Acil Servise Başvuran Hastaların Değerlendirilmesi: Acil Servis Bekleme Süresi ile Mortalite İlişkisi

Year 2025, Volume: 8 Issue: 3, 134 - 139, 30.09.2025

İskender Aksoy , Ali Altınbaş

https://doi.org/10.54996/anatolianjem.1627408

Abstract

Amaç: Çalışmamızda, acil servislerdeki bekleme sürelerinin mortalite üzerindeki etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Retrospektif olarak planladığımız çalışmamıza, hastanemiz acil servisine başvuran ve yatış endikasyonu konulan hastalar dâhil edildi. Hastalar hastane bilgi yönetim sistemi üzerinden taranarak demografik özellikleri (yaş, cinsiyet), acil servis bekleme süreleri, hastanede kalış süreleri, yatış endikasyonu türü (dahili, harici, travma vb.), yatış verilen branş ve yattıkları birimler (servis, yoğun bakım) kaydedildi.
Bulgular: Çalışmamıza 7631 hasta dâhil edildi. Hastaların %40,3’ü kadın, %57,7’si (n=4558) erkek olup, ortalama yaş 65,3±19,4 idi. Yaş ve ortalama acil servis bekleme süresi, yoğun bakımda yatan hastalarda anlamlı olarak daha yüksekti. Prognoz ile kıyaslandığında; ileri yaş, uzamış acil servis bekleme süresi ve uzamış hastane yatış süresi mortalite ile anlamlı bulundu.
Sonuç: Özellikle 8–24 saat arası acil servis bekleme süresi, mortalite oranlarında anlamlı artış ile ilişkili bulunmuştur. Bu gecikme, kritik müdahalelerin kaçırılmasına yol açabilir. 8–24 saat bekleyen hastalarda mortalite %19,8 iken, 8 saatten az bekleyenlerde %8,8 olarak kaydedilmiştir (p<0,001).

Keywords

Acil servis , mortalite , uzun bekleme süresi , travma , yoğun bakım

Ethical Statement

Bu çalışma için Giresun Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu'ndan (30.01.2023/07 ) etik kurul onayı alınmıştır.

Evaluation of Patients Presenting to the Emergency Department: The Relationship Between Emergency Department Waiting Time and Mortality

Abstract

Aim: In our study, we aimed to evaluate the effect of waiting times in emergency departments on mortality.
Material and Methods: In our retrospective study, we included patients who presented to the emergency department of our hospital and had an indication for hospitalization. Patients were scanned through the hospital information management system and demographic characteristics (age, gender), emergency department waiting times, hospitalization times, type of indication for hospitalization (internal, external, trauma, etc.), branch of hospitalization and units of hospitalization (ward, intensive care unit) were recorded.
Results: 7631 patients were included in our study. 40.3 % of the patients were female, 57.7 % (n=4558) were male and the mean age of the patients was 65.3±19.4 years. Age and mean emergency department waiting times were significantly higher in patients hospitalized in intensive care unit. When compared with prognosis, advanced age, prolonged emergency department waiting time and prolonged hospitalization were found to be significant with mortality.
Conclusion: Prolonged emergency department stays were associated with higher mortality rates, especially between 8–24 hours. This delay may lead to missed critical interventions. Mortality was 19.8% for patients who stayed 8–24 hours versus 8.8% for those under 8 hours (p<0.001).

Keywords

Emergency department , mortality , long waiting time , trauma , intensive care

References

• Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One. 2018;13(8):e0203316.
• Singer AJ, Thode HC Jr, Viccellio P, Pines JM. The association between length of emergency department boarding and mortality. Acad Emerg Med. 2011;18(12):1324-1329.
• Verma A, Shishodia S, Jaiswal S, et al. Increased Length of Stay of Critically Ill Patients in the Emergency Department Associated with Higher In-hospital Mortality. Indian J Crit Care Med. 2021;25(11):1221-1225.
• Gaughan J, Kasteridis P, Mason A, Street A. Why are the relong waits at English emergency departments? Eur J Health Econ. 2020;21(2):209-218.
• Lambe S, Washington DL, Fink A, et al. Waiting times in California's emergency departments. Ann Emerg Med. 2003;41(1):35-44.
• Chalfin DB, Trzeciak S, Likourezos A, Baumann BM, Dellinger RP; DELAY-ED study group. Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med. 2007;35(6):1477-1483.
• Darden DB, Moore FA, Brakenridge SC, et al.The Effect of Aging Physiology on Critical Care. Crit Care Clin. 2021;37(1):135-150.
• American College of Surgeons. Advanced trauma life support (ATLS): student course manual. 10th ed. Chicago (IL): American College of Surgeons; 2018.
• Kauvar DS, Lefering R, Wade CE. Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations. J Trauma. 2006;60(6 Suppl):S3-11.
• Özlüer YE., GüvençFD. Does Waiting Time for Hospitalization in the Emergency Department Increase Mortality in Patients with Febrile Neutropenia? – Retrospective Observational Research. Anatolian Journal of Emergency Medicine. 2022;5(3):99-102.
• Choi W, Woo SH, Kim DH, et al. Prolonged Length of Stay in the Emergency Department and Mortality in Critically Ill Elderly Patients with Infections: A Retrospective Multicenter Study. Emerg Med Int.2021;2021:9952324.
• Paling S, Lambert J, Clouting J, González-Esquerré J, Auterson T. Waiting times in emergency departments: exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emerg Med J. 2020;37(12):781-786.
• Altun M, Kudu E, Demir O, et al. Effect of Access block on emergency department crowding calculated by NEDOCS score. The American Journal of Emergency Medicine. 2024;82:136–141.