Abe Toshiyuki, Matsubara Tomoyasu, Sasaki Sho, Oda Hiroyuki, Imura Hiroshi, Mogi Tsunetoshi
Department of General Internal Medicine Iizuka Hospital Iizuka Japan.
Department of Gastroenterology Iizuka Hospital Iizuka Japan.
J Gen Fam Med. 2020 Jun 30;21(6):282-287. doi: 10.1002/jgf2.337. eCollection 2020 Nov.
In Japan, even if physicians have not experienced surgical training, they face many instances in which they must provide initial surgical treatment, especially during off-hours. This study aimed to identify the frequency and fields of commonly encountered problems in a Japanese emergency department.
A retrospective review was performed to identify walk-in outpatients with exogenous problems visiting during off-hours in the Japanese educational hospital providing primary to tertiary emergency care between January 1 and December 31, 2014. Diseases were aggregated according to International Classification of Primary Care (Second Edition; ICPC-2).
During the study period, 33 424 patients visited and 7476 were classified into the "exogenous" group. We analyzed the data of 7421 patients after excluding 55 who were deemed undiagnosable based on reviews of the charts. The median age of patients who visited the ED during off-hours was 29 years (range: 0-101 years, IQR: 8-60 years). Altogether, 226 types of problems included in ICPC-2 were identified during the study period. The majority fields of exogenous problems were 'skin,' 'Musculoskeletal,' and 'eye.' The 15 problems with the highest frequencies accounted for 50.2% of the total problems.
We identified surgical problems with high treatment frequencies among patients visiting the ED during off-hours. Providing education focusing on these frequent surgical problems can help to improve the initial treatment quality and reduce the anxiety for those doctors who provide initial surgical treatment.
在日本，即使医生没有接受过外科培训，他们也会面临许多必须提供初步外科治疗的情况，尤其是在非工作时间。本研究旨在确定日本急诊科常见问题的频率和领域。
进行回顾性研究，以确定2014年1月1日至12月31日期间在提供初级至三级急诊护理的日本教学医院非工作时间前来就诊的有外部问题的门诊患者。疾病根据国际初级保健分类（第二版；ICPC-2）进行汇总。
在研究期间，共有33424名患者就诊，其中7476名被归类为“外部”组。在排除55名经病历审查后被认为无法诊断的患者后，我们分析了7421名患者的数据。非工作时间到急诊科就诊的患者的中位年龄为29岁（范围：0-101岁，四分位距：8-60岁）。在研究期间，共确定了ICPC-2中包含的226种问题类型。外部问题的主要领域是“皮肤”、“肌肉骨骼”和“眼睛”。出现频率最高的15个问题占总问题的50.2%。
我们确定了非工作时间到急诊科就诊的患者中治疗频率较高的外科问题。针对这些常见的外科问题开展教育有助于提高初始治疗质量，并减轻那些提供初步外科治疗的医生的焦虑。
