Vest-Hansen Betina, Riis Anders Hammerich, Sørensen Henrik Toft, Christiansen Christian Fynbo
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
Eur J Intern Med. 2014 Sep;25(7):639-45. doi: 10.1016/j.ejim.2014.06.017. Epub 2014 Jul 2.
Despite extensive research on individual diseases, population-based knowledge about reasons for acute medical admissions remains limited. Our aim was to examine primary diagnoses, Charlson Comorbidity Index (CCI) score, age, and gender among patients admitted acutely to medical departments in Denmark.
In this population-based observational study, 264,265 acute medical patients admitted during 2010 were identified in the Danish National Registry of Patients (DNRP), covering all hospitals in Denmark. Reasons for acute admissions were assessed by primary diagnoses, grouped according to the International Classification of Diseases 10th edition. Additionally, the CCI score, age and gender were presented according to each diagnostic group.
Two-thirds of the patients had one of the four following reasons for admission: cardiovascular diseases (19.3%), non-specific Z-diagnoses ("Factors influencing health status and contact with health services") (16.9%), infectious diseases (15.5%), and non-specific R-diagnoses ("Symptoms and abnormal findings, not elsewhere classified") (11.8%). In total, 45% of the patients had a CCI score of one or more and there was a considerable overlap between the patients' chronic diseases and the reason for admission. The median age of the study population was 64 years (IQR 47-77 years), ranging from 46 years (IQR 27-66) for injury and poisoning to 74 years (IQR 60-83) for hematological diseases. Gender representation varied considerably within the diagnostic groups, for example with male predominance in mental disorders (59.0%) and female predominance in diseases of the musculoskeletal system (57.8%).
Our study identifies that acute medical patients often present with non-specific symptoms or complications related to their chronic diseases.
尽管对个体疾病进行了广泛研究，但基于人群的急性内科住院原因的知识仍然有限。我们的目的是研究丹麦内科各科室急性入院患者的主要诊断、查尔森合并症指数（CCI）评分、年龄和性别。
在这项基于人群的观察性研究中，通过丹麦国家患者登记处（DNRP）确定了2010年期间收治的264,265例急性内科患者，该登记处涵盖丹麦所有医院。急性入院原因通过主要诊断进行评估，并根据国际疾病分类第10版进行分组。此外，还根据每个诊断组列出了CCI评分、年龄和性别。
三分之二的患者有以下四种入院原因之一：心血管疾病（19.3%）、非特异性Z诊断（“影响健康状况和与卫生服务接触的因素”）（16.9%）、传染病（15.5%）和非特异性R诊断（“症状和异常发现，未在其他处分类”）（11.8%）。总体而言，45%的患者CCI评分为1分或更高，患者的慢性病与入院原因之间存在相当大的重叠。研究人群的中位年龄为64岁（四分位间距47 - 77岁），从损伤和中毒的46岁（四分位间距27 - 66岁）到血液系统疾病的74岁（四分位间距60 - 83岁）不等。各诊断组中的性别比例差异很大，例如精神障碍中男性占主导（59.0%），肌肉骨骼系统疾病中女性占主导（57.8%）。
我们的研究表明，急性内科患者常出现与慢性病相关的非特异性症状或并发症。
