检查急诊科疼痛患者再次入院的情况和原因

Oya Güven, Fatma Nazlı Ünkazan
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Patients were classified as traumatic/non-traumatic (patients who requested extremity radiography or tomography were considered traumatic). The files were retrospectively scanned to determine the treatments administered to specific patients in the emergency department. It was investigated whether these patients subsequently sought treatment in the relevant branches, such as neurosurgery, orthopedics, or physical medicine and rehabilitation outpatient clinics, within one month. Furthermore, the patients' re-admission to the emergency service within one month were examined. Results: A total of 1742 patient files were included in the study. 50.8% of the patients were male, and the mean age was 41.9±17.3. It was determined that 1407 patients (80.8%) were treated in the emergency department, and the highest rate (61.2%) was intramuscular (IM) injection. The rate of going to the outpatient clinic was 17.6%, and the mean time of being examined was 2±5.4 days. 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摘要

目的:疼痛是急诊科入院患者的基本症状,但很少有研究关注其影响。本研究旨在确定诊断为疼痛的患者的入院率,并评估一个月内再次进入急诊科的比率。此外,还将通过研究市中心唯一一家医院和该省最大医院的急诊服务数据,确定该患者群体重返急诊科的原因。材料和方法本研究选取了 2021 年 1 月 1 日至 12 月 31 日期间以肌肉骨骼疼痛为主诉到急诊科就诊,并在系统中输入 R52、M25、M54 和 M79 ICD 代码(及其分组)作为诊断的患者。患者被分为外伤性/非外伤性(要求进行四肢放射摄影或断层摄影的患者被视为外伤性患者)。对档案进行回顾性扫描,以确定急诊科对特定患者采取的治疗方法。此外,还调查了这些患者是否在一个月内到神经外科、骨科或物理医学和康复门诊等相关科室就诊。此外,还调查了患者在一个月内再次进入急诊服务的情况。研究结果研究共纳入了 1742 份患者档案。50.8%的患者为男性,平均年龄为(41.9±17.3)岁。经测定,1407 名患者(80.8%)在急诊科接受治疗,其中肌肉注射(IM)的比例最高(61.2%)。门诊就诊率为 17.6%,平均检查时间为 2±5.4 天。据观察,30.4%的患者再次进入急诊科。根据患者是否有外伤史将其分为两组。两组患者中男性比例均较高(P>0.05),有外伤史的患者平均年龄较低(35±18.6)岁。无外伤患者再次入住急诊科的比例明显高于另一组(P<0.05)。无外伤组患者在相关综合医院接受检查的比例更高(17.8%)。结论本研究发现,因疼痛主诉到急诊科就诊的患者比例较高。此外,无外伤患者在门诊检查后再次入院的比例也很高。很明显,要有效控制这些患者的疼痛可能需要大量时间。反复急诊入院的原因可能是疼痛症状持续存在
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Examination of re-admission and causes with pain patients in the emergency department
Objective: Pain is an essential symptom in emergency department admissions, but few studies have focused on its effect. This study aimed to determine the admission rates of patients with a pain diagnosis and to evaluate the rate of re-admissions to the emergency service within one month. Also, this patient group will determine the reasons for returning to the emergency department by examining the emergency service data of the only hospital in the city centre and the largest in the province. Material and Methods: In this study, patients who presented to the emergency department with a complaint of musculoskeletal pain between January 1 and December 31, 2021, and entered the R52, M25, M54, and M79 ICD codes (and their subgroups) as a diagnosis into the system were selected. Patients were classified as traumatic/non-traumatic (patients who requested extremity radiography or tomography were considered traumatic). The files were retrospectively scanned to determine the treatments administered to specific patients in the emergency department. It was investigated whether these patients subsequently sought treatment in the relevant branches, such as neurosurgery, orthopedics, or physical medicine and rehabilitation outpatient clinics, within one month. Furthermore, the patients' re-admission to the emergency service within one month were examined. Results: A total of 1742 patient files were included in the study. 50.8% of the patients were male, and the mean age was 41.9±17.3. It was determined that 1407 patients (80.8%) were treated in the emergency department, and the highest rate (61.2%) was intramuscular (IM) injection. The rate of going to the outpatient clinic was 17.6%, and the mean time of being examined was 2±5.4 days. It was observed that 30.4% of the patients were admitted to the emergency department again. The patients were divided into two groups according to whether they had a history of trauma or not. The ratio of male patients was higher in both groups (p>0.05), and the mean age of patients with trauma was lower (35±18.6). The rate of re-admission to the emergency department of the patients without trauma was significantly higher than the other group (p<0.05). The rate of being examined in the relevant polyclinic was higher in the group without trauma (17.8%). Conclusion: This study found a high admission rate to the emergency department for patients presenting with pain complaints. Furthermore, there was a notable high re-admission rate among patients without trauma following outpatient clinic examinations. It is evident that achieving effective pain control for these patients may require a significant amount of time. The recurrent emergency admissions may be attributed to persistent pain complaints
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