Impact of severe acute respiratory syndrome (SARS) outbreaks on the use of emergency department medical resources.
BACKGROUND
The impact of the severe acute respiratory syndrome (SARS) outbreak in 2003 on the emergency department (ED) medical needs of adult patients has not been elucidated. The purpose of this study was to investigate the demographic and clinical characteristics of ED adult patients before, during and after the SARS epidemic in a SARS-dedicated hospital.


METHODS
A retrospective, ED chart review was conducted, and demographic data were obtained from a computer database, for a total of 17,586 patients. Patient information, including age, gender, mode of arrival, triage category, time of visit, main diagnosis, use of ED services, and status after the ED visit, were collected and compared for pre-, early-, peak-, late-, and post-SARS epidemic stages.


RESULTS
Demographic data demonstrated a significant decrease in patient attendances per day, with a mean reduction of 92.5 +/- 8.3 patients (43.7 +/- 3.9% reduction in rate; p < 0.01) during peak- versus pre-epidemic stages, but revealed no differences in patient age and gender. The numbers of patients with ambulance transport, inter-hospital referral, and critical illnesses, including DOA, categorized as triage 1, or admitted to a ward or intensive care unit after the ED visit, were not influenced by the SARS epidemic. The number of patients with upper airway infections and suicide attempts from drug overdoses increased, but not statistically significantly. The number of patients with other diagnoses decreased progressively from early- to peak-epidemic stages, but returned to their earlier levels at the post-epidemic stage. Statistically significant decreases (p < 0.05) were noted in mean attendance at peak-versus pre- and early-epidemic stages for patients with cardiovascular disease, inflammatory or functional bowel disease, endocrine disease, dizziness or vertigo, or trauma.


CONCLUSIONS
The SARS outbreak did not eliminate the need of critically ill patients for advanced medical support. However, besides an overall decrease in patient numbers, the SARS epidemic markedly altered demographic information, clinical characteristics, and the use of medical services by adult patients in the ED of a SARS-dedicated hospital.
Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
Chien-Cheng
CC
Huang
David Hung-Tsang
DH
Yen
Hsien-Hao
HH
Huang
Wei-Fong
WF
Kao
Lee-Min
LM
Wang
Chun-I
CI
Huang
Chen-Hsen
CH
Lee
D000328:Adult; D000368:Aged; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology