| Objectives:To analyze the epidemiological characteristics of emergency patients in a grade A tertiary hospital from 2010 to 2014, and to provide data and evidence for the emergency department to make plans, manage resource, develop scientific research and training, so as to further promote the emergency medicine to develop in the direction of specialization and standardization.Methods:The data of the patients presenting to the emergency department between January 1, 2010 to December 31,2014 were collected through hospital information system (HIS), including gender, age, visiting time, visiting department, diagnosis, time of staying in the hospital, disease grades, visiting approach medical treatment, the time to stay in green channel, patients’outcomes and emergency cost, and so on. After establishing a database, SPSS 17.0 was used to analyze the data.Results:There were 284,466 cases in 2010-2014, of which men and women ratio was 1.11:1, and the 19-30 years old were in the main group of emergency patients, accounting for 32.35%, followed by a total of 53,648 cases of the 31-40 years old (18.86%). The highest proportion of patients in emergency surgery was 137,931 cases, accounting for 48.49%. The season of July, August, and September was the peak period of emergency patients; the peak time of the day was 17:00-24:00; January and August were the time for the most emergency stay and rescue. Emergency was an important source of hospitalized patients; the top five were trauma, respiratory diseases, nervous system diseases, digestive system diseases, acute labor, which had a total of 197,906 cases, accounting for 69.57%. There were 118,276 (41.58%) cases with trauma, accounting for 85.75% of the corresponding surgery. The number of emergency ordinary patients and critical patients were increasing year by year.The six major diseases confirmed by State Planning Commission were acute stroke, acute myocardial infarction, acute heart failure, acute respiratory failure, severe crania-cerebral trauma. In 5 years the key disease cases were 5,925 (accounted for 2.08% of the total number of emergency cases), the number of the patients older than 51 years old were 4,474 (75.51%), more men than women; acute stroke patients were the most (3,418 patients), accounting for total of 57.69%, severe trauma patients with 1,084 cases (18.3%) ranked second, acute myocardial infarction, acute heart failure, acute respiratory failure, and severe crania-cerebral trauma separately were third, fourth, fifth, sixth. Acute cerebral apoplexy, acute myocardial infarction, acute heart failure and acute respiratory failure patients were classed as intensive internal medicine diseases. Especially, acute heart failure and acute respiratory failure mainly occurred in the persons more than 70 years old, and the surgical treatment of severe trauma, severe head injury patients were mainly distributed in 18-60 years old male patients. In six major diseases, autumn and winter were the high incidence seasons of acute cerebral stroke, myocardial infarction, heart failure and respiratory failure, and severe crania-cerebral trauma, and trauma were more common in summer and autumn. The majority of green channel patients in the emergency department would stay for 1.5 hours, top 3 were acute respiratory failure (87.73%), acute heart failure (79.02%) and acute stroke (80.32%); and the diseases of which the retention time more than 3 hours were severe cranial trauma (22.67%), acute myocardial infarction (19.41%) and severe trauma patients (12.27%). In a total of 220 deaths,51 years of age were in the majority (177), significantly higher than the other age groups (P<0.001). Logistic regression analysis showed that, with the increasing age of emergency patients, the risk of death increased, for each one year increasing, the risk of death increased 1.14 times (95% CI:1.01-1.27); and there were no significant correlation between gender and the death (P=0.574); compared with stroke, after adjusting for age, gender, years, the risk of death in patients with acute myocardial infarction was 3.21 times of stroke patients (95% CI:2.03-5.08), the risk of death in patients with acute heart failure was 2.71 times (95% CI:1.69-4.32), the risk of death in patients with acute respiratory failure was 7.84 times (95% CI:5.17-11.87), the risk of death in patients with severe trauma was 2.2 times (95% CI:1.37-3.52), and the risk of severe brain trauma was 4.51 times (95% CI:2.22-9.18).Conclusion and suggestions:The majority of the emergency department patients were in the emergency surgery, while the patients with critical illness were mainly in the emergency internal medicine, those two were corresponding to the 19-60 years old male trauma population, as well as over 60 years old and older than those of the elderly patients with heart and lung function. Summer (July, August, and September) was the peak of the emergency patients, January and August for the emergency treatment of patients with the peak months, the daily 20:00 was the peak time of day. The results suggest that the human resources should be arranged reasonably.The research results show that in six key diseases, acute stroke, trauma, acute myocardial infarction, acute heart failure, acute respiratory failure and crania-cerebral trauma decreased in turn; there was no significant difference between deaths and other patients (inpatient and observing) in green channel residence time. In the future, the rapid diagnosis and treatment should be strengthened to reduce the reporting time, optimize the information transmission technology, improve the treatment and operation process, reduce the time of emergency green channel of the six major diseases, and improve the quality of diagnosis and treatment of critically ill patients.The hospital emergency department patients and key disease (critical diseases) patients with multiple and increased year by year, but the time that patients stay in resuscitation room and observation room was longer, which was associated with deficiency of specialist triage and lack of critical care unit and hospital ward. It is recommended to expand the emergency department diagnosis and treatment space, to ease the emergency resuscitation room "over crowded" state and shorten the time of emergency green channel, to further improve the emergency treatment of six key diseases.Through the analysis of the characteristics of emergency patients, the main disease spectrum, the distribution characteristics, the per capita expenditure and the income of the department and the outcome of the green channel were clear, providing data and evidence for the emergency department to make plans, manage resource, develop scientific research and teaching. |
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