National study of United States emergency department visits for acute pancreatitis, 1993-2003
National study of United States emergency department visits for acute pancreatitis, 1993-2003
复制标题
DOI：
10.1186/1471-227x-7-1
复制
发表时间：
2007-01-01
影响因子：
2.5
通讯作者：
Camargo, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Fagenholz, Peter J.;Castillo, Carlos Fernandez-del;Camargo, Carlos A., Jr.
背景：在美国，急性胰腺炎的流行病学很大程度上是未知的，特别是导致急诊科(ED)就诊的事件。我们试图解决这一差距，并描述急诊实践模式。方法：数据收集自1993-2003年间的全国医院门诊医疗服务调查。结果：在研究期间，急性胰腺炎的急诊就诊人次从1994年的最低点12.8万人次增加到2003年的峰值31.8万人次(p=0.01)。相应的每万美国人口的ED就诊率也从4.9次(95%CI，3.1-6.7)增加到10.9次(95%CI，7.6-14.3)(p=0.01)。在研究期间，因急性胰腺炎而去急诊室就诊的患者的平均年龄为49.7岁，其中54%为男性，27%为黑人。黑人ED就诊率(14.7；95%CI，I1.9-17.5)高于白人(5.8；95%CI，5.0-6.6)。在急诊科就诊的患者中，有42%没有接受止痛药。10%的ED就诊患者接受了CT或MRI成像，13%的就诊患者接受了超声波测试。三分之二的急诊室就诊导致住院。高龄(多因素优势比1.5；95%CI，1.3-1.8)和白人(多因素优势比2.3；95%CI，1.2-4.6)是住院的危险因素。结论：美国急性胰腺炎急诊率呈上升趋势，黑人急诊率高于白人。在许多就诊中，没有使用止痛药，诊断成像也很少见。白人比黑人更有可能被录取。在急诊室就诊率和入院率方面观察到的种族差异值得进一步研究。
Background: The epidemiology of acute pancreatitis in the United States is largely unknown, particularly episodes that lead to an emergency department (ED) visit. We sought to address this gap and describe ED practice patterns.Methods: Data were collected from the National Hospital Ambulatory Medical Care Survey between 1993 and 2003. We examined demographic factors and ED management including medication administration, diagnostic imaging, and disposition.Results: ED visits for acute pancreatitis increased over the study period from the 1994 low of 128,000 visits to a 2003 peak of 318,000 visits (p = 0.01). The corresponding ED visit rate per 10,000 U. S. population also increased from 4.9 visits (95% CI, 3.1-6.7) to 10.9 (95% CI, 7.6-14.3) (p = 0.01). The average age for patients making ED visits for acute pancreatitis during the study period was 49.7 years, 54% were male, and 27% were black. The ED visit rate was higher among blacks (14.7; 95% CI, I 1.9-17.5) than whites (5.8; 95% CI, 5.0-6.6). At 42% of ED visits, patients did not receive analgesics. At 10% of ED visits patients underwent CT or MRI imaging, and at 13% of visits they underwent ultrasound testing. Two-thirds of ED visits resulted in hospitalization. Risk factors for hospitalization were older age (multivariate odds ratio for each increasing decade 1.5; 95% CI, 1.3-1.8) and white race (multivariate odds ratio 2.3; 95% CI, 1.2-4.6).Conclusion: ED visits for acute pancreatitis are rising in the U. S., and ED visit rates are higher among blacks than whites. At many visits analgesics are not administered, and diagnostic imaging is rare. There was greater likelihood of admission among whites than blacks. The observed race disparities in ED visit and admission rates merit further study.