Breathlessness and presentation to the emergency department: a survey and clinical record review.
Breathlessness and presentation to the emergency department: a survey and clinical record review.
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DOI：
10.1186/s12890-017-0396-4
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发表时间：
2017-03-20
影响因子：
3.1
通讯作者：
Johnson MJ
中科院分区：
文献类型：
--
作者：
Hutchinson A;Pickering A;Williams P;Bland JM;Johnson MJ
呼吸困难是心肺疾病的常见症状，也是急诊科就诊的常见原因。本研究的目的是估计慢性急性呼吸困难的患病率，作为向急诊科主要急诊区域就诊的原因。对 2014 年 12 月 5 日至 2014 年 5 月 29 日期间连续前往一家三级医院急诊科主要急诊区域就诊的患者进行了前瞻性患者自我报告调查和临床记录审查。符合条件的患者临床情况稳定，并且有提供数据的心理能力。研究期间共有 2,041 份报告，其中 1,345 份（66%）符合资格。调查回复率为 90% (1,212/1,345)； 424/1,212 (35%) 人自我报告过去一个月的大部分时间都呼吸困难，其中 245 人将呼吸困难作为此次报告的原因。因此，作为前往重大紧急情况区域的理由的慢性急性呼吸困难的患病率为 20.2%（245/1,212，95% CI 17.9% 至 22.5%）。在此期间，共有 4,692 场主要和次要演讲；因此，呼吸困难是所有急诊科就诊中至少 5.2%（245/4,692，95% CI 4.6 至 5.9%）的原因。这项研究发现，五分之一的救护车就诊是由于慢性呼吸困难所致。大多数患者患有非恶性基础疾病，长期经历过严重的呼吸困难，曾与全科医生讨论过呼吸困难的情况，并且在白天就诊。其他人经常参与他们的演讲决定。这对患者、其家庭护理人员和紧急医疗服务来说是临床上的重大负担。
Breathlessness is a frequently occurring symptom of cardiorespiratory conditions and is a common cause of emergency department presentation. The aim of this study was to estimate the prevalence of acute-on-chronic breathlessness as a cause for presentation to the major emergencies area of the emergency department. A prospective patient self-report survey and clinical record review of consecutive attendees to the major emergencies area of the emergency department in a single tertiary hospital between 12/5/14 and 29/5/14 was conducted. Eligible patients were clinically stable and had mental capacity to provide data. There were 2,041 presentations during the study period, of whom 1,345 (66%) were eligible. There was a 90% survey response rate (1,212/1,345); 424/1,212 (35%) self-reported breathlessness most days over the past month of whom 245 gave breathlessness as a reason for this presentation. Therefore, the prevalence of acute-on-chronic breathlessness as a reason to present to the major emergencies area was 20.2% (245/1,212, 95% CI 17.9% to 22.5%). During this period there were 4,692 major and minor presentations; breathlessness was therefore a cause of at least 5.2% (245/4,692, 95% CI 4.6 to 5.9%) of all emergency department presentations. This study found that one in five ambulance presentations to the ED were due to acute-on-chronic breathlessness. Most patients had non-malignant underlying conditions, had experienced considerable breathlessness for an extended period, had discussed breathlessness with their GP and presented out of daytime hours. Others were often involved in their decision to present. This represents clinically significant burden for patients, their family carers and the emergency health services.