Retrospective analysis of admissions to the emergency department of an urban state hospital: A cross-sectional study of 5,279,630 patient visits (2019–2024)

The study aims to comprehensively evaluate the demographic data, diagnostic spectrum, and temporal changes of 5.3 million patients in a state hospital emergency department in an urban area of Istanbul between 2019 and 2024. Data of 5,279,033 patients admitted to Sultanbeyli State Hospital Emergency Department between 2019 and 2024 were retrospectively analyzed. Sociodemographic characteristics, diagnoses, time of presentation, and seasonal variables of 879,839 average annual admissions (minimum: 653,746, maximum: 1068,504) were evaluated. Upper respiratory tract diseases accounted for 26.7% to 35.2% of the admissions during the period analyzed (P < .001). A remarkable increase in the prevalence of myalgia (2019: 5.01%, 2024: 10.29%; odds ratio: 2.17, 95% confidence interval: 1.98-2.37) was observed. In terms of age distribution, while the number of applicants aged 0 to 20 years was 493,382 (48.3%) in 2019, it decreased to 101,560 (15.5%) in 2024 (P < .001). Gender: female predominance was observed in all groups over 21 years of age (odds ratio: 1.43, 95% confidence interval: 1.35-1.52). During the pandemic period (2020-2021), the diagnosis of suspected disease increased to 24.42% and significant changes were observed in emergency department admission dynamics (annual coefficient of variation: 0.68, P < .001). This large-scale epidemiologic study reveals the presentation characteristics of an urban emergency department with an annual average of 880,000 visits. The data, especially the marked variation between age groups and changes in specific diagnostic categories, are of strategic importance for planning health services. Our findings provide an evidence-based basis for the organization of emergency health services in accordance with health needs.