Impact of Severe Acute Respiratory Syndrome (SARS) Outbreaks on the Use of Emergency Department Medical Resources
Identifieur interne : 004795 ( Main/Exploration ); précédent : 004794; suivant : 004796Impact of Severe Acute Respiratory Syndrome (SARS) Outbreaks on the Use of Emergency Department Medical Resources
Auteurs : Chien-Cheng Huang [République populaire de Chine] ; David Hung-Tsang Yen [République populaire de Chine] ; Hsien-Hao Huang [République populaire de Chine] ; Wei-Fong Kao [République populaire de Chine] ; Lee-Min Wang [République populaire de Chine] ; Chun-I Huang [République populaire de Chine] ; Chen-Hsen Lee [République populaire de Chine]Source :
- Journal of the Chinese Medical Association [ 1726-4901 ] ; 2005.
Abstract
The impact of the severe acute respiratory syndrome (SARS) outbreak in 2003 on the emergency department (ED) medical needs of adult patients has not been elucidated. The purpose of this study was to investigate the demographic and clinical characteristics of ED adult patients before, during and after the SARS epidemic in a SARS-dedicated hospital.
A retrospective, ED chart review was conducted, and demographic data were obtained from a computer database, for a total of 17,586 patients. Patient information, including age, gender, mode of arrival, triage category, time of visit, main diagnosis, use of ED services, and status after the ED visit, were collected and compared for pre-, early-, peak-, late-, and post-SARS epidemic stages.
Demographic data demonstrated a significant decrease in patient attendances per day, with a mean reduction of 92.5 ± 8.3 patients (43.7 ± 3.9% reduction in rate;
The SARS outbreak did not eliminate the need of critically ill patients for advanced medical support. However, besides an overall decrease in patient numbers, the SARS epidemic markedly altered demographic information, clinical characteristics, and the use of medical services by adult patients in the ED of a SARS-dedicated hospital.
Url:
DOI: 10.1016/S1726-4901(09)70146-7
PubMed: 15984818
PubMed Central: 7128348
Affiliations:
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Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Chen Hsen" sort="Lee, Chen Hsen" uniqKey="Lee C" first="Chen-Hsen" last="Lee">Chen-Hsen Lee</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire 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Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Yen, David Hung Tsang" sort="Yen, David Hung Tsang" uniqKey="Yen D" first="David Hung-Tsang" last="Yen">David Hung-Tsang Yen</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Huang, Hsien Hao" sort="Huang, Hsien Hao" uniqKey="Huang H" first="Hsien-Hao" last="Huang">Hsien-Hao Huang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Kao, Wei Fong" sort="Kao, Wei Fong" uniqKey="Kao W" first="Wei-Fong" last="Kao">Wei-Fong Kao</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Lee Min" sort="Wang, Lee Min" uniqKey="Wang L" first="Lee-Min" last="Wang">Lee-Min Wang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Huang, Chun I" sort="Huang, Chun I" uniqKey="Huang C" first="Chun-I" last="Huang">Chun-I Huang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Chen Hsen" sort="Lee, Chen Hsen" uniqKey="Lee C" first="Chen-Hsen" last="Lee">Chen-Hsen Lee</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of the Chinese Medical Association</title><idno type="ISSN">1726-4901</idno><idno type="eISSN">1728-7731</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The impact of the severe acute respiratory syndrome (SARS) outbreak in 2003 on the emergency department (ED) medical needs of adult patients has not been elucidated. The purpose of this study was to investigate the demographic and clinical characteristics of ED adult patients before, during and after the SARS epidemic in a SARS-dedicated hospital.</p></sec><sec><title>Methods</title><p>A retrospective, ED chart review was conducted, and demographic data were obtained from a computer database, for a total of 17,586 patients. Patient information, including age, gender, mode of arrival, triage category, time of visit, main diagnosis, use of ED services, and status after the ED visit, were collected and compared for pre-, early-, peak-, late-, and post-SARS epidemic stages.</p></sec><sec><title>Results</title><p>Demographic data demonstrated a significant decrease in patient attendances per day, with a mean reduction of 92.5 ± 8.3 patients (43.7 ± 3.9% reduction in rate; <italic>p</italic> < 0.01) during peak-versus pre-epidemic stages, but revealed no differences in patient age and gender. The numbers of patients with ambulance transport, inter-hospital referral, and critical illnesses, including DOA, categorized as triage 1, or admitted to a ward or intensive care unit after the ED visit, were not influenced by the SARS epidemic. The number of patients with upper airway infections and suicide attempts from drug overdoses increased, but not statistically significantly. The number of patients with other diagnoses decreased progressively from early- to peak-epidemic stages, but returned to their earlier levels at the post-epidemic stage. Statistically significant decreases (<italic>p</italic> < 0.05) were noted in mean attendance at peak-versus pre- and early-epidemic stages for patients with cardiovascular disease, inflammatory or functional bowel disease, endocrine disease, dizziness or vertigo, or trauma.</p></sec><sec><title>Conclusion</title><p>The SARS outbreak did not eliminate the need of critically ill patients for advanced medical support. However, besides an overall decrease in patient numbers, the SARS epidemic markedly altered demographic information, clinical characteristics, and the use of medical services by adult patients in the ED of a SARS-dedicated hospital.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Varia, M" uniqKey="Varia M">M Varia</name></author><author><name sortKey="Wilson, S" uniqKey="Wilson S">S Wilson</name></author><author><name sortKey="Sarwal, S" uniqKey="Sarwal S">S Sarwal</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author><author><name sortKey="Gournis, E" uniqKey="Gournis E">E Gournis</name></author><author><name sortKey="Galanis, E" uniqKey="Galanis E">E Galanis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Seto, Wh" uniqKey="Seto W">WH Seto</name></author><author><name sortKey="Tsang, D" uniqKey="Tsang D">D Tsang</name></author><author><name sortKey="Yung, Rw" uniqKey="Yung R">RW Yung</name></author><author><name sortKey="Ching, Ty" uniqKey="Ching T">TY Ching</name></author><author><name sortKey="Ng, Tk" uniqKey="Ng T">TK Ng</name></author><author><name sortKey="Ho, M" uniqKey="Ho M">M Ho</name></author><author><name sortKey="Ho, Lm" uniqKey="Ho L">LM Ho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ho, As" uniqKey="Ho A">AS Ho</name></author><author><name sortKey="Sung, Jj" uniqKey="Sung J">JJ Sung</name></author><author><name sortKey="Chan Yeung, M" uniqKey="Chan Yeung M">M Chan-Yeung</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Tsai, Mc" uniqKey="Tsai M">MC Tsai</name></author><author><name sortKey="Arnold, Jl" uniqKey="Arnold J">JL Arnold</name></author><author><name sortKey="Chuang, Cc" uniqKey="Chuang C">CC Chuang</name></author><author><name sortKey="Chi, Ch" uniqKey="Chi C">CH Chi</name></author><author><name sortKey="Liu, Cc" uniqKey="Liu C">CC Liu</name></author><author><name sortKey="Yang, Yj" uniqKey="Yang Y">YJ Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Man, Cy" uniqKey="Man C">CY Man</name></author><author><name sortKey="Yeung, Rs" uniqKey="Yeung R">RS Yeung</name></author><author><name sortKey="Chung, Jy" uniqKey="Chung J">JY Chung</name></author><author><name sortKey="Cameron, Pa" uniqKey="Cameron P">PA Cameron</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hsueh, Pr" uniqKey="Hsueh P">PR Hsueh</name></author><author><name sortKey="Yang, Pc" uniqKey="Yang P">PC Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chang, Hj" uniqKey="Chang H">HJ Chang</name></author><author><name sortKey="Huang, N" uniqKey="Huang N">N Huang</name></author><author><name sortKey="Lee, Ch" uniqKey="Lee C">CH Lee</name></author><author><name sortKey="Hsu, Yj" uniqKey="Hsu Y">YJ 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Taylor-Clark</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lew, Twk" uniqKey="Lew T">TWK Lew</name></author><author><name sortKey="Kwek, Tk" uniqKey="Kwek T">TK Kwek</name></author><author><name sortKey="Tai, D" uniqKey="Tai D">D Tai</name></author><author><name sortKey="Earnest, A" uniqKey="Earnest A">A Earnest</name></author><author><name sortKey="Loo, S" uniqKey="Loo S">S Loo</name></author><author><name sortKey="Singh, K" uniqKey="Singh K">K Singh</name></author><author><name sortKey="Kwan, Km" uniqKey="Kwan K">KM Kwan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Twu, Sj" uniqKey="Twu S">SJ Twu</name></author><author><name sortKey="Chen, Tj" uniqKey="Chen T">TJ Chen</name></author><author><name sortKey="Chen, Cj" uniqKey="Chen C">CJ Chen</name></author><author><name sortKey="Olsen, Sj" uniqKey="Olsen S">SJ Olsen</name></author><author><name sortKey="Lee, Lt" uniqKey="Lee L">LT Lee</name></author><author><name sortKey="Fisk, T" uniqKey="Fisk T">T Fisk</name></author><author><name sortKey="Hsu, Kh" uniqKey="Hsu K">KH Hsu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tham, Ky" uniqKey="Tham K">KY Tham</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Huang, Chien Cheng" sort="Huang, Chien Cheng" uniqKey="Huang C" first="Chien-Cheng" last="Huang">Chien-Cheng Huang</name></noRegion><name sortKey="Huang, Chun I" sort="Huang, Chun I" uniqKey="Huang C" first="Chun-I" last="Huang">Chun-I Huang</name><name sortKey="Huang, Hsien Hao" sort="Huang, Hsien Hao" uniqKey="Huang H" first="Hsien-Hao" last="Huang">Hsien-Hao Huang</name><name sortKey="Huang, Hsien Hao" sort="Huang, Hsien Hao" uniqKey="Huang H" first="Hsien-Hao" last="Huang">Hsien-Hao Huang</name><name sortKey="Kao, Wei Fong" sort="Kao, Wei Fong" uniqKey="Kao W" first="Wei-Fong" last="Kao">Wei-Fong Kao</name><name sortKey="Lee, Chen Hsen" sort="Lee, Chen Hsen" uniqKey="Lee C" first="Chen-Hsen" last="Lee">Chen-Hsen Lee</name><name sortKey="Lee, Chen Hsen" sort="Lee, Chen Hsen" uniqKey="Lee C" first="Chen-Hsen" last="Lee">Chen-Hsen Lee</name><name sortKey="Wang, Lee Min" sort="Wang, Lee Min" uniqKey="Wang L" first="Lee-Min" last="Wang">Lee-Min Wang</name><name sortKey="Yen, David Hung Tsang" sort="Yen, David Hung Tsang" uniqKey="Yen D" first="David Hung-Tsang" last="Yen">David Hung-Tsang Yen</name><name sortKey="Yen, David Hung Tsang" sort="Yen, David Hung Tsang" uniqKey="Yen D" first="David Hung-Tsang" last="Yen">David Hung-Tsang Yen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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