Comparison of Disease Patterns and Outcomes Between Non-Japanese and Japanese Patients at a Single Tertiary Emergency Care Center in Japan.
Comparison of Disease Patterns and Outcomes Between Non-Japanese and Japanese Patients at a Single Tertiary Emergency Care Center in Japan.
复制标题
日本单一三级急诊中心的非日本和日本患者之间疾病模式和结果的比较。
DOI：
10.2188/jea.je20200211
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发表时间：
2022-02-05
影响因子：
4.7
通讯作者：
Fujiwara T
中科院分区：
文献类型：
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作者：
Ishii E;Nawa N;Matsui H;Otomo Y;Fujiwara T
日本历史上较低的移民率和单语文化使其成为澄清非国民医疗保健的特别有趣的背景。我们的研究目的是在一个快速全球化的国家中研究日本和非日本患者之间的疾病模式和结局差异。对2010年至2019年东京医科齿科大学医学院急诊科需要三级护理或重症监护病房或高度护理病房的325名非日本患者和13，370名日本患者进行了二次数据分析。应用多变量线性和逻辑回归模型来检查诊断百分比、死亡率和住院时间的差异，并根据格拉斯哥昏迷量表（GCS）评分分层，以考虑语言障碍的影响。调整性别和年龄。调整前，非日本患者有更多的过敏反应、烧伤和感染性疾病，但心血管诊断较少。调整后，与日本患者相比，过敏反应（调整后的比值比[aOR] 2.7; 95%置信区间[CI]，1.7-4.4）和感染性疾病诊断（aOR 2.2; 95% CI，1.3-3.7）显著更多，烧伤诊断（aOR 2.3; 95% CI，0.96-5.3）略多。无论GCS评分如何，在协变量调整后，非日本和日本患者因速发型过敏反应、烧伤和感染性疾病的住院时间无显著差异。诊断为过敏反应、烧伤和传染病的非日本患者较多，但住院时间方面的患者护理无显著差异。对于非日本游客或居民，需要进一步预防过敏反应、烧伤和传染病。
Japan’s historically low immigration rate and monolingual culture makes it a particularly interesting setting for clarifying non-national medical care. Our study objective was to examine disease patterns and outcome differences between Japanese and non-Japanese patients in a rapidly globalizing nation. A secondary data analysis of 325 non-Japanese and 13,370 Japanese patients requiring tertiary care or intensive-care unit or high-care unit admission to the emergency department at the Tokyo Medical and Dental University medical hospital from 2010 through 2019 was conducted. Multivariable linear and logistic regressions models were applied to examine differences in percentage of diagnosis, mortality rates, and length of stay, stratified by Glasgow Coma Scale (GCS) scores to consider the impact of language barriers. Sex and age were adjusted. Non-Japanese patients had more anaphylaxis, burns, and infectious disease, but less cardiovascular diagnoses prior to adjustment. After adjustment, there were significantly more anaphylaxis (adjusted odds ratio [aOR] 2.7; 95% confidence interval [CI], 1.7–4.4) and infectious disease diagnoses (aOR 2.2; 95% CI, 1.3–3.7), and marginally more burn diagnoses (aOR 2.3; 95% CI, 0.96–5.3) than Japanese patients. Regardless of GCS scores, there were no significant differences between non-Japanese and Japanese patient length of stay for anaphylaxis, burn, and infectious disease after covariate adjustment. There were more non-Japanese patients diagnosed with anaphylaxis, burns, and infectious disease, but no notable patient care differences for length of stay. Further prevention efforts are needed against anaphylaxis, burns, and infectious disease for non-Japanese tourists or residents.