Evaluation of Patients Who Applied to the Emergency Department with Falls From the Same Level Before and After the Covid-19 Pandemic

Abstract

Trauma is one of the leading causes of death worldwide, and falls constitute a significant portion of trauma-related admissions to emergency departments. Falls may occur due tolack of care, accidents, or due to various metabolic problems or other diseases. Our study aimed to evaluate the cases that were admitted to a university hospital due to falling from the same level in the pre-pandemic and post-pandemic periods and aimed to contribute to the literature. In this cross-sectional study, 1073 patients who were admitted to a university hospital emergency department before the pandemic due to falling from the same level and 1857 patients who were admitted during the pandemic were retrospectively included. 50% of the cases were male and the average age was 59.04 ± 20.87 years. The most common causes of falls were mechanical falls with 36.2%, falls due to neurological reasons with 27.6%, and vasovagal syncope with 26.2%. While 61.1% of the cases were discharged, 24.2% were admitted to the clinic, 7.6% were admitted to the intensive care unit and 1.4% died. In conclusion it was observed that the cases presenting with the same level of fall during the pandemic period were younger, the frequency of comorbidities and additional drug use increased, and the time spent in the emergency room decreased.

Keywords

• emergency department
• fall
• covid-19

COVID-19 Pandemi Öncesive Sonrası Dönemde Acil Servise Aynı Seviyeden Düşme ile Başvuran Hastaların Değerlendirilmesi

Abstract

Travma dünya genelinde ölümlerin başlıca nedenlerinden olup düşmeler ise acil servislere travma nedenli başvuruların önemli bir kısmını oluşturmaktadır. Düşme; dikkatsizlik, kaza nedenleriyle olabileceği gibi çeşitli metabolik sorunlara veya hastalıklara bağlı olarak da meydana gelebilir. Çalışmamızda pandemi öncesi ve sonrası dönemde bir üniversite hastanesine aynı seviyeden düşme nedeniyle başvuran olguların değerlendirilmesi amaçlanmış ve literatüre katkı sağlamak hedeflenmiştir.. Kesitsel tipte olan bu çalışmaya bir üniversite hastanesi acil servisine aynı seviyeden düşme nedeniyle pandemi öncesinde başvuran 1073 ve pandemi döneminde başvuran 1857 hasta retrospektif olarak dahil edilmiştir. Olguların %50’si erkekti ve yaş ortalaması 59,04 ± 20,87 yıldı. En sık düşme nedenleri %36,2 ile mekanik düşme, %27,6 ile nörolojik nedenlere bağlı düşme ve %26,2 ile vazovagal senkop olarak belirlendi. Olguların %61,1’i taburcu olurken, %24,2’si kliniğe, %7,6’sı yoğun bakım ünitesine yatırıldı ve %1,4’ü eksitus oldu. Sonuç olarak; pandemi döneminde aynı seviyeden düşme ile başvuran olguların daha genç olduğu, ek hastalık ve ek ilaç kullanım sıklığının arttığı ve acil serviste geçirilen sürenin azaldığı gözlenmiştir.

Keywords

• acil servis
• düşme
• covid-19

Thanks

Çalışmamıza katkıda bulunan değerli hocamız Prof.Dr.Erol ARMAĞAN’a teşekkürlerimizi sunarız.

References

1. 1. Tiensoli SD, Santos MLD, Moreira AD, et al. Characteristics of elderly patients attended in an emergency room due to falls. Características dos idosos atendidos em um pronto-socorro em decorrência de queda. Rev Gaucha Enferm. 2019;40:e20180285.
2. 2. Rhyn B, Barwick A. Health Practitioners’ perceptions of falls and fall prevention in older people: A metasynthesis. Qualitative Health Research. 2019;29(1):69-79.
3. 3. Aktürk Ü, İster ED. Some features of hospitalized elderly and effects of fall behavior on fall risk. Medicine Science. 2019;8(3):606-12.
4. 4. Turk E, Tsokos M. Pathologic features of fatal fall from height. Am J Foren Pathol. 2004;25(3):194–9.
5. 5. Buckman RF, Buckman PD. Vertical deceleration trauma. Principles of management. Surg Clin North Am. 1991;71(2):331–44.
6. 6. Eren A, Arslan M, Hilal A, Cekin N. Deaths due to fall from a height in Adana. Adli Tip Bülteni. 2009;14:12–5.
7. 7. Teixeira PG, Inaba K, Hadjizacharia P, et al. Preventable or potentially preventable mortality at a mature trauma center. J Trauma. 2007; 63:1338.
8. 8. Teixeira PG, Inaba K, Salim A, et al. Preventable morbidity at a mature trauma center. Arch Surg. 2009; 144:536.

9. 9. Clement ND, Tennant C, Muwanga C. Polytrauma in the elderly: predictors of the cause and time of death. Scand J Trauma Resusc Emerg Med. 2010; 18:26.
10. 10. Shoko T, Shiraishi A, Kaji M, Otomo Y. Effect of pre-existing medical conditions on in-hospital mortality: analysis of 20,257 trauma patients in Japan. J Am Coll Surg. 2010; 211:338.
11. 11. Spaniolas K, Cheng JD, Gestring ML, et al. Ground level falls are associated with significant mortality in elderly patients. Journal of Trauma and Acute Care Surgery. 2010;69(4):821-25.
12. 12. Chee PA, McIntyre L, Ebel BE, et al. Long-term outcomes of groundlevel falls in the elderly. Journal of trauma and acute care surgery. 2014;76(2):498-503.
13. 13. Arslan T, Saraç ZF, Ersel M, Savas S. Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods. European Geriatric Medicine. 2023, doi: 10.21203/rs.3.rs-2902013/v1.
14. 14. Reschen ME, Bowen J, Novak A, et al. Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions. BMC Emergency Medicine. 2021;21(1):1-14.
15. 15. Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The impact of the COVID-19 pandemic on hospital admissions in the United States. Health Aff (Millwood). 2020;39(11):2010–7.
16. 16. Alfrey EJ, Carroll M, Tracy M, et al. Increase in trauma volume as compared to emergency department volume during the COVID-19 pandemi. Injury. 2023;54(7):110758.
17. 17. Pelicioni PHS, Lord SR. COVID-19 will severely impact older people’s lives, and in many more ways than you think! Braz J Phys Ther. 2020;24(4):293–4.
18. 18. McIntyre CC, Prichett L, McNabney MK. Impact of COVID-19 Stay- AtHome Restrictions on Falls in One Community of High-Risk Older Adults. J Appl Gerontol. 2022;41(5):1473–9.
19. 19. İlhan B, Bozdereli BG, Aydın H, et al. COVID-19 outbreak impact on emergency trauma visits and trauma surgery in a level 3 trauma center. Ir J Med Sci. 2022;191(5):2319–24.