Prevalence of disease and complaints in homeless patients on admission to the Emergency Department at Imam Hossein Hospital, Tehran, Iran from 2012 to 2018

Background and Aim: Homelessness is a social problem with various contributory factors. This undesirable phenomenon involves various sections of civil and law enforcement in the community. The aim of this study was to determine the prevalence of disease and other complaints in homeless patients on admission to the Emergency Department of Imam Hossein Hospital, Tehran, Iran from 2012 to 2018. Methods: This retrospective descriptive study was carried out in Imam Hossein Hospital affiliated to Shahid Beheshti University of Medical Sciences. All homeless patients referring to emergency department of Imam Hossein Hospital from 2012 to 2018 were included in study. The data collection tool was a researcher-made checklist that included demographic features such as age and sex, and clinical conditions such as blood factors, hepatitis B and C status, HIV infection, blood culture, urine culture, abdominal fluid culture, complaints on admission, diagnosis and clinical outcome (discharge, operation, escape from hospital or death) of the patients. All data were collected from patients' records in emergency department. Results: The study included 1302 homeless patients who were admitted to the emergency department. The majority of patients were male (98.9 %). The mean age of all homeless patients was 45 years. The prevalence of hepatitis B, hepatitis C and HIV was 3%, 17.3% and 8.6%, respectively. The most prevalent complaints on admission were decreased level of consciousness (307 patients, 23.6%), weakness and lethargy (162 patients, 12.4%), dyspnea (154 patients, 11.8%), abdominal pain (134 patients, 10.3%) and car accident (128 people, 8.9%). MI was the most common diagnosis. The clinical outcome was 68.1% discharge and 23.7% death. There was a significant relationship between the final outcome and age, hemoglobin and hematocrit level (P<0.001). Conclusion: The prevalence of hepatitis B and C and HIV in homeless people is higher than in the general population. Due to the possibility of transmitting such diseases, the necessary planning must be made in cooperation with the Ministry of Health and Police and other relevant organisations in order to control these diseases in homeless people.