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

Yıl 2021, Cilt 6, Sayı 3, 433 - 439, 05.09.2021
https://doi.org/10.26453/otjhs.939569

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.

Kaynakça

  • Shah SM, Khanna CL. Ophthalmic emergencies for the clinician. Mayo Clin Proc. 2020;95(5):1050-1058. doi:10.1016/j.mayocp.2020.03.018
  • Jafari AK, Bozorgui S, Shahverdi N, Ameri A, Akbari MR, Salmasian H. Different causes of referral to ophthalmology emergency room. J Emerg Trauma Shock. 2012;5(1):16-22. doi:10.4103/0974-2700.93104
  • Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin North Am. 2008;26(1):35-55. doi:10.1016/j.emc.2007.10.002
  • Yiğit O, Yürüktümen A, Arslan S. Foreign body traumas of the eye managed in an emergency department of a single-institution. Ulus Travma Acil Cerrahi Derg. 2012;18(1):75-79. doi:10.5505/tjtes.2011.49354
  • Hodge C, Lawless M. Ocular emergencies. Aust Fam Physician. 2008;37(7):506-509.
  • Gilani CJ, Yang A, Yonkers M, Boysen-Osborn M. Differentiating urgent and emergent causes of acute red eye for the emergency physician. West J Emerg Med. 2017;18(3):509-517. doi:10.5811/westjem.2016.12.31798
  • Girard B, Bourcier F, Agdabede I, Laroche L. Activity and epidemiology in an ophthalmological emergency center. J Fr Ophtalmol. 2002;25(7):701-711.
  • Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001;345(9):663-668. doi:10.1056/NEJMsa003376
  • Zapf MA, Kothari AN, Markossian T, et al. The "weekend effect" in urgent general operative procedures. Surgery. 2015;158(2):508-514. doi: 10.1016/j.surg.2015.02.024
  • Adil MM, Vidal G, Beslow LA. Weekend effect in children with stroke in the nationwide inpatient sample. Stroke. 2016;47(6):1436-1443. doi:10.1161/STROKEAHA.116.013453
  • Tang L, Chen PF, Hu XQ, et al. Effect of Chinese national holidays and weekends versus weekday admission on clinical outcomes in patients with STEMI undergoing primary PCI. J Geriatr Cardiol. 2017;14(10):604-613. doi:10.11909/j.issn.1671-5411.2017.10.003
  • Channa R, Zafar SN, Canner JK, Haring RS, Schneider EB, Friedman DS. Epidemiology of eye-related emergency department visits. JAMA Ophthalmol. 2016;134(3):312-319. doi:10.1001/jamaophthalmol.2015.5778
  • Hötte GJ, De Keizer ROB. Ocular injury and emergencies around the globe. Atlas Oral Maxillofac Surg Clin North Am. 2021;29(1):19-28. doi:10.1016/j.cxom.2020.11.002
  • Kang EY, Tai WC, Lin JY, et al. Eye-related emergency department visits with ophthalmology consultation in Taiwan: Visual acuity as an indicator of ocular emergency. Sci Rep. 2020;10(1):982. doi:10.1038/s41598-020-57804-2
  • Bourdon H, Herbaut A, Trinh L, Tuil E, Girmens JF, Baudouin C. An algorithm in ophthalmic emergencies to evaluate the necessity of physical consultation during COVID-19 lockdown in Paris: Experience of the first 100 patients. J Fr Ophtalmol. 2021;44(3):307-312. doi:10.1016/j.jfo.2020.12.002
  • Boğan M, Sultanoğlu H, Demir MC, Karadağ M, Altınsoy HB. Analysis of the contents of consultations requested by the emergency department. IMC J Med Sci. 2021;15(1):004.
  • Somasundram K, Neville JJ, Sinha Y, et al. The weekend effect - How can it be mitigated? Introduction of a consultant-delivered emergency general surgical service. Ann Med Surg (Lond). 2020;57:315-320. doi:10.1016/j.amsu.2020.08.013
  • Ozdemir BA, Sinha S, Karthikesalingam A, et al. Mortality of emergency general surgical patients and associations with hospital structures and processes. Br J Anaesth. 2016;116(1):54-62. doi:10.1093/bja/aev372
  • Cram P, Hillis SL, Barnett M, Rosenthal GE. Effects of weekend admission and hospital teaching status on in-hospital mortality. Am J Med. 2004;117(3):151-157. doi:10.1016/j.amjmed.2004.02.035
  • Demir MC, Özdamar Y. Utilization trend of magnetic resonance imaging examinations in an academic emergency department and the weekend effect. J Clin Med Kaz. 2021;18(3):52-57. doi:10.23950/jcmk/10850
  • Shen Y, Lee LH. Improving the wait time to consultation at the emergency department. BMJ Open Qual. 2018;7(1):e000131. doi:10.1136/bmjoq-2017-000131
  • Demir MC, Ilhan B. Performance of the pandemic medical early warning score (PMEWS), simple triage scoring system (STSS) and confusion, uremia, respiratory rate, blood pressure and age ≥ 65 (CURB-65) score among patients with COVID-19 pneumonia in an emergency department triage setting: a retrospective study. Sao Paulo Med J. 2021;139(2):170-177. doi:10.1590/1516-3180.2020.0649.R1.10122020
  • Karakaya Z, Gökel Y, Açıkalın A, Karakaya O. Evaluation of the process and effectiveness of consultation system in the department of emergency medicine. Turkish Journal of Trauma & Emergency Surgery. 2009;15(3):210-216.

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

Yıl 2021, Cilt 6, Sayı 3, 433 - 439, 05.09.2021
https://doi.org/10.26453/otjhs.939569

Öz

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.

Kaynakça

  • Shah SM, Khanna CL. Ophthalmic emergencies for the clinician. Mayo Clin Proc. 2020;95(5):1050-1058. doi:10.1016/j.mayocp.2020.03.018
  • Jafari AK, Bozorgui S, Shahverdi N, Ameri A, Akbari MR, Salmasian H. Different causes of referral to ophthalmology emergency room. J Emerg Trauma Shock. 2012;5(1):16-22. doi:10.4103/0974-2700.93104
  • Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin North Am. 2008;26(1):35-55. doi:10.1016/j.emc.2007.10.002
  • Yiğit O, Yürüktümen A, Arslan S. Foreign body traumas of the eye managed in an emergency department of a single-institution. Ulus Travma Acil Cerrahi Derg. 2012;18(1):75-79. doi:10.5505/tjtes.2011.49354
  • Hodge C, Lawless M. Ocular emergencies. Aust Fam Physician. 2008;37(7):506-509.
  • Gilani CJ, Yang A, Yonkers M, Boysen-Osborn M. Differentiating urgent and emergent causes of acute red eye for the emergency physician. West J Emerg Med. 2017;18(3):509-517. doi:10.5811/westjem.2016.12.31798
  • Girard B, Bourcier F, Agdabede I, Laroche L. Activity and epidemiology in an ophthalmological emergency center. J Fr Ophtalmol. 2002;25(7):701-711.
  • Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001;345(9):663-668. doi:10.1056/NEJMsa003376
  • Zapf MA, Kothari AN, Markossian T, et al. The "weekend effect" in urgent general operative procedures. Surgery. 2015;158(2):508-514. doi: 10.1016/j.surg.2015.02.024
  • Adil MM, Vidal G, Beslow LA. Weekend effect in children with stroke in the nationwide inpatient sample. Stroke. 2016;47(6):1436-1443. doi:10.1161/STROKEAHA.116.013453
  • Tang L, Chen PF, Hu XQ, et al. Effect of Chinese national holidays and weekends versus weekday admission on clinical outcomes in patients with STEMI undergoing primary PCI. J Geriatr Cardiol. 2017;14(10):604-613. doi:10.11909/j.issn.1671-5411.2017.10.003
  • Channa R, Zafar SN, Canner JK, Haring RS, Schneider EB, Friedman DS. Epidemiology of eye-related emergency department visits. JAMA Ophthalmol. 2016;134(3):312-319. doi:10.1001/jamaophthalmol.2015.5778
  • Hötte GJ, De Keizer ROB. Ocular injury and emergencies around the globe. Atlas Oral Maxillofac Surg Clin North Am. 2021;29(1):19-28. doi:10.1016/j.cxom.2020.11.002
  • Kang EY, Tai WC, Lin JY, et al. Eye-related emergency department visits with ophthalmology consultation in Taiwan: Visual acuity as an indicator of ocular emergency. Sci Rep. 2020;10(1):982. doi:10.1038/s41598-020-57804-2
  • Bourdon H, Herbaut A, Trinh L, Tuil E, Girmens JF, Baudouin C. An algorithm in ophthalmic emergencies to evaluate the necessity of physical consultation during COVID-19 lockdown in Paris: Experience of the first 100 patients. J Fr Ophtalmol. 2021;44(3):307-312. doi:10.1016/j.jfo.2020.12.002
  • Boğan M, Sultanoğlu H, Demir MC, Karadağ M, Altınsoy HB. Analysis of the contents of consultations requested by the emergency department. IMC J Med Sci. 2021;15(1):004.
  • Somasundram K, Neville JJ, Sinha Y, et al. The weekend effect - How can it be mitigated? Introduction of a consultant-delivered emergency general surgical service. Ann Med Surg (Lond). 2020;57:315-320. doi:10.1016/j.amsu.2020.08.013
  • Ozdemir BA, Sinha S, Karthikesalingam A, et al. Mortality of emergency general surgical patients and associations with hospital structures and processes. Br J Anaesth. 2016;116(1):54-62. doi:10.1093/bja/aev372
  • Cram P, Hillis SL, Barnett M, Rosenthal GE. Effects of weekend admission and hospital teaching status on in-hospital mortality. Am J Med. 2004;117(3):151-157. doi:10.1016/j.amjmed.2004.02.035
  • Demir MC, Özdamar Y. Utilization trend of magnetic resonance imaging examinations in an academic emergency department and the weekend effect. J Clin Med Kaz. 2021;18(3):52-57. doi:10.23950/jcmk/10850
  • Shen Y, Lee LH. Improving the wait time to consultation at the emergency department. BMJ Open Qual. 2018;7(1):e000131. doi:10.1136/bmjoq-2017-000131
  • Demir MC, Ilhan B. Performance of the pandemic medical early warning score (PMEWS), simple triage scoring system (STSS) and confusion, uremia, respiratory rate, blood pressure and age ≥ 65 (CURB-65) score among patients with COVID-19 pneumonia in an emergency department triage setting: a retrospective study. Sao Paulo Med J. 2021;139(2):170-177. doi:10.1590/1516-3180.2020.0649.R1.10122020
  • Karakaya Z, Gökel Y, Açıkalın A, Karakaya O. Evaluation of the process and effectiveness of consultation system in the department of emergency medicine. Turkish Journal of Trauma & Emergency Surgery. 2009;15(3):210-216.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Araştırma Makalesi
Yazarlar

Mehmet Cihat DEMİR (Sorumlu Yazar)
DUZCE UNIVERSITY, FACULTY OF MEDICINE
0000-0002-0106-3383
Türkiye


Mustafa BOĞAN
DÜZCE ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.
0000-0002-3238-1827
Türkiye


Hanife Tuba AKÇAM
DÜZCE ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-5111-2270
Türkiye


Hasan SULTANOĞLU
DÜZCE ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-4099-572X
Türkiye


Yasemin ÖZDAMAR
Manisa Şehir Hastanesi
0000-0002-6529-5028
Türkiye


İlter AĞAÇKIRAN
Hitit University Erol Olçok Training and Research Hospital
0000-0003-4859-2220
Türkiye

Yayımlanma Tarihi 5 Eylül 2021
Başvuru Tarihi 19 Mayıs 2021
Kabul Tarihi 29 Haziran 2021
Yayınlandığı Sayı Yıl 2021, Cilt 6, Sayı 3

Kaynak Göster

AMA Demir M. C. , Boğan M. , Akçam H. T. , Sultanoğlu H. , Özdamar Y. , Ağaçkıran İ. Examination of Emergency Ophthalmologic Consultations in Terms of Urgency, Ophthalmic Pathology, and the Weekend Effect. OTSBD. 2021; 6(3): 433-439.

İndeks:  ULAKBİM TR Dizin; Türk MedlineKaynakca.info; Türkiye Atıf DiziniSobiad Atıf DiziniIndex Copernicus; International Institute of Organized Research (I2OR) EuroPubWorldCatZDBCROSSREFCABI (CAB Abstracts and Global Health)



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