ArticleBMJ open2026
Circadian patterns of patient symptoms in a tertiary university emergency department: a single-centre retrospective analysis.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
objectivesTo evaluate emergency patient care from a chronophysiological perspective, examining circadian variations in symptom presentations and physiological parameters.Single-centre retrospective analysis.
design
settingDepartment of Emergency Medicine, Clinical Centre, University of Pécs, Hungary (August 2022 to August 2023).
participantsPatient data including symptom categories, time of presentation (divided into eight 3-hour intervals), sex and age were collected. A total of 32 977 patient records were analysed. Symptoms were classified using the PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were the circadian distribution of emergency presentations across 14 symptom categories and their variation by time of day, age and sex. Secondary outcomes included diurnal variation in hypertension-related cases, examining blood pressure, pulse rate, triage time and medication use.
resultsCardiovascular cases peaked between 09:00 and 12:00 (p<0.001), toxicological emergencies between 18:00 and 21:00 (p<0.001) and endocrine-metabolic cases between 12:00 and 15:00 (p<0.001). In hypertensive patients, the lowest systolic pressure occurred between 12:00 and 15:00 (p=0.037). More patients presented on weekdays than weekends (p=0.013).
conclusionsSymptom presentations in emergency care follow distinct circadian patterns, highlighting the influence of biological rhythms on clinical demand. Recognition of these temporal trends may support more effective ED scheduling and resource allocation.
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