529015例急诊患者的特征和就诊规律分析

Analysis of the Emergency Patients Characteristics and Visiting Pattern Based on 529015 Cases

目的总结我院急诊患者的特点,为急诊科的科学运行提供依据。方法收集我院2012~2019年急诊患者的就诊信息,总结急诊患者的就诊特点,分析常见疾病的疾病谱及其变化趋势。结果共收治急诊患者529015例,男∶女=1.09∶1,中位年龄20岁(0~109岁)。急诊量及急诊入院量逐年增长,分别增长150.1%和97.0%。急诊入院率15.4%,呈下降趋势。高峰月份为10~12月,每周高峰为周末,每日高峰为9~11时和14~21时。最常见的前5类病种是呼吸系统(43.6%)、消化系统(14.5%)、创伤(13.3%)、神经系统(3.4%)和心血管系统(3.3%)疾病。前十类疾病构成比在成人、儿童之间,差异均有统计学意义(P<0.05),14~17岁的构成比大小更接近于成人(主要具体疾病也一样)。45~64岁是呼吸系统疾病由下降到上升、创伤与泌尿系疾病由上升转为下降的转折年龄段。成人、儿童的呼吸系统疾病都位居首位,均呈逐年波动性上升趋势,最常见的是急性上呼吸道感染(包括急性扁桃体炎)和急性气管支气管炎(共占40.2%);创伤则分别位居第二、三位,均呈持续性下降趋势。结论急诊患者的特征和就诊规律具有普遍规律性和地域特异性的特点,目前到急诊科就诊的多数患者不适宜首选在急诊处置,急诊儿科与成人的分界年龄低于18岁可能在我国更合理。总结急诊患者的特征可以为当地急诊科建设,急诊医务人员和社会公众培训,以及政策制定提供符合本地区实际情况的流行病学依据。

Objective To analyze the characteristics of emergency patients and provide the evidence for scientific management in emergency department.Methods We collected the information of emergency patients in our hospital from 2012 to 2019 and analyzed the characteristics,visiting pattern,the spectrum and trend of common diseases.Results A total of 529015 cases of emergency patients were summarized,male∶female=1.09∶1,the median age was 20 years old(0~109 years old).The numbers of visits and admissions increased by 150.1%and 97.0%respectively,and both trends were growing by year.The admission rate was 15.4%,showing a downward trend by year.The visits peak months were from October to December,the weekly peak was on weekends,and the daily peaks were from 9:00 to 11:00 and 14:00 to 21:00.The top 5 kinds of common diseases were respiratory system(43.6%),digestive system(14.5%),trauma(13.3%),nervous system(3.4%)and cardiovascular system(3.3%)diseases,respectively.In the first 10 kinds of diseases,there were significant differences in each kind of diseases proportions between adults cases and children cases(all P<0.05),and the proportions of 14~17 years old cases were closer to that of adults cases(also for major specific diseases).The diseases proportions of 45~64 years old cases were the transition period from decline to rise in respiratory diseases and from rise to decline in trauma and urinary diseases.The respiratory diseases topped the list of diseases in both adults and children cases,showing an increasing trend with fluctuation by year,and the most common diseases were acute upper respiratory tract infection(including acute tonsillitis)and acute tracheobronchitis(total 40.2%).Trauma was the second or third ranked top diseases in adults and children respectively,showing a continuous downward trend by year.Conclusion There are general regularity and geographical specificity characteristics on visiting pattern and diseases spectrum in emergency patients.At present,most patients who come to the emergency department are not the first choice for emergency treatment,and the cut-off age belowed 18 between emergency paediatrics and adults may be more reasonable in our country.Analysis of the emergency cases characteristics can provide the epidemiological evidence which conforms to the actual situation of the region for the construction of emergency department,training of emergency medical staff and general public,and policy development.