Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-08T23:49:00.426Z Has data issue: false hasContentIssue false
  • English
  • Français

Emergency Department Admission Rates, Waiting Times, and Mortality: An Observational Study in the Tertiary Center Most Proximal to Gaza During a Military Conflict

Published online by Cambridge University Press:  23 August 2023

Jacob Dreiher ,
Sharon Einav ,
Shlomi Codish  and
Amit Frenkel Open the ORCID record for Amit Frenkel [Opens in a new window]
Jacob Dreiher
Affiliation:
Hospital Administration, Soroka University Medical Center, and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Sharon Einav*
Affiliation:
General Intensive Care Unit, Shaare Zedek Medical Center, and Anesthesia and Intensive Care Medicine, Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel
Shlomi Codish
Affiliation:
Hospital Administration, Soroka University Medical Center, and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Amit Frenkel
Affiliation:
General Intensive Care Unit, Soroka University Medical Center, and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
Corresponding author: Sharon Einav; Email: einav_s@szmc.org.il.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Military conflicts may be ongoing and encompass multiple medical facilities. This study investigated the impact of a military conflict (“Protective Edge” PE) on emergency department (ED) function in a tertiary medical center.

Methods:

Visits to the ED during PE (July-August 2014) were compared with ED visits during July-August 2013 and 2015 with regard to admission rates, waiting times and 30-d mortality. Odds ratios (ORs) adjusted for confounders were used for the multivariable regression models.

Results:

There were 32,343 visits during PE and 74,279 visits during the comparison periods. A 13% decrease in the daily number of visits was noted. During PE, longer waiting times were found, on average 0.25 h longer, controlling for confounders. The difference in waiting times was greater in medicine and surgery. Admission rates were on average 10% higher during PE military conflict, controlling for confounders. This difference decreased to 7% controlling for the daily number of visits. Thirty-day mortality was significantly increased during PE (OR = 1.42; 95% CI: 1.18-1.70). ORs for mortality during PE were significantly higher in medicine (OR = 1.45; 95% CI: 1.15-1.81) and pediatrics (OR = 4.40; 95% CI: 1.33-14.5).

Conclusions:

During an ongoing military conflict, waiting times, admission rates, and mortality were statistically significantly increased.

Keywords

waremergency departmentvisitsadmission rateswaiting timesmortality
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e463
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the Society for Disaster Medicine and Public Health

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Remick, NK, Shackelford, S, Oh, JS, et al. Surgeon preparedness for mass casualty events: adapting essential military surgical lessons for the home front. Am J Disaster Med. 2016;11(2):77-87.CrossRefGoogle ScholarPubMed
Copper, FA, Mayigane, LN, Yingxin, P, et al. Simulation exercises and after action reviews - analysis of outputs during 2016-2019 to strengthen global health emergency preparedness and response. Global Health. 2020;16(1):115.CrossRefGoogle ScholarPubMed
Anan, H, Otomo, Y, Kondo, H, et al. Development of Mass-casualty Life Support-CBRNE (MCLS-CBRNE) in Japan. Prehosp Disaster Med. 2016;31(5):547-550.CrossRefGoogle ScholarPubMed
Waxman, DA, Chan, EW, Pillemer, F, et al. Assessing and Improving Hospital Mass-Casualty Preparedness: a no-notice exercise. Prehosp Disaster Med. 2017;32(6):662-666.CrossRefGoogle ScholarPubMed
Park, S, Jeong, J, Song, KJ, et al. Surge capacity and mass casualty incidents preparedness of emergency departments in a metropolitan city: a regional survey study. J Korean Med Sci. 2021;36(33):e210.CrossRefGoogle Scholar
Einav, S, Aharonson-Daniel, L, Weissman, C, et al. In-hospital resource utilization during multiple casualty incidents. Ann Surg. 2006;243(4):533-540.CrossRefGoogle ScholarPubMed
Hadary, A, Schecter, W, Embon, OM, et al. Impact of military conflict on a civilian receiving hospital in a war zone. Ann Surg. 2009;249(3):502-509.CrossRefGoogle Scholar
Ashkenazi, I, Einav, S, Olsha, O, et al. The impact of age upon contingency planning for multiple-casualty incidents based on a single center’s experience. Prehosp Disaster Med. 2016;31(5):492-497.CrossRefGoogle ScholarPubMed
Kostopoulou, E, Gkentzi, D, Papasotiriou, M, et al. The impact of COVID-19 on paediatric emergency department visits. A one-year retrospective study. Pediatr Res. 2022;91(5):1257-1262.CrossRefGoogle ScholarPubMed
Lesi, OK, Igho-Osagie, E, Walton, S-J. The impact of COVID-19 pandemic on colorectal cancer patients at an NHS Foundation Trust hospital-A retrospective cohort study. Ann Med Surg (Lond). 2022;73:103182.Google ScholarPubMed
Tam, DY, Qiu, F, Manoragavan, R, et al. The impact of the COVID-19 pandemic on cardiac procedure wait list mortality in Ontario, Canada. Can J Cardiol. 2021;37(10):1547-1554.CrossRefGoogle ScholarPubMed
Burgess, L, Ray-Barruel, G, Kynoch, K. Association between emergency department length of stay and patient outcomes: a systematic review. Res Nurs Health. 2022;45(1):59-93.CrossRefGoogle ScholarPubMed