| [Objective]To evaluate the spectrum of ED disease and characteristics of acute exacerbation of internal chronic diseases in Tianjin Medical University General Hospital in 2017,which will provide evidence-based evidence support for ED standard disease diagnosis process,rational allocation of emergency resources and improvement of emergency service quality.[Method]Retrospective analysis of patients in ED of Tianjin Medical University General Hospital from January 1,2017 to December 31,2017.Basic patient status,time of visit,department of visit,initial diagnosis and treatment costs were collected and separately analyzed.The ICD-10 disease grading standard were used to classify the diseases.Thirty most common initial diagnoses,the composition of the internal system diseases,the cost of medical treatment and nine acute exacerbation of internal chronic diseases were screened out.The distribution characteristics of each disease were analyzed by factors such as season,gender,age,time period,average cost of treatment and maximum cost.Data was statistically analyzed using Excel and SPSS 21.0 software.The mean comparison was performed by t test,and the clinical data of inter-groups were compared using the ?2 test.[Result]The emergency department had 241,277 complete patients.Among them,105,515 were men,accounting for 43.73%;135,762 were women,accounting for 56.27%;the ratio of male to female was 0.78:1.There were two peaks in the age distribution of patients in the year:21 to 40 years old and 51 to 70 years old,accounting for 34.26%and 33.52%of the total.Except for the 14 to 20 age group,the number of males was higher than that of females.The top three departments with the largest number of people:internal medicine(49.65%),neurology(13.12%)and surgery(8.41%).The number of patients during the day was significantly higher than at night.According to the time period,the number of visits throughout the day presents“three peaks and one valley”:the three peaks are:10:00?11:00,14:00?15:00 and 20:00?21:00.The visit is low from 02:00 to 06:00.The number of visits was the lowest in February,with the largest number of visits in December.the number of visits in autumn is significantly higher than in the other three quarters.The number of patients on non-working days was significantly higher than that on weekdays.The number of daily visits per week was the highest on weekdays,followed by Monday and Saturday again.The top five most common initial diagnosis in the year were respiratory infections(upper feeling,pneumonia),trauma(trauma,car accident),abdominal pain,fever and dizziness(or chest tightness,fatigue).Among the medical system diseases,respiratory diseases,nervous system diseases,and cardiovascular diseases were ranked in the top three.Among the medical system diseases,the disease with the highest personal and average visit cost is gastrointestinal bleeding.The total number of patients with 9 acute exacerbations of chronic diseases was 11,082,accounting for 4.59%of the total annual emergency.Respiratory system,cardiovascular and cerebrovascular emergency patients mostly visited in spring and winter,more men than women,more than 50 years old patients as the main body.DK/DKA and poisoning patients are mainly young people.There was no significant difference in the number of patients in the four seasons of gastrointestinal bleeding.There were significantly more men than women,and 51 to 90 years old was the high age group.The number of patients during the day was about twice that of night visits.Hypertensive emergencies/sub-emergency patients have a relatively large number of people in summer,more women than men,and 61-80 year-old patients are significantly more than other age groups.Patients with acute renal failure had no significant seasonal,time,and gender differences.[Conclusion]The number of ED patients in our hospital is the highest in the fall,and there are more patients on non-working days and Mondays.The peak of daily visits is concentrated.According to this feature,ED personnel and facilities should be added in a timely manner,and countermeasures should be taken in advance to improve the efficiency of patient visits.The ED disease spectrum is extensive,and the internal medicine disease accounts for about 50%of the total.The hospital should focus on strengthening the construction of emergency department of internal medicine and arrange support personnel.At the same time,it should strengthen the training of emergency doctors on symptom science and common frequently-occurring diseases to guide fast and accurate diagnosis and treatment.Critically ill patients are mainly elderly,with multiple occurrences in winter and spring.Emergency doctors should quickly identify,optimize disease diagnosis procedures,strengthen first aid training,improve disease treatment rate,reduce emergency congestion,and minimize the economic burden of patients. |
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