Revista nº 815

Lacorzana J, et al. | Use of emergency department during COVID-19 pandemic 29 Actual Med.2022;107(815):27- 33 The classification of patients was divided into five priorities according to the Manchester Triage System (MTS). The MTS is a priority classification system for patients in the EDs and it is widely used in Europe. This system classifies the patients into five colors, indicating the urgency levels and the ideal timing for delivering the first medical care: red (immediate, emergency; priority 1), orange (within 10 minutes, very urgent; priority 2), yellow (within 60 minutes, urgent; priority 3), green (within 2 hours, standard; priority 4) and blue (within 4 hours, non-urgent; priority 5) (7,8). 3. RESULTS Differences in the number of admitted patients in the 3 centers comparing the same dates of 2019 and 2020 were found. Globally, the EDs of the Virgen de las Nieves complex admitted 118382 patients between the February 1 st and the July 31 st in 2019, and 71236 patients during the same period of 2020; this difference represents a 38.83% of overall reduction in the number of admissions. Reduction in each complex was 35.39%, 54.59%, and 34.83% (GH, CH and NTH; respectively) (Table 1). The evolution of EDs admissions in the different centers of the Hospital Complex followed a clear pattern that is shown in Fig 1. There was a marked decrease in the number of patients who came to these EDs coinciding with the beginning of the lockdown. The curve shows a slow increase in the numbers as the lockdown progressed, but still clearly different from the past year. Surroundings phase 3 of the de-scalation process, the pattern is very similar compared to 2019. Regarding hospitalizations, from February 1 st to July 31 st 2020, there were 6841 compared with 7648 in the same period in 2019, which gives an overall reduction of 10.55%. Decrease in hospitalizations in each complex was 5.30%, 33.37%, and 14.98% (GH, CH and NTH; respectively) (Table 2). The hospitalization ratios were higher than the previous year with some differences among centers (Fig 2). These rose considerably during the lockdown and continued to show peaks until phase 3. Globally, all complex was affected by the changes in the new patters of use of the EDs, however, the complex which presented higher hospitalization ratio was GH. This ratio in GH’s ED reached almost 51% in March 27 th 2020, being this ratio of 11% at the same day of 2019. Finally, they normalized concerning 2019 in that last phase. GH Patients (mean per day) CH Patients (mean per day) NTH Patients (mean per day) TOTAL Patients (mean per day) 2019 56353 (311.4) 28326 (156.5) 33703 (186.2) 118382 (654.0) 2020 36409 (200.1) 12862 (70.7) 21965 (120.9) 71236 (391.4) Table 1 . Patients admissions in Virgen de las Nieves Hospital Complex in the period covered. GH, General Hospital; CH, Children’s Hospital; NTH, Neuro-Trauma Hospital GH Patients (mean per day) CH Patients (mean per day) NTH Patients (mean per day) TOTAL Patients (mean per day) 2019 5033 (27.8) 806 (4.5) 1809 (10.0) 7648 (42.3) 2020 4766 (26.2) 537 (2.9) 1538 (8.5) 6841 (37.6) Table 2 . Patients hospitalization in Virgen de las Nieves Hospital Complex in the period covered. GH, General Hospital; CH, Children’s Hospital; NTH, Neuro-Trauma Hospital