综合性医院急诊科急危重疾病早期诊断率及影响因素分析

The Early Diagnostic Rate of the Acute and Critical Diseases and Its Influencing Factors in Emergency Department of General Gospital

目的分析就诊于综合性医院急诊内科门诊患者急、危重疾病的早期诊断率及影响因素。方法将2014年9月1日至2015年2月28日就诊于内蒙古医科大学附属医院急诊内科门诊的全部患者入选。将就诊的患者记录从入急诊室至确诊的时间,建立计数资料统计表,分别统计就诊后不同时间段急、危重疾病确诊率,分析影响急诊科疾病早期诊断率的主要因素。结果从2014年9月1日至2015年2月28日共就诊于急诊内科的人数为19 230人次,其中确诊的急、危重症患者为1 419人次。不同急危重疾病早期诊断率不同,用非条件Logistic回归模型进行多因素分析后结果显示:首诊思维方式、相关辅助检查及时到位、患者和/或家属配合程度及就诊时间段是急诊科急、危重疾病早期诊断率的独立影响因素。结论多因素影响急诊科急、危重疾病早期诊断率,医院、医生、患者及家属需共同努力多方面控制这些影响因素,提高急诊科疾病早期诊断率。

Objective To analyze the early diagnostic rate of the acute and critical diseases and its influenc- ing factors in emergency internal medicine of general hospital. Methods All the patients who visited the emer- gency internal medicine of Affiliated Hospital of Inner Mongolia Medical University from 1st September 2014 to 28th February 2015 were selected. The time from the patients who arrived the emergency department to who had clear diagnose was recorded, and count data was created. The diagnostic rate of the acute and critical dis- eases in differentperiod was counted and influencing factors were analyzed. Results 19 230 person - time were included, and 1 419 were acute and critical. Different diseases had various early diagnostic rate. Multiple factor Logistic regression analysis show that mode of thinking in first - diagnosis, assistant examination in place, pa- tient compliance and visiting periods of time are independent influencing factors of early diagnostic rate. Conclu- sions There are multiple factors who influence early diagnostic rate of the acute and critical diseases in emer- gency department, in which the hospital, doctors and patients all play a key role.