对城市急诊科儿科精神科患者住院时间的回顾性研究。

A retrospective look at length of stay for pediatric psychiatric patients in an urban emergency department.

作者信息

Waseem Muhammad, Prasankumar Rahul, Pagan Krystal, Leber Mark

机构信息

Department of Emergency Medicine, Lincoln Medical & Mental Health Center, Bronx, NY 10451, USA.

出版信息

Pediatr Emerg Care. 2011 Mar;27(3):170-3. doi: 10.1097/PEC.0b013e31820d644b.

DOI:10.1097/PEC.0b013e31820d644b

PMID:21346682

Abstract

OBJECTIVE

The objective of the study was to compare the length of stay (LOS) of patients with psychiatric diagnoses in a pediatric emergency department (ED) to that of patients with nonpsychiatric diagnoses.

METHODS

This is a retrospective review of all patients younger than 19 years with psychiatric conditions, who presented to an urban teaching hospital ED with psychiatric symptoms, from January 2004 to December 2007. A control group of patients with nonpsychiatric diagnoses was selected over a random 4-day period. Emergency department LOS (in minutes) of nonpsychiatric versus psychiatric patients was compared. Length of stay was determined from the time of triage to disposition (discharge or admission). Patients with psychiatric diagnoses were further classified into 1 of 2 categories: major psychiatric diagnoses (bipolar disorder, psychoses, major depression, suicidal attempt or ideation, homicidal ideation, and hallucination) and minor psychiatric diagnoses (attention deficit/hyperactivity disorder, adjustment disorder, anxiety or panic attack, and behavioral issues).

RESULTS

A total of 1468 patients with psychiatric diagnoses visited the ED. Three hundred eighty-two patients had major psychiatric diagnoses, and 1086 patients had minor psychiatric diagnoses. The control group (patients with nonpsychiatric diagnosis) consisted of 345 patients. Mean LOS of nonpsychiatric patients was 160 minutes (95% confidence interval [CI], 142-177 minutes); LOS for minor psychiatric patients was 737 minutes (95% CI, 670-803 minutes) and 1127 minutes for major psychiatric patients (95% CI, 972-1283 minutes). On the other hand, median LOS of nonpsychiatric patients was 129 minutes; minor psychiatric patients, 328 minutes; and major psychiatric patients, 437.5 minutes. Kruskal-Wallis test showed a significant difference between each group with P = 0.0001.

CONCLUSIONS

The LOS was significantly higher in patients with psychiatric diagnoses. The mean and median for LOS both rose steadily from nonpsychiatric to major psychiatric diagnoses.

摘要

目的

本研究的目的是比较儿科急诊科（ED）中患有精神疾病诊断的患者与非精神疾病诊断患者的住院时间（LOS）。

方法

这是一项对2004年1月至2007年12月期间因精神症状就诊于城市教学医院急诊科的所有19岁以下患有精神疾病的患者进行的回顾性研究。在随机的4天期间选取了一组非精神疾病诊断的患者作为对照组。比较了非精神疾病患者与精神疾病患者的急诊科住院时间（以分钟为单位）。住院时间从分诊时间到处置（出院或入院）来确定。患有精神疾病诊断的患者进一步分为以下两类中的一类：主要精神疾病诊断（双相情感障碍、精神病、重度抑郁症、自杀企图或念头、杀人念头和幻觉）和次要精神疾病诊断（注意力缺陷/多动障碍、适应障碍、焦虑或惊恐发作以及行为问题）。

结果

共有1468名患有精神疾病诊断的患者就诊于急诊科。382名患者患有主要精神疾病诊断，1086名患者患有次要精神疾病诊断。对照组（非精神疾病诊断患者）由345名患者组成。非精神疾病患者的平均住院时间为160分钟（95%置信区间[CI]，142 - 177分钟）；次要精神疾病患者的住院时间为737分钟（95%CI，670 - 803分钟），主要精神疾病患者的住院时间为1127分钟（95%CI，972 - 1283分钟）。另一方面，非精神疾病患者的中位住院时间为129分钟；次要精神疾病患者为328分钟；主要精神疾病患者为437.5分钟。Kruskal - Wallis检验显示每组之间存在显著差异，P = 0.0001。