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大阪药物过量急诊患者的特征与趋势

Characteristics and trends of emergency patients with drug overdose in Osaka.

作者信息

Kubota Yoshie, Hasegawa Kohei, Taguchi Hirokazu, Kitamura Tetsuhisa, Nishiyama Chika, Iwami Taku, Nishiuchi Tatsuya, Hiraide Atsushi

机构信息

Department of Acute Medicine Faculty of Medicine Kinki University Boston Massachusetts.

Department of Emergency Medicine Harvard Medical School Massachusetts General Hospital Boston Massachusetts.

出版信息

Acute Med Surg. 2015 Mar 15;2(4):237-243. doi: 10.1002/ams2.107. eCollection 2015 Oct.

Abstract

AIM

Drug overdose is an important issue in emergency medicine. However, studies covering overdose patients transported by ambulance have not been sufficiently carried out. We attempted to clarify problems of suspected drug overdose patients transported by ambulance.

METHODS

This is a prospective population-based cohort study. Data were collected by emergency medical service crews in Osaka City, Japan, between January 1998 and December 2010.

RESULTS

Drug overdose cases increased annually from 1,136 in 1998 to 1,822 in 2010 ( < 0.0001 for trend). In these cases, the dominant age range was between 16 and 40 years and the age distribution did not change over time. The age of non-overdose cases increased ( < 0.0001 for trend), with patients aged ≥66 years becoming most common in recent years, reflecting the aging of society. Males comprised most non-overdose patients, but the percentage of females increased annually ( < 0.0001 in trend). Females comprised approximately 70% in overdose cases annually throughout the study period. The duration from the emergency call to the arrival at the hospital for overdose patients has increased markedly in recent years. It also takes more time to obtain acceptance from hospitals to care for patients of suspected overdose.

CONCLUSION

The characteristics of drug overdose patients are clearly different from those of non-overdose patients. Recent trends of drug overdose patients indicate the accelerated burden on emergency medical services system.

摘要

目的

药物过量是急诊医学中的一个重要问题。然而,针对由救护车运送的过量用药患者的研究尚未充分开展。我们试图阐明由救护车运送的疑似药物过量患者的问题。

方法

这是一项基于人群的前瞻性队列研究。数据由日本大阪市的紧急医疗服务人员在1998年1月至2010年12月期间收集。

结果

药物过量病例从1998年的1136例逐年增加至2010年的1822例(趋势P<0.0001)。在这些病例中,主要年龄范围为16至40岁,且年龄分布未随时间变化。非过量用药病例的年龄有所增加(趋势P<0.0001),≥66岁的患者近年来最为常见,这反映了社会老龄化。男性构成了大多数非过量用药患者,但女性的比例逐年增加(趋势P<0.0001)。在整个研究期间,每年过量用药病例中女性约占70%。近年来,过量用药患者从紧急呼叫到抵达医院的时间明显增加。获得医院接收疑似过量用药患者的护理也需要更多时间。

结论

药物过量患者的特征与非过量用药患者明显不同。药物过量患者的近期趋势表明紧急医疗服务系统的负担加重。

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