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

Mohammed S. Alshahrani (), Dunya Alfaraj, Jehan AlHumaid, Khalid Alshahrani, Aisha Alsubaie, Nasser Almulhim, Dana Althawadi, Salah Alam, Malak Alzahrani, Hassan Alwosibai, Abdullah Alshahrani, Rawan Makhdom, Faisal Alkhadra, Sukayna Al-faraj, Saad Al-Qahtani, Amal AlSulaibikh, Mohammed Al Jumaan, Laila Perlas Asonto, Sarah Alahmadi, Mohannad Alghamdi and Mohammed Al-Mulhim
Additional contact information
Mohammed S. Alshahrani: Emergency Medicine and Intensive Care Departments, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Dunya Alfaraj: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Jehan AlHumaid: Preventive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Khalid Alshahrani: College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Aisha Alsubaie: Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
Nasser Almulhim: Emergency Department, King Fahad Hospital (KFU), Hofuf 36277, Saudi Arabia
Dana Althawadi: Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
Salah Alam: Department of Emergency, King Hamad University Hospital, Road 2835, Busaiteen P.O. Box 24343, Bahrain
Malak Alzahrani: College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Hassan Alwosibai: Emergency Department, King Fahad Hospital (KFU), Hofuf 36277, Saudi Arabia
Abdullah Alshahrani: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Rawan Makhdom: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Faisal Alkhadra: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Sukayna Al-faraj: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Saad Al-Qahtani: Department of Orthopedic Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Amal AlSulaibikh: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Mohammed Al Jumaan: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Laila Perlas Asonto: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Sarah Alahmadi: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Mohannad Alghamdi: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
Mohammed Al-Mulhim: Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia

IJERPH, 2022, vol. 19, issue 16, 1-10

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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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