2019-2022 Yılları Arasında Mevsim ve Hava Koşullarının Çocuk Acil Servis Ziyaretleri Üzerindeki Etkisi: Tek Merkezli Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı çevresel faktörlerin, özellikle olumsuz hava koşullarının, çocuk acil servis ziyaretlerinin oranı üzerindeki etkisini incelemektir. Yöntemler: Pediatrik ve acil tıpta uzmanlaşmış üçüncü basamak bir hastanede retrospektif bir analiz yapıldı. Partikül madde (PM10) ve nitrojen oksit (NOX) seviyeleri, sıcaklık, rüzgar hızı ve yağış gibi çevresel faktörlere ilişkin veriler resmi Türk kaynaklarından toplandı ve bir yıl boyunca pediatrik acil servis yatışlarıyla ilişkilendirildi. Yatışlar mevsimsel olarak kategorize edildi ve analiz edilen değişkenler arasında hasta demografisi, ziyaret ayrıntıları, tanı ve sonuçlar yer aldı ve geniş bir yelpazedeki koşullar için ICD-10 kodları kullanıldı. Bulgular: 2019-2022 yılları arasında yapılan retrospektif bir çalışmada 15 yaşından küçük 126.364 pediatrik hasta incelendi. Mevsimsel değişim kaydedildi ve en yüksek yatış sayısı 2022 sonbaharında gerçekleşti. Su ve hava kirliliği dönemlerinde yatışlar önemli ölçüde azaldı ve en büyük düşüş 2021 pandemi yılında görüldü. Pandemi sonrası dönemde ziyaret sayısında keskin bir artış oldu. Üst solunum yolu enfeksiyonları tüm vakaların %47'sini oluşturuyordu ve acil servis ziyaretlerinin önde gelen nedeniydi. Hastaların çoğu (%99) ayaktan, sadece %1'i ambulansla geldi. %0,2 oranında daha üst düzey bakıma sevk edilmesi gerekti, acil servis ziyaretlerinin %3'ü hastane yatışlarıyla sonuçlandı ve bunların %5'i yoğun bakım gerektirdi. Ziyaret sıklığı çevresel faktörlerle ilişkiliydi ve olumsuz hava koşullarında daha az ziyaret meydana geldi (P<,001). Aşırı hava koşulları veya kirlilik olayları sırasında bile, üst solunum yolu enfeksiyonları baskın tanı olmaya devam etti; bu da çevresel faktörlerin bu durumların aciliyetini azaltmadığını gösteriyor. Sonuç: Bu çalışma, özellikle çocukların daha sıcak hava nedeniyle daha fazla açık hava aktivitesine katıldığı yaz aylarında çevresel faktörlerin çocuk acil servis ziyaretlerini etkilediğini buldu. Elde edilen sonuçlarla, sağlık sistemleri kaynakları tahsis edebilir ve acil sağlık hizmetleri altyapısının dayanıklılığını artırma amacıyla çocuklara yönelik bakım sunumunu optimize eden yanıt stratejileri geliştirebilir.

Keywords

• Pediatrik Acil Tıp
• Çevresel Sağlık Etkisi
• Hava Kalitesi ve Çocuk Sağlığı
• Pediatri Acil Servisine Kabulde Mevsimsel Değişim
• Pediatrik Sağlık Hizmeti Kullanım Modelleri

The Impact of Weather and Air Conditions on Pediatric Emergency Department Visits in 20192022: A Single-Center Study

Abstract

Objective: This study aimed to explore the impact of environmental factors, specifically adverse weather conditions, on the rate of pediatric emergency department visits. Methods: A retrospective analysis was performed at a tertiary care hospital specializing in pediatric and emergency medicine. Data on environmental factors, including particulate matter (PM10) and nitrogen oxide (NOX) levels, temperature, wind speed, and precipitation, were collected from official Turkish sources and correlated with pediatric emergency department admissions over a year. Admissions were categorized seasonally, and analyzed variables included patient demographics, visit details, diagnosis, and outcomes, utilizing ICD-10 codes for a broad range of conditions. Results: A retrospective study from 2019 to 2022 investigated 126,364 pediatric patients aged < 15 years. Seasonal variation was noted, with the highest number of admissions in the fall of 2022. Admissions significantly decreased during periods of water and air pollution, with the most substantial decline seen during the pandemic year of 2021. During the post-pandemic period, there was a sharp increase in the number of visits. Upper respiratory tract infections (URTIs) constitute 47% of all cases and are the leading cause of emergency department visits. The majority of patients (99%) walked, whereas only 1% arrived by ambulance. (0.2%) required referral to higher-level care, and 3% of emergency visits resulted in hospital admissions, of which 5% required intensive care. The frequency of visits was correlated with environmental factors, with fewer visits occurring during adverse weather conditions (P<.001). URTIs remained the predominant diagnosis, even during extreme weather or pollution events, suggesting that such environmental factors did not diminish the urgency of these conditions. Conclusion: This study found that environmental factors influence child emergency room visits, particularly during summer when children engage in more outdoor activities due to warmer weather. Based on the results obtained, health systems are able to allocate resources and formulate response strategies that enhance the provision of care for children, thereby increasing the resilience of the emergency health services infrastructure.

Keywords

• Pediatric Emergency Medicine
• Environmental Health Impact
• Air Quality and Child Health
• Seasonal Variation in PED Admissions
• Pediatric Healthcare Utilization Patterns

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