Objective: To describe the characteristics of patients with non-urgent demand to the emergency room of an urban social security hospital. Methods: Observational study in a referral hospital. Stratified random sampling, 120 patients older than 14 years of priority IV (patients without commitment to vital functions or risk of immediate complication, which can be attended in outpatient room or decentralized offices). A validated predesigned questionnaire was applied. Performing descriptive statistics with IBM SPSS 24. Results: 66% of patients were female, most frequent ages over 65 years and between 20-40 years. 47% were active workers, with high school level or higher 86%, they had 83% personal cell phone and 73% wire TV or internet at home. 63% arrived at the public transport emergency, the delay time to the hospital was 30-60 minutes in 50% of cases and <30 minutes in 28%. He did ...

Over-demand and overcrowding is a problem in the emergency department of our environment. Objective: to determine the characteristics of the demand for medical care at the emergency department of a tertiary social security hospital. Methodology: observational study at Rebagliati hospital, first quarter 2019. Sociodemographic, time and emergency indicators of the institutional statistical system, descriptive statistical statistics with IBM SPSS 24.00 were evaluated. Results: 51294 patient care between 14 and 102 years (median 60), 56.7% female sex, 18% recorded more than one visit in the quarter. Monday was the day of greatest demand and the schedule between 8 and 13 hours. Priority attention 3 and 4 corresponded to 60.8 and 20.8% of the total. The topics of medicine, relief and surgery performed 41, 22 and 20% of attentions respectively. In the shock trauma unit, 3% of attentions were pe...

Background: The symptoms and complications of urinary lithiasis are a frequent cause of emergency care. Objectives: To determine characteristics and evolution of patients with urinary lithiasis attended in the emergency room of a tertiary social security hospital. Methods: Observational study carried out at the Rebagliati hospital Lima-Peru, during the first quarter of 2019. Sociodemographic variables, time and emergency indicators of the institutional statistical system were evaluated, performing descriptive statistics with IBM SPSS 25.0. Results: 583 attentions for urinary lithiasis (194 per month) were registered, corresponding to 14% of the genito-urinary pathology seen in the evaluated service. 55% male, average age 48 years (range 14 to 92). Mainly attended by surgical topic and priority 3, most frequent causes pain, infection and hematuria. Time of first attention 4.8 hours, leavi...

Introduction. Overcrowding in emergency department of tertiary hospitals collapses its processes and prolongs waiting times. Objective. To evaluate waiting times for patients with urgent medical problems, in an emergency department after implementing a program of process improvement with facilitators. Methods. An observational study. Patients older than 14 years-old with priority III problems, who were attended between 6-23 hours, were included in the study. The team of facilitators was made up of trained administrative technicians (two each 8-hour period per day), who accelerated the diagnostic and therapeutic processes in outpatient. Waiting time for first attention and total length of stay in emergency services were measured. Results. 36 thousand attentions of priority III were evaluated, being higher in the fourth quarter of the year, on Monday, bet...

Objective: To describe the characteristics of patients with non-urgent demand to the emergency room of an urban social security hospital. Methods: Observational study in a referral hospital. Stratified random sampling, 120 patients older than 14 years of priority IV (patients without commitment to vital functions or risk of immediate complication, which can be attended in outpatient room or decentralized offices). A validated predesigned questionnaire was applied. Performing descriptive statistics with IBM SPSS 24. Results: 66% of patients were female, most frequent ages over 65 years and between 20-40 years. 47% were active workers, with high school level or higher 86%, they had 83% personal cell phone and 73% wire TV or internet at home. 63% arrived at the public transport emergency, the delay time to the hospital was 30-60 minutes in 50% of cases and <30 minutes in 28%. He did ...

La sobredemanda y hacinamiento es un problema en los servicios de  emergencia de nuestro medio. Objetivo: determinar las características de la demanda de atención médica al servicio de emergencia de un hospital terciario de la seguridad social. Metodología: estudio observacional en hospital Rebagliati, primer trimestre 2019. Se evaluó variables sociodemográficas, de tiempo e indicadores de emergencia del sistema estadístico institucional, realizando estadística descriptiva con IBM SPSS 24.00. Resultados: 51294 atenciones de pacientes entre 14 y 102 años (mediana 60), 56,7% sexo femenino, 18% registró más de una atención en el trimestre. El lunes fue el día de mayor demanda y el horario entre 8 y 13 horas. Las atenciones de prioridad III y IV correspondieron al 60,8 y 20,8% del total. Los tópicos de medicina, alivio y cirugía realizaron el 41, 22 y 20% de atenciones re...

Background: The symptoms and complications of urinary lithiasis are a frequent cause of emergency care. Objectives: To determine characteristics and evolution of patients with urinary lithiasis attended in the emergency room of a tertiary social security hospital. Methods: Observational study carried out at the Rebagliati hospital Lima-Peru, during the first quarter of 2019. Sociodemographic variables, time and emergency indicators of the institutional statistical system were evaluated, performing descriptive statistics with IBM SPSS 25.0. Results: 583 attentions for urinary lithiasis (194 per month) were registered, corresponding to 14% of the genito-urinary pathology seen in the evaluated service. 55% male, average age 48 years (range 14 to 92). Mainly attended by surgical topic and priority 3, most frequent causes pain, infection and hematuria. Time of first attention 4.8 hours, leavi...

Objetivo: Evaluar el impacto del triaje estructurado en indicadores de hacinamiento del servicio de urgencias (SU) de un hospital terciario. Material y Métodos: Estudio observacional retrospectivo de diseño pre y post. Realizado en un hospital de la seguridad social, comparando las atenciones de dos trimestres. Se evaluó la implementación de triaje estructurado de cinco prioridades tipo Manchester, comparando número de atenciones, atendidos, prioridad de atención, tópico de ingreso, pacientes no atendidos, fallecidos en las primeras 6 horas y tiempo de primera atención. Con datos del sistema institucional se realizó el análisis estadístico (intervalo de confianza de 95%) utilizando SPSS 24.0, con aprobación institucional. Resultados: 42000 atenciones por trimestre, donde el 12% fue admitida a salas de observación. Mediana de edad 57 años (rango 14 - 103), sexo femenino 57%....

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La estancia prolongada (EP) en los servicios de emergencia (SE) es un reto relevante trascendente con repercusiones sociales y sanitarias. El objetivo fue analizar los determinantes o facilitadores de la EP en las salas del SE de un hospital terciario. El presente estudio es observacional, analítico y transversal en el SE de un hospital terciario de la seguridad social de Lima-Perú, que reporta 27,000 admisiones anuales. Se incluyeron 370 historias clínicas digitales de pacientes egresados en febrero del 2024. Los determinantes o facilitadores de la estancia prolongada se agruparon en 4 dimensiones: Relacionados al personal de salud, administrativo hospitalario, del paciente y de la red sanitaria. Se aplico estadística descriptiva y para determinar asociación significativa se empleó la prueba de chi cuadrado, considerando significativo p<0.05. La mediana de la estancia en SE fue de...

La investigación analiza los determinantes de la estancia prolongada (EP) en los servicios de emergencia (SE) de un hospital terciario de Lima, Perú, durante febrero de 2024. Se realizó un estudio observacional, analítico y transversal con 370 historias clínicas digitales, agrupando los factores en dimensiones relacionadas al personal de salud, administración hospitalaria, paciente y red sanitaria. Los resultados evidenciaron que la mediana de estancia fue de 93.5 horas, con un 72% de pacientes permaneciendo más de 48 horas. La EP se asoció significativamente con la limitada disponibilidad de camas hospitalarias, ser adulto mayor, dependencia funcional total y pertenecer a la especialidad médica. Se concluye que la EP supera los estándares recomendados y está influenciada principalmente por factores administrativos y del paciente, resaltando la necesidad de optimizar la gesti�...

Objetive: To assess the impact of structured triage on overcrowding indicators in the emergency department (ED) of a tertiary hospital. Material and Methods: Retrospective observational study of pre and post design. Carried out in a social security hospital, comparing care during two quarters. The implementation of structured triage of five Manchester-type priorities was evaluated, comparing the number of visits, patients attended, priority of care, admission topic, patients not attended, patients who died in the first 6 hours and time to first attention. Statistical analysis (95% confidence interval) was performed with data from the institutional system using SPSS 24.0, with institutional approval. Results: 42000 attendances per quarter, 12% were admitted to observation wards. Median age 57 years (range 14 - 103), female 57%. Average daily number of patients admitted to the ED was 240 v...

Objective: To determine the waiting time for admission (WTA) of patients to the adult emergency department (ED) of a tertiary hospital and to identify the factors associated with their delay. Methodology: Observational cross-sectional study that included patients older than 14 years admitted during four consecutive weeks (June 2018). We evaluated waiting time from triage to emergency discharge, time between first medical attention, indication for admission to the hospital ward and its completion; the reason for delay, age, sex, priority of care, destination area and admission diagnosis were evaluated. For statistical analysis, Mann Whitney U and Chi-square tests were applied according to type of data, using SPSS-IBM 25.0. Results: 380 patients were included, 51% female, median age 69 years (Inter quartile range 18.7), most frequent reasons for admission were respiratory infection 18% and...

Objetivo. Determinar la evolución de pacientes con cirrosis hepática avanzada luego de ser admitidos al servicio de Emergencia de un hospital terciario e identificar factores asociados a mortalidad a los seis meses. Material y métodos. Estudio observacional y retrospectivo, en pacientes mayores de 18 años con cirrosis hepática avanzada (Child-Pugh estadio C) admitidos al servicio de Emergencia en un hospital terciario de febrero 2017 a agosto de 2017. Se revisó reportes médicos, historia clínica y sistema informático (seguimiento 12 meses). Análisis estadístico bivariado con el uso de SPSS 24 y según los principios éticos. Resultados. Se identificó 83 casos, con edad promedio de 68 años (± 9,5), sexo masculino 52 %, etiología alcohólica 22 % y viral 6 %. Dicinueve (23 %) de pacientes fallecieron en la primera admisión a emergencia; 61 %, a los 3 meses; 73 %, a los 6 me...

Objective. To determine the evolution of patients with advanced liver cirrhosis after being admitted to the emergency ward of a tertiary hospital and identify associated factors to mortality at six months of follow up. Material and methods. A retrospective and observational study was carried out in patients older than 18 year-old with advanced liver cirrhosis (Child-Pugh C stage) admitted to the emergency ward in a tertiary hospital, from February to August of 2017. Medical reports, clinical history and computerized files (follow-up at 12 months) were reviewed. A bivariate statistical analysis was applied using SPSS 24 and according to ethical principles.Results. We identified 83 cases, with an average age of 68 year-old (± 9.5), male 52%; 22% alcoholic and 6% viral etiology. Nineteen (23%) patients died on first admission to emergency ward, 61% at three months, 73% at 6 months and 81% ...

Introduction: The COVID-19 pandemic has caused more than 70 thousand deaths worldwide. Objective: To describe the characteristics of COVID-19 patients who died in a tertiary hospital. Methods: A descriptive study was carried out in the emergency service of the Hospital Rebagliati in Lima, Peru, which includes deceased patients with a positive result for SARS-CoV-2 infection diagnosed by PCR-TR until April 4, 2020. The medical history was reviewed. and hospital records looking for sociodemographic variables, clinical characteristics, radiological manifestations, treatment and evolution. Results: 14 cases were identified, 78.6% were male, average age 73.4 years (range 26 to 97). 21.4% of cases acquired the infection out of Peru. Risk factors were found in 92.9% of patients (more frequent elderly, hypertension and obesity). The most frequent symptoms were dyspnea, fever and cough, with illn...

Introduction: The COVID-19 pandemic has caused more than 70 thousand deaths worldwide. Objective: To describe the characteristics of COVID-19 patients who died in a tertiary hospital. Methods: A descriptive study was carried out in the emergency service of the Hospital Rebagliati in Lima, Peru, which includes deceased patients with a positive result for SARS-CoV-2 infection diagnosed by PCR-TR until April 4, 2020. The medical history was reviewed. and hospital records looking for sociodemographic variables, clinical characteristics, radiological manifestations, treatment and evolution. Results: 14 cases were identified, 78.6% were male, average age 73.4 years (range 26 to 97). 21.4% of cases acquired the infection out of Peru. Risk factors were found in 92.9% of patients (more frequent elderly, hypertension and obesity). The most frequent symptoms were dyspnea, fever and cough, with illn...

Introducción:Actualmente existe un gran interés en establecer la relación entre la severidad de la infección por SARS-COV-2 en pacientes hipertensos usuarios de antagonistas de la angiotensina II (ARAII). Estudiar la relación entre el uso Objetivo.previo de antagonistas de la ARAII en pacientes hipertensos y la mortalidad por COVID-19..Serealizóunestudioobservacional Materialesymétodosretrospectivo en un hospital de referencia en Lima, Perú, en pacientes hipertensos hospitalizados en marzo del 2021 por COVID-19 severo. Ingresaron al Resultados. estudio 101 pacientes, con una media de edad de 70,1 + 12,0 y sexo masculino 48%. Los usuarios de ARAII fueron 45 (45,6%) y no los tomaban 56 (54,4%). El Índice de comorbilidad de Charlson fue mayor en el grupo ARAII (3,6 + 1,56 vs 3,04 + 1,24) (p<0,05). La mortalidad total y por sexo (varones vs mujeres), entre los que usaban ARAII o no,...

Introduction: There is currently great interest in establishing the relationship between the severity of SARSCOV-2 infection in hypertensive patients who use angiotensin II antagonists (AIIRAs). Objective: To study the relationship between the previous use of angiotensin II antagonists (ARB) in hypertensive patients and mortality from COVID-19. Materials and methods: A retrospective observational study was carried out in a tertiary care hospital in Lima, Peru, in hypertensive patients hospitalized in March 2021 for severe COVID-19. Results: A total of 101 patients entered the study, with a mean age of 70.1 + 12.0 and 48% male. ARB users and non-users were 45 (45.6%) and 56 (54.4%), respectively. The Charlson Comorbidity Index was higher in the ARB group (3.6 + 1.56 vs 3.04 + 1.24) (p<0.05). Total and male vs women mortality, among those using ARBs or not, were 57.8% vs 62% (p = 0.633)...