School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.
School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia.
Int J Infect Dis. 2020 Apr;93:305-310. doi: 10.1016/j.ijid.2020.02.036. Epub 2020 Feb 25.
To identify the impact of a mass gathering event (MGE) on emergency department (ED) patient presentations with communicable diseases and underpinning syndromic indicators (SIs).
This retrospective observational cohort study was undertaken in one large public teaching hospital ED in Queensland, Australia. Routinely collected ED data for patient presentations with an ICD-10 diagnosis corresponding to a communicable disease were used to compare demographic characteristics, clinical characteristics, and outcomes before (March 23 to April 3), during (April 4 to April 15), and after (April 16 to April 27) the 2018 Commonwealth Games.
Over the study period, there were 10 595 patient presentations to the ED; 14.2% (n = 1503) were diagnosed with a communicable disease. The median age of those with a communicable disease was 8 years, 50.5% (n = 759) were female, and 24.8% (n = 373) arrived by ambulance. The most common communicable disease profile was respiratory in nature (51.4%, n = 772). The most common SI was altered breathing (24.0%, n = 185). ED length of stay (LOS) increased over the study period (pre: 160 min; during: 163 min; post: 180 min, p < 0.001).
The 2018 Commonwealth Games had an impact on ED presentations with communicable diseases, in terms of LOS. A longer LOS and higher percentage of patients with a LOS of more than 4 hrs in the ED were noted following the MGE period. This outcome indicates a potential need to continue with up-scaled services. Future research is required to understand the broader impact on other EDs in the area, and longitudinal patient follow-up is needed to determine the potential spread of communicable diseases.
识别大型集会活动(MGE)对急诊科(ED)传染病患者就诊情况以及潜在综合征指标(SIs)的影响。
本研究为澳大利亚昆士兰州一家大型公立教学医院 ED 的回顾性观察性队列研究。使用常规收集的 ED 数据,对符合传染病 ICD-10 诊断的患者进行比较,比较人口统计学特征、临床特征以及在 2018 年英联邦运动会前(3 月 23 日至 4 月 3 日)、期间(4 月 4 日至 4 月 15 日)和之后(4 月 16 日至 4 月 27 日)的结局。
研究期间,共有 10595 名患者到 ED 就诊;其中 14.2%(n=1503)被诊断为传染病。患有传染病的患者的中位年龄为 8 岁,50.5%(n=759)为女性,24.8%(n=373)通过救护车到达。最常见的传染病特征是呼吸系统疾病(51.4%,n=772)。最常见的 SI 是呼吸改变(24.0%,n=185)。ED 住院时间(LOS)在研究期间增加(前:160min;期间:163min;后:180min,p<0.001)。
2018 年英联邦运动会对 ED 传染病患者就诊情况,尤其是 LOS 产生了影响。在 MGE 后,ED 中 LOS 较长且 LOS 超过 4 小时的患者比例更高。这一结果表明,可能需要继续扩大服务规模。需要进一步研究了解该事件对该地区其他 ED 的广泛影响,还需要对患者进行长期随访以确定传染病的潜在传播情况。