| Abstract | Cilj istraživanja: Analiza morbiditeta na hitnom neurološkom prijemu (HNP) KBC-a Split, utvrditi stupanj opterećenosti HNP-a, procijeniti opravdanost dolazaka na HNP, te utvrditi najučestalije dijagnoze na HNP-u.Materijal i metode: Retrospektivnim istraživanjem obuhvaćene su sve punoljetne osobe koje su od 01. siječnja do 31. prosinca 2015. godine primljene u ambulantu hitnog neurološkog prijema KBC-a Split. Podatci prikupljeni iz protokola hitnog neurološkog prijema KBC-a Split za svakog pacijenta uključivali su: kalendarski mjesec, datum, dan u tjednu i vrijeme (sat) prijema, dob, spol, konzilijarni pregled, dijagnozu i odluku na prijemu. Prikupljeni podatci uneseni su u Microsoft Excel, te statistički obrađeni preko MedCalc software-a. Rezultati: Na HNP ukupno je primljeno 8146 pacijenata, od kojih 3589 (44,1%) su muškarci, dok 4557 (55,9%) čine žene, (P<0,0001, 2=114,791). Nije bilo statistički značajne razlike u dobi u odnosu na spol pacijenata. Najviše pregleda je bilo u srpnju, a najmanje u travnju, (P=0,0002, 2=35,599). Prema danima u tjednu, najviše pregleda obavljeno je ponedjeljkom (1411), a najmanje subotom (932) i nedjeljom (820). Najveći broj bolesnika primljen je na HNP tijekom dana i to u poslijepodnevnim satima (13-18 sati), dok je najveći broj pregleda obavljen između 10 i 11 sati, a najmanji između 4 i 5 sati ujutro (P<0,0001, 2=3763,268). Ambulantno je obrađeno 4187 (51,4%) pacijenata, što je bilo statistički značajno (P<0,0001, 2=6175,434). Utvrđeno je deset najučestalijih dijagnoza koje obuhvaćaju 91,6% svih postavljenih dijagnoza na HNP-u. Statistički značajno najučestalije postavljena dijagnoza je moždani udar (P<0,0001, 2=38597,601) koju je imalo 1822 (22,4%) pacijenta. Najviša prosječna dob je utvrđena kod pacijenata s dijagnozom moždanog udara (76 godina), a najniža kod epilepsije (47 godina).Zaključci: Prenapučenost HNP-a (prosječno dnevno 22 pregleda) mogla bi se riješiti uspostavom objedinjenog hitnog bolničkog prijema. Više od polovice ukupno primljenih pacijenata (51,4%) je ambulantno obrađeno, što ukazuje na neopravdanost dolazaka na HNP, kao i nedostatnu trijažu kroz primarnu zdravstvenu zaštitu te hitnu medicinsku pomoć. Od deset najučestalijih dijagnoza na HNP-u, moždani udar čini 24,43% zbog čega je potrebno bolje razumijevanje rizičnih čimbenika u cilju primarne i sekundarne prevencije. |
| Abstract (english) | Objectives: Analysis of morbidities on an Emergency Neurological Department (END) in KBC Split, determine the degree of the overcrowding problem. Determine the degree of necessity of the visit to END.Material and Methods: This retrospective study included all patients over the age of 18 admitted to the END of the University Medical Center of Split from the 1 st of January till the 31 st of December 2015. Information were collected from the protocols of the END and included patients age, gender, time of arrival (date and hour), diagnosis and medical decision. Gathered information were analysed using MedCalc software.Results: Total of 8146 patients were admitted to the END of whom 3589 (44.1%) were males and 4557 (55,9%) were females (P<0,0001, 2=114,791). There were no statistically significant differences in patients age according to gender. Most of the examinations were performed in July and least in April (P=0,0002, 2=35,599). According to the days of the week most examinations were performed on Mondays (1411) and least on Saturdays (932) and Sundays (820). Most patients were admitted to the END during afternoon (1 p.m. to 6 p.m.). Most of examinations were performed between 10 a.m. and 11 a.m. and least between 4 a.m. and 5 a.m. (P<0.0001, 2=3763.268). Most of the patients (n=4187, 51,4%) were ambulatory processed, which was statistically significant (P<0.0001, 2=6175.434). Ten most common diagnoses were 91.6% of all the diagnoses on the END. The most common diagnosis was brain stroke (22.4%) (P<0.0001, 2=38597.601). The age average was highest in patients diagnosed with stroke (76 years) and the lowest in patients with epilepsy (47 years). Conclusions: Overcrowding END (daily average of 22 examinations) could be solved by establishing a unified Emergency Department of the Split University Medical Center. More than half patients admitted were ambulatory (51.4%) and were sent home after examination and symptomatic treatment which indicates unjustified arrivals to the END and the lack of screening in primary health care and emergency medical help. Of the ten most common diagnosis of the END the stroke made 24.43% indicating a need for a better understanding of risk factors for the purpose of primary and secondary prevention. |
