Rosen Monica W, Weyand Angela C, Pennesi Christine M, Stoffers Victoria L, Bourdillon Charlotte M, George Jenny S, Quint Elisabeth H
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
Department of Pediatric Hematology-Oncology, University of Michigan, Ann Arbor, MI.
J Pediatr Adolesc Gynecol. 2020 Apr;33(2):139-143. doi: 10.1016/j.jpag.2019.11.010. Epub 2019 Nov 22.
To describe the adolescent population that seeks care in the emergency department (ED) for heavy menstrual bleeding (HMB), and to compare those who are discharged to those who are admitted to the hospital.
Retrospective study.
Emergency department and inpatient unit at a national tertiary care hospital from 2006-2018.
Adolescents 11-19 years old with ICD-9 and ICD-10 codes for HMB.
Chart abstraction for demographic data, symptoms, laboratory tests, outcomes, and treatments.
Adolescents who were admitted were compared to girls who were treated as outpatients.
There were 258 adolescents who sought care for HMB in the ED during the study period. A total of 44 patients (17%) were admitted to the hospital, whereas 214 (83%) were discharged. The average age of those admitted was 15 years, compared to 17 years for those discharged (P < .001). In the admitted group, the mean initial hemoglobin (Hgb) was 6.3 g/dL compared to 12.0 g/dL in the discharged group (P < .0001). Only 23% of the discharged patients were released with medications; the remainder did not receive treatment. Anovulation was the etiology of HMB in the majority (56%) of both inpatients and outpatients. Of the 44 adolescents admitted to the hospital for HMB, 12 (27%) had a bleeding disorder (BD) and 32 (73%) did not.
The majority of adolescents who presented to the emergency department for HMB were not anemic and did not receive any treatment. Of those admitted, almost one-third had an underlying BD, which is higher than previously reported.
描述因月经过多（HMB）到急诊科（ED）就诊的青少年人群，并比较出院患者与住院患者的情况。
回顾性研究。
2006年至2018年期间一家国家级三级护理医院的急诊科和住院部。
年龄在11至19岁之间、具有国际疾病分类第九版（ICD - 9）和第十版（ICD - 10）中HMB编码的青少年。
提取病历中的人口统计学数据、症状、实验室检查、结局和治疗信息。
将住院青少年与门诊治疗的女孩进行比较。
在研究期间，有258名青少年因HMB到急诊科就诊。共有44名患者（17%）住院，而214名（83%）出院。住院患者的平均年龄为15岁，而出院患者为17岁（P < 0.001）。住院组的平均初始血红蛋白（Hgb）为6.3 g/dL，而出院组为12.0 g/dL（P < 0.0001）。只有23%的出院患者带药出院；其余患者未接受治疗。无排卵是大多数住院患者和门诊患者（56%）HMB的病因。在因HMB住院的44名青少年中，12名（27%）患有出血性疾病（BD），32名（73%）没有。
到急诊科就诊的大多数HMB青少年没有贫血且未接受任何治疗。在住院患者中，近三分之一有潜在的BD，这一比例高于先前报道。
