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).