Schauer Steven G, Goolsby Craig A
Bayne Jones Army Community Hospital, 1585 3rd Street, Fort Polk, LA 71459.
Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
Mil Med. 2015 Nov;180(11):1128-31. doi: 10.7205/MILMED-D-14-00599.
We determine the incidence of clinically significant findings within mandatory screening studies during medical clearance of patients for psychiatric care.
This is a retrospective review of emergency department patients medically cleared for psychiatric care over 11 months. All patients evaluated for behavioral health-related issues are recorded on a daily report which was used to locate subjects. Laboratory studies were reviewed during that visit for the presence of abnormalities. If abnormalities were noted, the individual chart was reviewed. Our primary outcome was the incidence of clinically significant findings that warranted admission to a medical or surgical unit.
204 psychiatric patient reports were reviewed. 191 of these patients had screening studies performed. Seven patients were admitted to a nonpsychiatric unit. These admissions were all for elevated ethanol levels. These patients were admitted until their ethanol level decreased, and then transferred to a psychiatric facility. The total screening lab cost during this study period was $27,893.
Routine screening has limited utility in this population and comes at significant cost. Further research should be directed to determine which patients may benefit from screening studies.
我们确定在患者精神科治疗医学检查的强制筛查研究中具有临床意义的发现的发生率。
这是一项对11个月内接受精神科治疗医学检查的急诊科患者的回顾性研究。所有因行为健康相关问题接受评估的患者都记录在一份每日报告中，该报告用于查找研究对象。在那次就诊期间对实验室检查结果进行审查，以确定是否存在异常。如果发现异常，则查看个人病历。我们的主要结局是有临床意义的发现的发生率，这些发现需要入住内科或外科病房。
共审查了204份精神科患者报告。其中191名患者进行了筛查研究。7名患者入住了非精神科病房。这些患者均因乙醇水平升高而入院。这些患者在乙醇水平下降之前一直住院，然后转至精神科机构。本研究期间的总筛查实验室费用为27,893美元。
常规筛查在该人群中的效用有限，且成本高昂。应开展进一步研究以确定哪些患者可能从筛查研究中获益。
