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Volume 19
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10.3390/ijerph19169818
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Article

Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study

by
Mohammed S. Alshahrani
1,2,*,
Dunya Alfaraj
3,
Jehan AlHumaid
4,
Khalid Alshahrani
2,
Aisha Alsubaie
5,
Nasser Almulhim
6,
Dana Althawadi
5,
Salah Alam
5,
Malak Alzahrani
2,
Hassan Alwosibai
6,
Abdullah Alshahrani
3,
Rawan Makhdom
3,
Faisal Alkhadra
3,
Sukayna Al-faraj
3,
Saad Al-Qahtani
7,
Amal AlSulaibikh
3,
Mohammed Al Jumaan
3,
Laila Perlas Asonto
3,
Sarah Alahmadi
3,
Mohannad Alghamdi
3 and
Mohammed Al-Mulhim
3add Show full author list remove Hide full author list
1
Emergency Medicine and Intensive Care Departments, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
2
College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
3
Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
4
Preventive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
5
Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
6
Emergency Department, King Fahad Hospital (KFU), Hofuf 36277, Saudi Arabia
7
Department of Orthopedic Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(16), 9818; https://doi.org/10.3390/ijerph19169818
Submission received: 26 June 2022 / Revised: 7 August 2022 / Accepted: 8 August 2022 / Published: 9 August 2022
(This article belongs to the Section Health Care Sciences & Services)
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Abstract

Objective: The coronavirus disease (COVID-19) pandemic has disrupted healthcare systems worldwide, resulting in decreased and delayed hospital visits of patients with non-COVID-19-related acute emergencies. We evaluated the impact of the COVID-19 pandemic on the presentation and outcomes of patients with non-COVID-19-related medical and surgical emergencies. Method: All non-COVID-19-related patients hospitalized through emergency departments in three tertiary care hospitals in Saudi Arabia and Bahrain in June and July 2020 were enrolled and categorized into delayed and non-delayed groups (presentation ≥/=24 or <24 h after onset of symptom). Primary outcome was the prevalence and cause of delayed presentation; secondary outcomes included comparative 28-day clinical outcomes (i.e., 28-day mortality, intensive care unit (ICU) admission, invasive mechanical ventilation, and acute surgical interventions). Mean, median, and IQR were used to calculate the primary outcomes and inferential statistics including chi-square/Fisher exact test, t-test where appropriate were used for comparisons. Stepwise multivariate regression analysis was performed to identify the factors associated with delay in seeking medical attention. Results: In total, 24,129 patients visited emergency departments during the study period, compared to 48,734 patients in the year 2019. Of the 256 hospitalized patients with non-COVID-19-related diagnoses, 134 (52%) had delayed presentation. Fear of COVID-19 and curfew-related restrictions represented 46 (34%) and 25 (19%) of the reasons for delay. The 28-day mortality rates were significantly higher among delayed patients vs. non-delayed patients (n = 14, 10.4% vs. n = 3, 2.5%, OR: 4.628 (CI: 1.296–16.520), p = 0.038). Conclusion: More than half of hospitalized patients with non-COVID-19-related diagnoses had delayed presentation to the ED where mortality was found to be significantly higher in this group. Fear of COVID-19 and curfew restrictions were the main reasons for delaying hospital visit.
Keywords: delayed presentation; non-COVID-19 emergencies; emergency department delayed presentation; non-COVID-19 emergencies; emergency department

Share and Cite

MDPI and ACS Style

Alshahrani, M.S.; Alfaraj, D.; AlHumaid, J.; Alshahrani, K.; Alsubaie, A.; Almulhim, N.; Althawadi, D.; Alam, S.; Alzahrani, M.; Alwosibai, H.; et al. Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study. Int. J. Environ. Res. Public Health 2022, 19, 9818. https://doi.org/10.3390/ijerph19169818

AMA Style

Alshahrani MS, Alfaraj D, AlHumaid J, Alshahrani K, Alsubaie A, Almulhim N, Althawadi D, Alam S, Alzahrani M, Alwosibai H, et al. Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study. International Journal of Environmental Research and Public Health. 2022; 19(16):9818. https://doi.org/10.3390/ijerph19169818

Chicago/Turabian Style

Alshahrani, Mohammed S., Dunya Alfaraj, Jehan AlHumaid, Khalid Alshahrani, Aisha Alsubaie, Nasser Almulhim, Dana Althawadi, Salah Alam, Malak Alzahrani, Hassan Alwosibai, and et al. 2022. "Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study" International Journal of Environmental Research and Public Health 19, no. 16: 9818. https://doi.org/10.3390/ijerph19169818

APA Style

Alshahrani, M. S., Alfaraj, D., AlHumaid, J., Alshahrani, K., Alsubaie, A., Almulhim, N., Althawadi, D., Alam, S., Alzahrani, M., Alwosibai, H., Alshahrani, A., Makhdom, R., Alkhadra, F., Al-faraj, S., Al-Qahtani, S., AlSulaibikh, A., Jumaan, M. A., Asonto, L. P., Alahmadi, S., ... Al-Mulhim, M. (2022). Prevalence, Causes, and Adverse Clinical Impact of Delayed Presentation of Non-COVID-19-Related Emergencies during the COVID-19 Pandemic: Findings from a Multicenter Observational Study. International Journal of Environmental Research and Public Health, 19(16), 9818. https://doi.org/10.3390/ijerph19169818

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