Acil Oftalmolojik Konsültasyonların Aciliyet, Oftalmik Patoloji ve Hafta Sonu Etkisi Açısından İrdelenmesi

Öz

Amaç: Acil serviste oftalmoloji konsültasyonlarının aciliyetini ve oftalmik patolojinin varlığını değerlendirmek. Bu çalışma aynı zamanda hafta sonu fenomeninin, acil oftalmolojik konsültasyon taleplerini etkileyip etkilemediğini belirlemeyi amaçladı.

Materyal ve Metot: Türkiye'de bir üçüncü basamak hastanenin akademik acil servisini Ocak-Aralık 2019 tarihleri arasında ziyaret eden hastalar için acil hekimi tarafından talep edilen oftalmoloji konsültasyonları geriye dönük olarak incelendi. Konsültasyon talepleri olası acil, acil olması muhtemel olmayan ve belirsiz olarak gruplandırıldı.

Bulgular: Çalışmaya uygun toplam 256 hasta dahil edildi. Acil oftalmolojik konsültasyonların ilk üç nedeni künt travma (% 29,7), yabancı cisim (% 24,2) ve konjonktivit (% 13,3) idi. Hastaların % 70,3'ü olası acil, % 18,4'ü acil olması muhtemel olmayan ve % 11,3'ü belirsiz olarak kategorize edildi. Hafta sonları ve mesai saatleri dışında acil olması muhtemel olmayan olan tanılarla konsültasyon isteme sıklığı, hafta içi ve mesai saatlerine göre daha düşüktü (sırasıyla p=0.032, p=0.029). Olası acil konsültasyonların çoğunda oftalmik patoloji vardı (p =0.001).

Sonuç: Travmatik yaralanmalar acil serviste oftalmoloji konsültasyonunun en sık nedenidir. Hastaların yaklaşık beşte biri acil olması muhtemel olmayanlardır. Olası acil kategorideki hastalarda erken oftalmoloji değerlendirmesi gereklidir. Hafta sonu etkisi, oftalmoloji konsültasyonlarını etkilememektedir. Göz acil servislerinin kurulması veya bir göz doktorunun bulunması özel uygulama becerisi gerektiren bu hastaların acil tanı ve tedavisinde büyük öneme sahiptir.

Anahtar Kelimeler

• Acil servis
• hafta sonu
• konsültasyon
• oftalmoloji

Examination of Emergency Ophthalmologic Consultations in Terms of Urgency, Ophthalmic Pathology, and the Weekend Effect

Abstract

Aim: To evaluate the urgency of ophthalmology consultations in the emergency department (ED) and the presence of ophthalmic pathology. This study also aimed to determine whether the weekend phenomenon affected emergency ophthalmologic consultation requests.

Materials and Methods: Ophthalmology consultations requested by the emergency physician for patients who visited the academic ED of a tertiary care hospital in Turkey from January to December 2019 were retrospectively investigated. Consultation requests were grouped as possible emergent, unlikely to be emergent, and undetermined.

Results: A total of 256 eligible patients were included in the study. The top three reasons for emergency ophthalmologic consultations were blunt trauma (29.7%), foreign body (24.2%), and conjunctivitis (13.3%). 70.3% of the patients were categorized as a possible emergent, 18.4% as unlikely to be emergent, and 11.3% undetermined. The frequency of consultation requests with diagnoses that are unlikely to be emergent at weekends and out of working hours was lower than during weekdays and working hours (p = 0.032, p = 0.029, respectively). Most of the possible emergent consultations had ophthalmic pathology (p = 0.001).

Conclusion: Traumatic injuries are the most common cause of ophthalmology consultation in the ED. Approximately one-fifth of patients are unlikely to be emergent. Early ophthalmology evaluation is required in possible emergent category patients. The weekend effect does not influence ophthalmology consultations. Establishing eye emergency services or having an available ophthalmologist is crucial in the emergency diagnosis and treatment of patients who require special practice skills.

Keywords

• Consultation
• emergency department
• ophthalmology
• weekend

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