Results:
There were 700 and 597 pediatric admissions during the specified periods
of 2019 and 2020, respectively. The demographic and clinical
characteristics of the patients were summarized in Table 1. In 2019,
9.46% of the cases admitted to the emergency department were home
accidents; this rate was 24.43% in 2020. The ratio of female and male
patients was similar in both periods (p=0.520). The median age of the
children admitted in 2020 was significantly higher than that in 2019 (36
months vs. 33 months) (p=0.010). The children aged ≤5 were more commonly
admitted in both periods (p=0.463). The rate of the patients referred
from an initial receiving hospital significantly increased from 10.5%
in 2019 to 18.4% in 2020 (p<0.001). Emergency medical
services were used significantly and more frequently for these patients
in 2020 (p=0.011). A comparison of monthly admissions between 2019 and
2020 revealed that there was no significant difference between the
admissions during 11-31 March in 2019 and 2020, but the percentage of
the patients admitted during April 2020 was higher than those in April
2019 (38.5 % vs. 25.3%). The rates in May or 1-10 June in 2020 were
significantly lower than those in 2019 (p<0.001). There was no
significant difference between the groups in terms of the time of
admission and the time to hospital admission (p=0.732 and p=0.147,
respectively).
The main clinical presentations showed significant differences between
the groups. The proportion of falls, gastric/intestinal foreign bodies,
and penetrating stab injuries were significantly higher in 2020
(p<0.001).
Significant differences were found between the groups regarding the
diagnostic and therapeutic interventions as well. (Table 2). Although
minor surgical procedures were the most common treatment procedures in
both groups, they were more frequently performed in 2020
(p<0.001). There were no significant differences between the
groups regarding the type of urgency, the ESI triage categories, the
Glasgow Coma Scale (GCS) scores at the admission, and the type of
poisoning (p>0.05).
ESI resource utilization was homogenous in 2019, and significant
differences were found between those admitted in 2019 and 2020 regarding
resource utilization. A significantly lower proportion of the patients
(16.2%) required no resource utilization in 2020, compared to 30.8% in
2019. Those requiring more than one source were significantly more in
2020.
A total of 623 patients (89.5%) were discharged from the emergency
department during the study period in 2019, which was significantly
higher than the rate of discharge in 2020 (84.9%). A significantly
higher proportion of the patients was hospitalized in other wards in
2020 than in 2019 (3.7% vs. 1.0%) (p=0.004).
A comparison of demographic and clinical characteristics of the cases
based on the date of admission was shown in Table 3. The proportion of
female patients was significantly higher during the period of May 1 to
June 10 (p=0.015). The proportion of female patients increased
progressively from 35.0% to 52.65 during the study period. The median
age of the patients was significantly lower in this period compared to
those in the period of March 11 to April 30 (p=0.023). The majority of
the admissions occurred between 4 PM and 0 AM. A significant difference
was found in the distribution of admission time in different months
(p=0.029) (Table 3). However, the admission status, the type of
admission, the time to hospital admission after the event, and the
distribution of the main clinical presentations were similar in the
patients admitted in different months (p>0.05).
The distributions of main clinical presentation in two age groups in
2019 and 2020 were shown in Table 4. In both periods, the most common
reason for visiting the emergency room was falls in those under five
years. Significant differences were found between the age groups
regarding the complaints at admission in both years (p<0.001
for both).