Analyzing emergency department presentations linked to secondary earthquake effects

Ömerul Faruk Aydin; Sarper Yilmaz; Mustafa Ulusoy; Mustafa Polat

doi:10.1016/j.ajem.2024.12.037

Analyzing emergency department presentations linked to secondary earthquake effects

Am J Emerg Med. 2024 Dec 15:89:61-66. doi: 10.1016/j.ajem.2024.12.037. Online ahead of print.

Authors

Ömerul Faruk Aydin¹, Sarper Yilmaz², Mustafa Ulusoy³, Mustafa Polat⁴

Affiliations

¹ Emergency Physician, Assist. Prof., MD., Department of Emergency Medicine, Faculty of Medicine, Istanbul Yeni Yüzyıl University, Istanbul, Turkey. Electronic address: omerulfaruk.aydin@yeniyuzyil.edu.tr.
² Assoc. Prof., M.D., University of Health Sciences, Dept. of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey; The Chair of the Disaster Commission of the Turkish Emergency Medicine Association, Ankara, Turkey. Electronic address: sarperyilmaz08@gmail.com.
³ Emergency Physician, MD., Department of Emergency Medicine, Izmir City Hospital, İzmir, Turkey.
⁴ Emergency Physician, Assist. Prof., MD., Department of Emergency Medicine, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Türkiye.

PMID: 39700881
DOI: 10.1016/j.ajem.2024.12.037

Abstract

Objective: The earthquakes that struck Türkiye on February 6, 2023, significantly impacted the province of Hatay. A portion of the patients presenting to emergency departments (ED) following the earthquake were exposed to secondary effects without experiencing direct physical trauma. This study aims to evaluate the demographic, clinical, and psychosocial characteristics of patients presenting to the ED during the early post-earthquake period due to secondary effects, as well as to examine the challenges encountered during this process.

Methods: This cross-sectional case study was conducted at the only tertiary healthcare center in Hatay that continued patient care after the earthquake. Data were collected between February 6, 2023, and February 27, 2023. Patients aged 18 and older who did not experience direct physical trauma during the earthquake were included in the study.

Results: A total of 1257 patients were included in the study. The median age was 41 (IQR 29-58), with 52.7 % male and 47.3 % female. Most patients were Turkish (62.5 %) and 37.5 % were Syrian. Chronic diseases worsened or a new symptom emerged in 30.5 % of the patients, medication loss (24.8 %), and psychosocial complaints (25.1 %) were the leading reasons for ED visits. The majority were triaged as green (83.1 %), followed by yellow (11.1 %) and red (5.8 %). Most patients presented on the 2nd day (252 patients) and 1st day (198 patients), with a gradual decrease in visits over the following weeks. Among the discharged patients (89.4 %), the median length of stay was 45 min (IQR 20-90). A significant shift in triage levels was observed between 2022 and 2023 (p < 0.001), with a higher proportion of green triage patients in 2023.

Conclusion: Patients affected by secondary health impacts began presenting to the ED shortly after the earthquake, with many requiring medical treatment, hospitalization, or referral. The most common reasons for ED visits were disruptions in access to medical supplies and the exacerbation of chronic diseases.

Keywords: Disaster; Earthquake; Emergency department; Immigrants; Mass casualty incidents; Preparedness; Vulnerable groups.