Tiempos de atención por emergencias como predictor de mala evolución en pacientes adultos diagnosticados de disnea, en el Hospital General del Norte de Guayaquil IESS Los Ceibos durante el período enero-marzo de 2023.

Abstract

Introduction: Dyspnea is one of the most prevalent symptoms in patients undergoing some pathological process, its manifestation in the emergency room is frequent and its broad differential diagnosis can involve time-dependent conditions, so the response time and prolonged stay in the Emergency Room can be associated with higher mortality. Objective: To know if medical care times influence the prognosis and evolution of the patient who is treated in the emergency of a General Hospital (HG). Materials and methods: Retrospective cohort study in patients treated for dyspnea in the adult emergency room of the HG IESS Los Ceibos, between January 1 and March 31, 2023. Results: In total, 38,151 patients over 18 years of age attended the Emergency Department in During the study period, around 253 reported dyspnea (incidence 6.6 per 1,000 visits). The care time until the first care was less than 60 minutes was independently associated with mortality (OR 4.8, 95% CI 1.1-20, p=0.03) and Intensive Care Unit (ICU) requirement. The most frequent discharge diagnoses were pneumonia (36.6%), others, including atrial fibrillation, pleural effusion, interstitial disease (18.8%), Acute Respiratory Distress Syndrome (14.3%) and heart failure (12. 5%). Conclusion: Those with a waiting time of less than 60 minutes required more ICU care and their hospital stay was longer than those with a waiting time of more than 60 minutes. This could be explained because the most serious patients who come to the emergency room with dyspnea are treated earlier.