Chew B H, Than T L, Chew K S, Jamaludin N K, Hassan H
University Putra Malaysia, Faculty of Medicine & Health Sciences, Department of Family Medicine, 43400 Serdang, Selangor, Malaysia.
Med J Malaysia. 2012 Dec;67(6):571-6.
Our study was to examine prevalence and treatment outcomes of medical emergencies at two urban public health clinics in the Petaling district, Selangor, Malaysia.
A prospective universal sampling was employed to recruit all emergencies over one month period (12 April to 11 May 2011). A structured case record form was used to capture demographic data, whether the index case was selfpresenting or decided by health care workers as a medical emergency, presenting complaints, diagnoses, concurrent chronic diseases and their treatment outcomes at the clinic level. Emergency presentations and diagnoses were classified according to the International Classification of Primary Care, revised second edition (ICPC-2-R).
A total of 125 medical emergencies with 276 presenting complaints were recorded. The mean age was 30.7 years old (SD 19.9). The prevalence of medical emergency was 0.56% (125/22,320). Chief complaints were mainly from ICPC-2-R chapter R (respiratory system) and chapter A (general and unspecified), 40.0% and 28.0% respectively. The most common diagnosis was acute exacerbation of bronchial asthma (34.6%). Forty percent were referred to hospitals. After adjusting for age and gender, patients who presented with painful emergency (OR 4.9 95% CI 2.0 to 11.7), cardiovascular emergency (OR 63.4 95% CI 12.9 to 310.4) and non-respiratory emergency were predictors of hospital referral (OR 4.6 95% CI 1.1 to 19.1).
There was about one medical emergency for every 200 patients presenting to these urban public polyclinics which were mainly acute asthma. More than half were discharged well and given a follow-up.
我们的研究旨在调查马来西亚雪兰莪州八打灵再也区两家城市公共卫生诊所的医疗紧急情况的患病率和治疗结果。
采用前瞻性普查方法，在一个月的时间内（2011年4月12日至5月11日）招募所有紧急情况患者。使用结构化病例记录表收集人口统计学数据，包括索引病例是自行就诊还是由医护人员判定为医疗紧急情况、就诊主诉、诊断结果、并发慢性病情况以及诊所层面的治疗结果。根据国际初级保健分类第二版修订版（ICPC - 2 - R）对紧急就诊情况和诊断进行分类。
共记录了125例医疗紧急情况，涉及276个就诊主诉。平均年龄为30.7岁（标准差19.9）。医疗紧急情况的患病率为0.56%（125/22320）。主要就诊主诉分别来自ICPC - 2 - R的R章（呼吸系统）和A章（一般及未特指），分别占40.0%和28.0%。最常见的诊断是支气管哮喘急性加重（34.6%）。40%的患者被转诊至医院。在调整年龄和性别后，出现疼痛性紧急情况（比值比4.9，95%置信区间2.0至11.7）、心血管紧急情况（比值比63.4，95%置信区间12.9至310.4）和非呼吸性紧急情况的患者是医院转诊的预测因素（比值比4.6，95%置信区间1.1至19.1）。
每200名前往这些城市公共诊疗所就诊的患者中约有1例医疗紧急情况，主要为急性哮喘。超过一半的患者康复出院并得到随访。
