Üçüncü Basamak Bir Hastanede Dermatolojik Acil Durumlar: Tanımlayıcı Bir Çalışma

Year 2022, Volume: 2 Issue: 3, 42 - 45, 22.12.2022

Dilber Üçöz Kocaşaban , Mehmet Serkan Yurdakul , Figen Coşkun

https://doi.org/10.58252/artukluder.1175138

Abstract

Amaç: Bu çalışmada, acil servise deri lezyonları ile gelen erişkin hastaların başvuru sıklıkları ve acil serviste konulan ana tanıların belirlenmesi amaçlanmıştır. Acil olmayan durumlarda hastaların dermatoloji polikliniği yerine acil servisi tercih etme nedenlerini araştırmayı amaçladık.
Gereç ve Yöntem: : Bu çalışma, üçüncü basamak bir hastanenin acil servisinde prospektif olarak yapıldı. Altı aylık bir süre içinde dermatolojik şikayetleri olan hastalar çalışmaya alındı. Temel epidemiyolojik ve klinik veriler ile hastaların ve klinisyenlerin bakış açısından durumun "gerçek bir acil durum" olup olmadığı kaydedilmiştir.
Bulgular: Çalışmaya 262 hasta dahil edildi. Acil serviste en sık görülen üç tanı akut ürtiker (%41.6), makülopapüler ilaç döküntüleri (%17.2) ve kaşıntı (%7.6) idi. Tüm hastaların 26'sına (%9,9) dermatoloji konsültasyonu istendi. Acil servis muayenesinin hasta ve hekim açısından gerekliliği değerlendirildiğinde ve durumun gerçekten acil olup olmadığı sorulduğunda 262 hastanın %74.0'ü durumunun acil olduğunu bildirdi, ancak hekimler sadece %40.0 hastanın acil müdahale ihtiyacı olduğunu değerlendirdi. Acil olmayan hastalarda acil servis seçiminde en önemli faktör sağlık güvencesinin olmamasıdır (%20,6).
Sonuç: Acil servise dermatolojik şikayetlerle başvuran hastalar her zaman "gerçek acil durumlar" değildir ve hastaların dermatoloji polikliniği yerine acil servis tercihinde çeşitli faktörler rol oynayabilir. Çalışmamızın sonucuna göre en sık acil servise başvuru nedeni sağlık sigortası sorunlarıydı.

Keywords

Dermatolojik aciller, acil servis, üçüncü basamak hastane, cilt hastalıkları

Dermatological Emergencies in a Tertiary Hospital: A Descriptive Study

Abstract

Objective: This study aims to determine the frequency of adult patients presenting to the emergency department with skin lesions, and the main diagnoses made in the ED. We aimed to investigate the reasons of patients choose the emergency department rather than dermatology outpatient clinics in non-emergency situations.
Material and Method: This is a prospective study conducted on patients with dermatological conditions diagnosed in the emergency department of a tertiary hospital during a 6-month period. Basic epidemiological and clinical characteristics, and whether the situation is a "real emergency" from the perspectives of the patients and clinicians were recorded.
Results: A total of 262 patients were included. The three most common diagnoses in the ED were acute urticaria (41.6%), maculopapular drug eruptions (17.2%) and pruritus (7.6%). Dermatology consultation was requested for 26 (9.9%) of all patients. When evaluating the necessity of emergency ED examination from the point of view of the patient and the physician, and asked whether the situation was emergent, 74.0% of 262 patients reported that their condition was emergent, but the physicians evaluated only 40.0% of patients has a truly emergent situation. The most important factor in the choice of ED in non-emergent patients was the lack of medical insurance (20.6%).
Conclusion: Patients who presented to the ED with dermatological complaints were not always "true emergencies" and several factors may play a role preference of patients’ for the ED instead of the outpatient dermatology clinic. The most common cause was medical insurance problems according to our results.

Keywords

Dermatological emergencies, emergency department, tertiary hospital, skin disease

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