Hunter L D, Lahri S, van Hoving D J
Khayelitsha Hospital, Cape Town, South Africa.
Division of Emergency Medicine, Stellenbosch University, Cape Town, South Africa.
Afr J Emerg Med. 2017 Mar;7(1):19-23. doi: 10.1016/j.afjem.2017.01.001. Epub 2017 Jan 28.
At the core of the district health system is the emergency centre, for many the entry point into the healthcare system. Limited data is available on the patient population served by district-level emergency centres in South Africa. The objective of this study is to describe the case mix of adult patients managed in the resuscitation unit of a district-level hospital in the Western Cape.
A six-month prospective observational study was conducted in the resuscitation unit of Khayelitsha Hospital. Data were collected by clinicians in the unit by means of a Smartphone application on their own devices. Variables collected included patient demographics, patient acuity, patient comorbidities, diagnosis made in the unit, interventions received, length of stay, and disposition. Summary statistics were used to describe all variables.
A total of 2324 patient admissions were analysed. The mean age was 36.9 years with a male predominance (n = 1367, 58.8%). Most patients were triaged into high-acuity categories (n = 1626, 70%). HIV infection was the most common comorbidity (n = 530, 22.8%). Acute medical (n = 1181, 50.8%) and trauma-related patients (n = 928, 39.9%) dominated the cohort. The median length of stay was 195 min and 502 (21.6%) patients were transferred to higher levels of care. There were 74 (3.2%) deaths.
This study yields novel epidemiological data of emergency care in a district-level emergency centre. It highlights the burden of trauma and acute medical emergencies at the district level and can be used as a foundation for further research to provide targeted and effective healthcare to all citizens.
地区卫生系统的核心是急救中心,对许多人来说,这是进入医疗系统的入口。关于南非地区级急救中心所服务患者群体的数据有限。本研究的目的是描述西开普省一家地区级医院复苏病房中成年患者的病例组合情况。
在Khayelitsha医院的复苏病房进行了一项为期六个月的前瞻性观察研究。数据由该病房的临床医生通过他们自己设备上的智能手机应用程序收集。收集的变量包括患者人口统计学信息、患者 acuity、患者合并症、在病房做出的诊断、接受的干预措施、住院时间和处置情况。汇总统计数据用于描述所有变量。
共分析了2324例患者入院情况。平均年龄为36.9岁,男性占主导(n = 1367,58.8%)。大多数患者被分诊为高 acuity 类别(n = 1626,70%)。艾滋病毒感染是最常见的合并症(n = 530,22.8%)。急性内科患者(n = 1181,50.8%)和创伤相关患者(n = 928,39.9%)在队列中占主导。中位住院时间为195分钟,502例(21.6%)患者被转至更高水平的护理机构。有74例(3.2%)死亡。
本研究得出了地区级急救中心急诊护理的新流行病学数据。它突出了地区一级创伤和急性医疗紧急情况的负担,并可作为进一步研究的基础,以便为所有公民提供有针对性和有效的医疗保健。