Department of Emergency Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
ALESOPI Consulting, Paris, France.
Medicine (Baltimore). 2023 Sep 29;102(39):e35194. doi: 10.1097/MD.0000000000035194.
Presentations to the emergency department (ED) are growing worldwide. With the increasing risk factors of non-communicable disease (NCD) and communicable diseases (CD) in low- and middle-income countries, it is crucial to understand how ED presentations are changing with time to meet patients' needs and allocate acute care resources. The aim of this study is to compare the changes in patient and diseases characteristics over 2 time periods 10 year apart at the largest tertiary care center in Lebanon. This was a retrospective descriptive study of patients presenting to the ED at a large tertiary care center in 2009/2010 and 2018/2019. The discharge diagnoses were coded into Clinical Classification Software codes. We used descriptive statistics, odds ratios (OR), and non-parametric test to compare the different diagnoses. The total number of ED visits increased by 33% from 2009/2010 to 2018/2019. The highest increase rate was among patients older than 65 years (2.6%), whereas the percentage of pediatric patients decreased from 30.8% to 25.3%. ED presentations shifted from NCD to CD. A shift in the discharge diagnoses was also noted within age groups, specifically a shift in cardiovascular diseases to a younger age. Our study suggests that the role of the ED is changing and moving towards treating the aging population and CD. There is a need to invest and mitigate CD, better allocate resources to accommodate the aging population, focus on awareness campaigns targeting early detection of cardiovascular diseases and modifying its risk factors.
急诊科就诊呈上升趋势。随着中低收入国家非传染性疾病（NCD）和传染性疾病（CD）风险因素的增加，了解急诊科就诊随时间变化的情况，以满足患者的需求并分配急性护理资源至关重要。本研究旨在比较黎巴嫩最大的三级保健中心相隔 10 年的两个时间点患者和疾病特征的变化。这是一项回顾性描述性研究，纳入了 2009/2010 年和 2018/2019 年在一家大型三级保健中心就诊的急诊科患者。出院诊断被编码为临床分类软件代码。我们使用描述性统计、比值比（OR）和非参数检验来比较不同的诊断。急诊科就诊次数从 2009/2010 年增加了 33%。65 岁以上患者的增长率最高（2.6%），而儿科患者的比例从 30.8%下降到 25.3%。急诊科就诊从 NCD 转移到 CD。各年龄组的出院诊断也发生了变化，特别是心血管疾病向更年轻的年龄转移。我们的研究表明，急诊科的作用正在发生变化，开始治疗老年人口和 CD。需要投资和减轻 CD 的影响，更好地分配资源以适应老年人口，注重针对心血管疾病早期发现和改变其风险因素的宣传活动。
