Udosen A M, Glen E, Ogbudu S, Nkposong E
Department of Surgery, UCTH, RM.B. 1278, Calabar, Nigeria.
Niger J Clin Pract. 2006 Dec;9(2):120-3.
The causes and incidence of the commonly observed phenomenon of leaving against medical advice (LAMA) in our hospitals have not been studied. This retrospective study was aimed at evaluating its incidence and pattern in order to suggest possible solutions.
The case files of patients who left against medical advice at the Casualty unit of the University of Calabar Teaching Hospital between July 2002 and December 2003 were retrieved from the Medical Records Department and information regarding age, sex, education/occupation, religion, diagnosis, reason(s) for leaving and duration of stay in casualty were extracted.
A total of 3708 patients were seen at the casualty unit within this period. Ninety-seven patients left against medical advice but only ninety case notes were analyzable. Seven folders had incomplete information. Male/Female ratio was 2:1 and the ages ranged between 7 and 70 years (average 31.5 years). The average duration of stay in Hospital was 2.4 days (110 days). Sixty-five patients (72.2%) were those who had various forms of trauma while 8 (8.8%) had general surgical problems. 19% (17) patients had medical emergencies.
The youths are the most vulnerable group and the principal causes in our environment are ignorance and poverty. Because of poor documentation in our centres, it was not possible to know where these patients go and the results of their treatments. There is therefore a need for further studies.
我院常见的擅自离院（LAMA）现象的原因及发生率尚未得到研究。本回顾性研究旨在评估其发生率和模式，以提出可能的解决方案。
从病历科检索2002年7月至2003年12月在卡拉巴尔大学教学医院急诊科擅自离院患者的病历档案，提取有关年龄、性别、教育程度/职业、宗教信仰、诊断、离院原因及在急诊科停留时间的信息。
在此期间，急诊科共诊治3708例患者。97例患者擅自离院，但仅90份病历可分析。7份病历信息不完整。男女比例为2:1，年龄在7岁至70岁之间（平均31.5岁）。平均住院时间为2.4天（1至10天）。65例患者（72.2%）有各种形式的创伤，8例（8.8%）有普通外科问题。19%（17例）患者有内科急症。
年轻人是最易受影响的群体，在我们的环境中，主要原因是无知和贫困。由于我们中心的记录不完善，无法得知这些患者去向何处以及治疗结果。因此，有必要进行进一步研究。
