Medikal uyarılara rağmen, muayeneden sonra acil servisi terk eden hastaların özellikleri
General characteristics of patients who leave emergency department againts medical advice after examination
Yazar: MURAT SARITEMUR
Danışman: DOÇ. DR. ARZU DENİZBAŞI
Marmara Üniversitesi / Tıp Fakültesi / İlk ve Acil Yardım Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2008
Konu: İlk ve Acil Yardım = Emergency and First Aid

Özet:
IObjectives: Patients with serious illnesses who leave emergency department (ED) without being treated or who are insufficiently treated burden both physicians and themselves. The aim of this study was to evaluate general characteristics of patients who leave ED against medical advice and to determine the causes and severity of their illnesses.Materials and Methods: A prospective chart was performed covering June 2007 to May 2008 including patients who were elder than 18 years and left ED against medical advice with their own consent. The general characteristics of patients, severity of their illnesses according to The Canadian Emergency Department Triage and Acuity Scale (CTAS), and length of ED stay were recorded. The causes of leaving ED were determined from the discharge consent forms filled by patients before leaving ED.Results: A total of 321 patients were included into the study. The patients who left the ED against medical advice after being examined by a physician composed 1,1 % of all emergency cases during study period. 54,2 % of the patients were triaged as `urgent'. The mean age of the study patients was 48.7 ± 18,6 years and 47,7% were male. Mean length of ED stay was 150,5 ± 149,8 minutes. One third of the patients (111 patients, 34.7%) left ED refusing to be observed in the ED. Second most frequent reason for leaving was that these patients had no domestic insurance and that they could not afford the expenses. Finally, 60 of the patients (18.7%) left due to the length of stay.Conclusion: Determining the causes of leaving ED against medical advises should contribute finding solutions to this issue.Key words: Emergency room; leave against medical advice

Abstract:
Objectives: Patients with serious illnesses who leave emergency department (ED) without being treated or who are insufficiently treated burden both physicians and themselves. The aim of this study was to evaluate general characteristics of patients who leave ED against medical advice and to determine the causes and severity of their illnesses.Materials and Methods: A prospective chart was performed covering June 2007 to May 2008 including patients who were elder than 18 years and left ED against medical advice with their own consent. The general characteristics of patients, severity of their illnesses according to The Canadian Emergency Department Triage and Acuity Scale (CTAS), and length of ED stay were recorded. The causes of leaving ED were determined from the discharge consent forms filled by patients before leaving ED.Results: A total of 321 patients were included into the study. The patients who left the ED against medical advice after being examined by a physician composed 1,1 % of all emergency cases during study period. 54,2 % of the patients were triaged as `urgent?. The mean age of the study patients was 48.7 ± 18,6 years and 47,7% were male. Mean length of ED stay was 150,5 ± 149,8 minutes. One third of the patients (111 patients, 34.7%) left ED refusing to be observed in the ED. Second most frequent reason for leaving was that these patients had no domestic insurance and that they could not afford the expenses. Finally, 60 of the patients (18.7%) left due to the length of stay.Conclusion: Determining the causes of leaving ED against medical advises should contribute finding solutions to this issue.Key words: Emergency room; leave against medical advice