Analysis Of Spectrum Of The Emergency Patients In Tianjin Medical University General Hospital

Objective To understand the characteristics of epidemiology among the emergency patients in a comprehensive hospital in Tianjin and for a future better development.Methods A retrospective analysis was made on patients’ data received in Tianjin Medical University General Hospital from January 1 through December 31 in 2013,including sex, age, visiting time, visiting department and emergency diagnosis.Criteria for inclusion were the complete information cases, excluding incomplete and non-urgent cases. In this study, the emergency diagnosis refers to the diagnosis when the patients left the ER, may not be line with the final diagnosis. The common symptoms were enrolled, such as fever, abdominal pain, chest pain, dizziness,syncope, disturbance of consciousness etc.. Emergency general surgery, orthopedics,neurosurgery and Five Sense Organs were charged with surgical operation, can be seen as a group, which were designated as the surgical department.The data was received from the electronic systems of the hospital and all the statistical computations were performed by SPSS 17.0 statistical software. Chi-square test was applied for comparison between groups and t test for means.Results 116 942 emergency cases were enrolled, accounting for 95.96% of the total emergency patients in the whole year, the male was 19 480 and female was 14 548,Male to female ratio was 0.84 to 1 among the patients. In the surgical department,the male was 19 480 and female was 14 548, Male to female ratio was 1.07 to 1.The patients were centralized at ages of 20~29 years old, 30~39 years old and 50~59 years old and in July, August and September. The number of emergency patients significantly increased at weekends and long holidays. The patients were mainly from internal medicine department, followed by neurology department and surgical department. Everyday’s main visiting time occurred during 17:00~24:00, which accounted for 44.28% of the whole day.The peak time of the whole day was 20:00.40 diagnosis were reported and the top five was trauma, respiratory tract infection,abdominal pain, fever, dizziness with palpitation and vomiting or not. The top three spectrum of internal medicine diseases were respiratory system( upper respiratory infections 10.04%, pneumonia 2.26%, COPD/AECOPD 0.57%), cardiovascularsystem(hypertension 2.47%, CHD/heart failure 1.86%, acute coronary syndrom0.90%) and nervous system diseases(stroke 2.32%, ischemic cerebrovascular disease1.61%, epilepsy 0.27%). Report of the 10 common critical diseases, including a quarterly distribution, gender distribution and characteristics of day and night.Trauma and respiratory system diseases were more common in the third and fourth quarter(60.21% and 63.25%), digestive system diseases were ofen seen in the third quarter(34.01%). AECOPD, gastrointestinal bleeding, hypertension and heart failure had obvious seasonal characteristics, were mainly seen in spring and winter, accounting for the total patients 56.47%and 59.37%, 57.27% and 56.84%. The patients with ACS were ofen seen in winter, sepsis commonly occured in spring. The onset of stroke and DK/DKA had no seasonal variation.Conclusions This study objectively reflect the current situation of the emergency department of our hospital in Tianjin. According to the characteristics of spectrum of the patients in emergency department, focuse on the main period of visiting time, the peak seasons and the key departments like internal medicine for better arrangement of emergency resources and impprovement of the trauma treatment system. The specialist training for emergency clinician about the management of patients presenting with undifferentiated or common symptom and diseases is necessary and could improve the levels of treatment capability and nursing quality.