Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Queen’s Medical Centre Campus, Nottingham, UK.
Emerg Med J. 2012 May;29(5):379-82. doi: 10.1136/emj.2010.106229. Epub 2011 May 23.
To describe the common medical presenting problems of children attending a paediatric emergency department (ED) compared with 10 years previously.
A retrospective review of electronic patient record and comparison with previous cohort.
A UK university hospital ED.
A cohort of children and young people aged 0-15 years who attended the ED between 7 February 2007 and 6 February 2008 (n=39 394) compared with a historical cohort from 10 years earlier.
Information on presenting problem, demographic data and source of referral were collected. Presenting problems were ranked and comparisons made with previous data using the difference between proportions analysis and the significance test for a difference in two proportions. A total of 39 394 children (57% boys) were seen with 14 724 medical attendances compared with 10 369 attendances from the 1997 cohort, an increase of 42%. Most (85%) ED attendances can be accounted for by the 10 most common presenting problems, including breathing difficulty (2494, 20.1%), febrile illness (1752, 14.1%), diarrhoea with or without vomiting (1731, 14.0%), rash (1066, 8.6%) and cough (835, 6.7%). Similar proportions are described to a decade earlier; however, there were fewer patients attending with breathing difficulty (-10.9%, p<0.001).
Over a 10-year period, there has been a rise in the number of people attending the ED with medical conditions. The 10 most common presenting problems account for 85% of medical attendees. These results suggest the increasing utilisation of ED services for children with common medical presenting problems and should inform further research exploring the pathways for attendance and the thresholds in seeking medical advice in order to inform the commissioning of paediatric emergency and urgent care services.
描述在小儿急诊科（ED）就诊的儿童常见的医学就诊问题，与 10 年前相比。
对电子病历进行回顾性分析，并与以前的队列进行比较。
英国一所大学医院 ED。
2007 年 2 月 7 日至 2008 年 2 月 6 日期间在 ED 就诊的 0-15 岁儿童和青少年队列，与 10 年前的历史队列进行比较。
收集就诊问题、人口统计学数据和转诊来源。根据比例差异分析和两个比例差异显著性检验，对就诊问题进行了排序，并与以前的数据进行了比较。共观察到 39394 名儿童（57%为男性），就诊 14724 次，与 1997 年队列的 10369 次就诊相比，增加了 42%。最常见的 10 个就诊问题可解释 85%的 ED 就诊，包括呼吸困难（2494 例，20.1%）、发热性疾病（1752 例，14.1%）、腹泻伴或不伴呕吐（1731 例，14.0%）、皮疹（1066 例，8.6%）和咳嗽（835 例，6.7%）。与 10 年前相比，这些比例相似；然而，呼吸困难就诊的患者减少了（-10.9%，p<0.001）。
在 10 年期间，到 ED 就诊的患有医疗疾病的人数有所增加。10 个最常见的就诊问题占就诊者的 85%。这些结果表明，越来越多的儿童因常见的医学就诊问题而利用 ED 服务，应进一步研究就诊途径和寻求医疗建议的门槛，以便为儿科急诊和紧急护理服务的委托提供信息。
