiary care centre emergency service. The Medical Bulletin of Sisli Etfal Hospital 2018.
• Öztürkcan S, Ermertcan AT, Eser E, Fiahin MT: Cross validation of the Turkish version of dermatology life quality index. Int J Dermatol 2006;45:1300-7.
• Eren I, Sahin M, Tunc SE, Cure E, Civi II: Psychiatric symptoms and quality of life in patients with Behçet’s disease. Neurol Psychiatr Brain Res 2006;13:169-74.
• Faul F., Erdfelder E., Buchner A., Lang A.G., Statistical power analyses using G power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009; 41: 1149-60.
• Murr D, Bocquet H, Bachot N, Bagot M, Revuz J, Roujeau JC: Intérêt d'une consultation hospitalière d'urgences dermatologiques. Ann Dermatol Venereol 2003; 130:167- 70.
• Craft N, Robbin D, Manassi L, Art P. Overdiagnosis of cellulitis and soft tissue infections: designing decision support systems to reduce predictable diagnostic error. Paper presented at: AHRQ/AMIA Diagnostic Error in Medicine National Conference; May 31, 2008; Phoenix, Arizona.
• Jayaprakasam A, Darvay A, Osborne G, McGibbon D. Comparison of assessments of severity and quality of life in cutaneous disease. Clin Exp Dermatol. 2002; 27:306-8.
• Yazici K, Baz K, Yazici AE, Köktürk A, Tot S, Demirseren D, Buturak V. Disease-specific quality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol Venereol. 2004 ;18:435-9.
• Schmitt J, Küster D. Correlation between Dermatology Life Quality Index (DLQI) scores and Work Limitations Questionnaire (WLQ) allows the calculation of percent work productivity loss in patients with psoriasis. Arch Dermatol Res. 2015 ;307:451-3.
• Engin B, Uguz F, Yilmaz E, Ozdemir M, Mevlitoglu I. The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria. J Eur Acad Dermatol
• Venereol. 2008 ;22:36-40.
• Alegre-Sánchez A, de Perosanz-Lobo D, Pascual-Sánchez A, Pindado-Ortega C,Fonda-Pascual P, Moreno-Arrones ÓM, Jaén-Olasolo P. Impact on Quality of Life in Dermatology Patients Attending an Emergency Department. Actas Dermosifiliogr. 2017 ;108:918-23.