Emergency Department Admission Rates, Waiting Times, and Mortality: An Observational Study in the Tertiary Center Most Proximal to Gaza During a Military Conflict

Abstract

Objectives: Military conflicts may be ongoing and encompass multiple medical facilities. This study investigated the impact of a military conflict (“Protective Edge” PE) on emergency department (ED) function in a tertiary medical center. Methods: Visits to the ED during PE (July-August 2014) were compared with ED visits during July-August 2013 and 2015 with regard to admission rates, waiting times and 30-d mortality. Odds ratios (ORs) adjusted for confounders were used for the multivariable regression models. Results: There were 32,343 visits during PE and 74,279 visits during the comparison periods. A 13% decrease in the daily number of visits was noted. During PE, longer waiting times were found, on average 0.25 h longer, controlling for confounders. The difference in waiting times was greater in medicine and surgery. Admission rates were on average 10% higher during PE military conflict, controlling for confounders. This difference decreased to 7% controlling for the daily number of visits. Thirty-day mortality was significantly increased during PE (OR = 1.42; 95% CI: 1.18-1.70). ORs for mortality during PE were significantly higher in medicine (OR = 1.45; 95% CI: 1.15-1.81) and pediatrics (OR = 4.40; 95% CI: 1.33-14.5). Conclusions: During an ongoing military conflict, waiting times, admission rates, and mortality were statistically significantly increased.

October 7th 2023 Mass Casualty Incident in Southern Israel: Lessons for Emergency Preparedness and Management.

“…Emergency practice strengths: strengths of routine are strengths in emergency One of the major strengths of our hospital stems from frequent MCI drills, both by the Ministry of Health and independently by our emergency preparedness team. In addition, SUMC has extensive experience in actual MCIs, both in times of war 12 and in times of peace. The signi cance of well-de ned protocols cannot be overstated.…”

“…For example, during the 50 days of Protective Edge military con ict in 2014, the hospital served as the frontline and referral centre for those injured, while continuing to cover the regular needs of its catchment population. 12 October 7 th 2023 MCI uniqueness and challenges Casualty volume, in ux and ow During this unprecedented MCI of October 7 th 2023, a total of 673 injured individuals arrived at SUMC within the rst 24 hours. The rate of arrivals was described in a previous manuscript from our medical centre, showing that the maximal rate was 83 casualties per hour.…”