Evaluation of fatigue in a family practice.
Evaluation of fatigue in a family practice.
复制标题
家庭实践中的疲劳评估。
作者：
J. Sugarman;A. O. Berg
一个回顾性的图表审查描述的发生率，评估方法，并在大学家庭医学教学实践中的病人抱怨疲劳的诊断进行。排除初次就诊时明确解释疲劳的患者后，在一项为期两年的研究中，在约6，000名活跃成人患者（每年9.9/1，000例患者）中确定了118名年龄在15岁及以上的患者。病例的年龄和性别分布与活动患者人群相同。实验室检查的平均费用约为48美元。平均每名患者进行2.7次实验室检查。尽管12%的实验室检查结果异常，但在118名患者中，只有9名患者的实验室检查对确诊很重要。临床诊断分为主要是生物医学或主要是心理社会。在50%的患者中发现了心理社会诊断，而主要是生物医学诊断的患者占22%。28%的患者没有诊断。68%的患者至少有一次随访。在抑郁症或除病毒综合征以外的生物医学诊断的患者中，未能随访是不常见的，但在其他主要的心理社会诊断中很常见。
A retrospective chart review describing the rates of occurrence, methods of evaluation, and diagnoses of patients complaining of fatigue in a university family medicine teaching practice was performed. After excluding patients in whom an unequivocal explanation for the fatigue was reached at the initial encounter, 118 patients aged 15 years and over were identified during a two-year study in a practice with about 6,000 active adult patients (9.9/1,000 patients per year). The age and sex distributions of the cases were identical to those of the active patient population. The average laboratory examination cost approximately $48. An average of 2.7 laboratory tests per patient were ordered. Although 12 percent of laboratory tests were abnormal, laboratory tests were important in securing a diagnosis in only 9 of the 118 patients. Clinical diagnoses were classified as either primarily biomedical or primarily psychosocial. Psychosocial diagnoses were identified in 50 percent of patients, while primarily biomedical diagnoses were found in 22 percent. No diagnosis was made in 28 percent of patients. Sixty-eight percent of patients had at least one follow-up visit. Failure to follow up was uncommon in patients with depression or biomedical diagnoses other than viral syndromes but was common with other primarily psychosocial diagnoses.