Epidemiology of visits and predictors of admission at an obstetrics and gynecology emergency room in Saudi Arabia: Implications for women's health services in primary care

沙特阿拉伯妇产科急诊就诊流行病学及入院预测因素:对基层医疗妇女保健服务的启示

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Abstract

BACKGROUND: Obstetrics and gynecology emergency rooms (OB-GYN ERs) are crucial for treating acute women's health issues. However, utilization of ER services for non-urgent complaints is a challenging issue in the healthcare system and could reflect gaps in the primary healthcare (PHC) setting. OBJECTIVES: To evaluate the epidemiology of OB-GYN ER visits and identify the patterns and predictors of hospital admissions in a referral university hospital in the Eastern Province of Saudi Arabia. DESIGN: A retrospective, record-based, epidemiological study. METHODS: All OB-GYN ER visits from January to December 2022 were included. Data on patient demographics, triage levels, timing of visits, chief complaints, and admission status were collected. Logistic regression models were used to assess factors associated with hospital admission. RESULTS: Among 8781 ER visits, the median patient age was 30 years (Interquartile range: 26-36), and 85.30% were Saudi nationals. The majority of visits were triage level IV (71.84%), with only 12.46% resulting in admission. Obstetric complaints (47.44%) were the most common, followed by gastrointestinal and gynecological symptoms. Older age, higher acuity triage levels, the winter season, and visits during night or morning shifts were significantly associated with increased odds of admission. Most presenting complaints had a lower odd of admission when compared to the obstetrics complaints. CONCLUSION: The study demonstrates a substantial number of non-urgent OB-GYN ER visits, underscoring gaps in continuity of care. Strengthening PHC services and optimizing referral pathways for women's health may help reduce unnecessary ER utilization and ensure more appropriate use of emergency resources.

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