Ribbeck B M, Runge J W, Thomason M H, Baker J W
Department of Medical Education and Research, Carolinas Medical Center, Charlotte, NC.
Ann Emerg Med. 1992 Jan;21(1):37-40. doi: 10.1016/s0196-0644(05)82234-6.
Little information exists on the cause of injury for patients who are treated and discharged from emergency departments; these patients comprise approximately 90% of all injured patients requiring medical care. A method is described to assign external cause of injury codes (E codes) prospectively to all injured patients seen in a large-volume ED.
E code assignment was performed by the ED triage nurses on entrance to the ED. A checklist was used that contained frequently occurring codes as identified in a pilot study. E codes were entered into the patients' records on the hospital mainframe computer by a medical records technician. These were acquired for a nine-month period to determine feasibility, accuracy, and ease of use. Accuracy was verified retrospectively.
During the nine-month period, 67,495 patients were treated. Acute injury accounted for 16,186 of the visits, and 2,085 were return visits for a previously treated injury. The majority of patients with any injury type were treated and discharged and would not have been included in traditional data sets of injured patients. Overall admission rate for injury was 13%. Accuracy of prospectively assigned E codes was 98%, and this method of assigning E codes resulted in no additional effort by the triage nurse.
E coding is a valuable method for injury surveillance, easily performed in EDs with high volume. Its value is essential for injury prevention research on injuries from any cause.
关于从急诊科接受治疗并出院的患者的受伤原因，现有信息较少；这些患者约占所有需要医疗护理的受伤患者的90%。本文描述了一种向前瞻性地为在大容量急诊科就诊的所有受伤患者分配外部伤害原因编码（E编码）的方法。
E编码由急诊科分诊护士在患者进入急诊科时进行分配。使用了一份清单，其中包含在一项试点研究中确定的常见编码。E编码由一名医疗记录技术员输入医院主机计算机上的患者记录中。收集这些数据为期九个月，以确定其可行性、准确性和易用性。准确性通过回顾性验证。
在九个月期间，共治疗了67495名患者。急性损伤占就诊病例的16186例，其中2085例为先前受伤后的复诊。大多数任何类型损伤的患者接受治疗后出院，这些患者不会被纳入传统的受伤患者数据集。总体损伤入院率为13%。前瞻性分配的E编码的准确率为98%，这种分配E编码的方法没有给分诊护士带来额外的工作量。
E编码是一种用于伤害监测的有价值的方法，在大容量急诊科易于实施。其价值对于任何原因导致的伤害的预防研究至关重要。
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