Seasonal Variation of Hospital Emergency Visits and Hospitalizations of Patients with Asthma and Chronic Obstructive Pulmonary Disease

前言：根據過去之研究，各國兒童氣喘罹病率皆有顯著的季節性變化。至於成人氣喘及慢性阻塞性肺疾之罹病率的季節性變化則較少報告。本研究之目的為探討此兩種疾病之急診及住院的季節性變化。材料與方法：分析台大醫院1995至2000年之氣喘及慢性阻塞性肺疾病患因急性惡化到醫院急診及住院人次，並依每月日數計算其平均數，再區分成數個年齡層，探討其季節性變化的趨勢。其中慢性阻塞性肺疾因35歲以下病人數甚少，且有時診斷不易確定，因而不計在內。結果：氣喘病人之急診人次在六年間似無明顯增加，但住院人次則增加69%。氣喘病人住院與急診人次之比例在1995年是0.17，而在2000年則增加為0.29。依此觀之，氣喘惡化之嚴重度似乎有逐年增加之趨勢。至於慢性阻塞性肺疾之急診就醫率和住院率則皆呈逐年上升之勢，六年間分別增加80%和176%。其住院與急診人次之比例在1995年為0.92，在2000年則為1.41。可見絕大部分慢性阻塞性肺疾病患因急性惡化到急診就醫者絕大部分都需住院做進一步治療，甚至有不少病患是經由門診住院。氣喘之季節性變化較慢性阻塞性肺疾為明顯，在急診及住院方面皆有相同之趨勢。兩者之發作尖峰在冬季出現，而夏季較少發作。在各種不同年齡層，都有類似的變化，但是在程度上略有差異，年齡小者隨季節起伏較大，年紀大者起伏較小，尤其是365歲之慢性阻塞性肺疾者，其住院之季節性變化較不明顯。結論：氣喘及慢性阻塞性肺疾之急性發作具有明顯的季節性變化，在冬季較多、夏季較少。此一季節性變化在氣喘比慢性阻塞性肺疾更明顯，年齡較低者與年長者相比，前者的變化趨勢較為明顯。

關鍵字

氣喘；慢性阻塞性肺疾；季節性；急診；住院

並列摘要

Background: The morbidity caused by asthma has been found to have seasonal periodicity. Less is known about the seasonal variability of morbidity in chronic obstructive pulmonary disease (COPD). The aim of this study was to determine the seasonal periodicity trend in hospital emergency visits and hospitalizations of patients with asthma and COPD with acute exacerbation. Materials and Methods: The data of emergency visits and hospitalizations of patients with an acute exacerbation of asthma and COPD at the National Taiwan University Hospital from January 1995 through December 2000 were analyzed. Results: The frequency of emergency visits because of asthma did not increase in this 6-year period. The increasing hospitalizations-to-emergency visit ratio, moving from 0.17 to 0.29, indicated an increasing severity of asthma in this study period. The number of emergency visits and hospitalizations of patients with COPD steadily increased in the corresponding period. The ratio of hospitalizations to emergency visits ranged from 0.92-1.41, indicating that most COPD with acute exacerbation required hospitalization for further management. Seasonality of morbidity could be found in both asthma and COPD, with a greater seasonal variation for asthma than for COPD. There were more exacerbations observed in the winter and fewer during the summer for both diseases. Among different age groups, similar patterns were documented but with different magnitudes, particularly regarding hospitalizations in the older age group (＞65 years). Conclusion: The morbidity of asthma and COPD reveals a seasonal variation in Taipei City. This pattern is more obvious in younger patients and in patients with asthma.

並列關鍵字

asthma ； chronic obstructive pulmonary disease ； seasonality ； emergency visit ； hospitalization

國際替代計量

Seasonal Variation of Hospital Emergency Visits and Hospitalizations of Patients with Asthma and Chronic Obstructive Pulmonary Disease

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