Greenslade Jaimi H, Hawkins Tracey, Parsonage William, Cullen Louise
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia; School of Medicine, The University of Queensland, Brisbane, Qld, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld, Australia.
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
Heart Lung Circ. 2017 Dec;26(12):1310-1316. doi: 10.1016/j.hlc.2017.01.001. Epub 2017 Feb 16.
Patients with panic disorder experience symptoms such as palpitations, chest pain, dizziness, and breathlessness. Consequently, they may attend the Emergency Department (ED) to be assessed for possible emergency medical conditions. Recognition of panic disorder within the ED is low. We sought to establish the prevalence of panic disorder in patients presenting for ED investigation of potential acute coronary syndrome. We also sought to characterise the cohort of patients with panic disorder in terms of presenting symptoms, risk factors, medical history and major adverse cardiac events (MACE).
This was an observational study of 338 adult patients presenting to the Emergency Department of a tertiary hospital in Australia. Research nurses collected clinical data using a customised case report form. The outcome was panic disorder, assessed using the Mini International Neuropsychiatric Interview.
The average age of participants was 50.2 years and 37.9% were female. Thirty-day MACE occurred in 7.7% of the cohort. The clinical diagnosis of panic disorder was made in 5.6% (95% CI: 3.4-8.6%) of patients. Compared to patients without panic disorder, patients with panic disorder were slightly more likely to report that their pain felt heavy (48.9% and 73.7% respectively, p=0.04). All other reported symptoms were similar in the two groups.
The prevalence of panic disorder was low in patients presenting to an Australian ED with chest pain. Clinical signs or symptoms that are routinely collected as part of the chest pain workup cannot be used to distinguish patients with and without panic disorder.
惊恐障碍患者会出现心悸、胸痛、头晕和呼吸急促等症状。因此，他们可能会前往急诊科接受评估，以排查可能的紧急医疗状况。急诊科对惊恐障碍的识别率较低。我们试图确定在因潜在急性冠状动脉综合征前往急诊科就诊的患者中惊恐障碍的患病率。我们还试图从就诊症状、危险因素、病史和主要不良心脏事件（MACE）方面对惊恐障碍患者群体进行特征描述。
这是一项对澳大利亚一家三级医院急诊科的338名成年患者进行的观察性研究。研究护士使用定制的病例报告表收集临床数据。结局指标为惊恐障碍，采用迷你国际神经精神访谈进行评估。
参与者的平均年龄为50.2岁，37.9%为女性。该队列中7.7%的患者发生了30天MACE。5.6%（95%CI：3.4 - 8.6%）的患者被临床诊断为惊恐障碍。与无惊恐障碍的患者相比，惊恐障碍患者更有可能报告其疼痛感觉沉重（分别为48.9%和73.7%，p = 0.04）。两组报告的所有其他症状相似。
在因胸痛前往澳大利亚急诊科就诊的患者中，惊恐障碍的患病率较低。作为胸痛检查常规收集的临床体征或症状不能用于区分有无惊恐障碍的患者。
