The analysis of patients that admit to emergency medicine with dermatological symptoms

Background and Objective: Dermatological diseases constitute 5-8% of all causes of emergency department applications. Also, these diseases rarely can threaten the extremity or life of a patient. Therefore, the aim of this study is to obtain epidemiologic information about demographic features, final diagnoses and admission rates of patients who applied to the emergency department for a dermatological complaint. Methods: This retrospective cross-sectional study was conducted between January and June, 2015 in Akdeniz University Hospital. Patients over 18 years-of-age who applied to the emergency department with one of the complaints of rash, pruritus, and edema sensation in the throat and shortness of breath due to allergy were included in the study. Patient information about age, sex, chief complaints, other health center visits prior to the application, final diagnoses, referral for dermatology department and admission rates were obtained through a computerized database of the hospital by using ICD-10 codes that were specified prior to the study according to the chief complaints of dermatological diseases. The study data were analyzed by "IBM SPSS Statistics" version 20. Results: In the study period, out of 50622, 958 (1.89%) patients applied to our ED for a dermatological complaint. 99 patients were excluded and 859 patients were included in the study. 511 (59.5%) patients were female and 348 (40.5%) patients were man. The mean age was 39.03±15 (18-89). Considering all the applications, only two patients (0.2%) had a triage category as emergent. 45.9% of all patients applied to the ED between 08:00-17:00 hours when outpatient clinics were also open and servicing. The most frequent final diagnoses were urticaria and drug eruptions. Out of all patients, 804 (93.6%) were prescribed and discharged as outpatient by ED physicians while only 55 (6.4%) patients were consulted with other departments. 19 (34.5%) of all consultations were resulted in admission to the hospital. Patients who had been referred to our ED were consulted (p=0.002) more and had a higher admission rate (p=0.034). 682 (84.8%) of all the patients who were discharged from ED never applied to the dermatology clinics for a control visit. Conclusion: It is known that patients with dermatological complaints apply to the emergency departments instead of outpatient clinics for various reasons. Regarding low control visit rates of patients to the dermatology outpatient clinics, ED physicians should also have the knowledge to recognize, treat and determine the consultation indication or admission requirements of the non-emergent dermatological diseases. Considering our study results, it may be appropriate that ED physicians' knowledge especially about urticaria and drug eruptions should be increased.