Analysis of the Characteristics of Emergency Patients in Taipei City

台北市急診室疾病特徵之分析

胡勝川(Sheng-Chuan Hu) ； 張國頌(Kuo-Song Chang) ； 李建賢(Chen-Hsen Lee)

《慈濟醫學雜誌》 10卷1期 (1998/03) Pp. 9-17

https://doi.org/10.6440/TZUCMJ.199803.0009

摘要

為瞭解台北大都會區之急診疾病盛行概況及創傷機轉之排行，以做為政府擬定適當的傷害防治計畫及公共衛生計畫，自84年7月1日至85年6月30日期間，我們進行一項前瞻性病歷審核式研究。研究地點設在台北市八家責任醫院的急診室。專職研究助理赴各醫院收集病歷，根據病歷記載將臆斷及創傷機轉輸入電腦，臆斷中之急性心肌更塞(AMI)急性腹痛及到院前死亡(DOA)須特別分出來。急性腸胃炎及上呼吸道感染是最常見的二種疾病，分別佔成人急診的14.3%和12.6%、小兒急診的15.4%和43.8%。成人創傷機轉的前三名是交通意外事故(35.7%)、摔倒(22.3%)、被撞或打到(9.3%)。然而小兒的排名依序是摔倒(39.5%)、被撞或打到(22.1%)、交通事故(11.6%)。急性腹痛佔成人急診的5.9%，其中23.3%不知原因、15.2%是膽道結石或發炎引起、12.5%為闌尾炎。於小兒急診，不明原因的膓痛更高達56.9%，其次常見的為闌尾炎(15.4%)和功能性胃腸障礙(7.7%)。在43例AMI病人(成人急診的0.2%)中54%是發病後12小時內送到急診室，但只有31.7%是在急診室使用血栓溶解劑。我們的結論是於急診室建立一個廣泛的疾病和創傷監視系統是可行且重要的。(慈濟醫學1998:10J:9-17)

關鍵字

監視系統 ； 急診室 ； 流行病學

並列摘要

In order to determine the disease prevalence and the ranking of trauma mechanisms among patients admitted to emergency departmens (ED) in Taipei City for general reference and use in the development of injury prevention plans and public health plans, a prospective chart review study was conducted from July 1, 1995 to June 30, 1996. Date was collected from the EDs of 8 hospitals in Taipei City. Full time research assistants were used to input the major diagnostic category and other relevant material of each ED patient into a computer based on the impression obtained from the patients history chart. Particular attention was focused on acute myocardial infarction (AMI); dead on arrival (DOA) and acute abdominal cases as the management of these patients is known to be problematic. The trauma mechanism and type of injury was recorded in all cases of trauma. Acute gastroenteritis (AGE) and acute upper respiratory infection (URI) were the 2 leading diseases in both adult and pediatric ED (14.3% and 12.6% of adult ED patients; 15.4% and 43.8% of pediatric ED patients, respectively). The leading 3 trauma mechanisms in adult patients were traffic accident (35.7%); trip (22.3%) and hit by object (9.3%), however, in pediatric patients, the sequence was trip (39.5%); hit by object (22.1%) and traffic accident (11.6%). Acute abdomen was responsible for 5.9% of adult emergency patients, of which 23.3% were cases with unknown cause followed by biliary tract stone or infection (15.2%) and appendicitis (12.5%). In pediatric EDs, differential diagnosis was not accomplished in 56.9% of acute abdomen cases, followed by 15.4% of appendicitis and 7.7% of functional gastrointestinal disorders. Of the total of 43 cases of AMI(0.2% of adult ED patients), 54% were sent to ED within 12 hours of the onset of symptoms and only 31.7% were treated with thrombolytic agents in the ED. The results of this study clearly indicate that the establishment of a comprehensive disease and trauma surveillance system in ED is both feasible and important.(Tzu Chi Med J 1998;10:9-17)

並列關鍵字

surveillance system ； emergency department ； epidemiology