比较 COVID-19 期间频繁就诊者的医学无法解释症状在急诊科的表现。
A comparison of emergency department presentations for medically unexplained symptoms in frequent attenders during COVID-19.
机构信息
University of Cambridge School of Clinical Medicine, Cambridge, UK
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
出版信息
Clin Med (Lond). 2021 Jul;21(4):e399-e402. doi: 10.7861/clinmed.2020-1093. Epub 2021 May 20.
Medically unexplained symptoms (MUS) are those with no identified organic aetiology. Our emergency department (ED) perceived an increase in MUS frequency during COVID-19. The primary aim was to compare MUS incidence in frequent attenders (FAs) during COVID-19 and a control period.A retrospective list of FA-MUS presenting to our ED from March to June 2019 (control) and March to June 2020 (during COVID-19) was compared. Fisher's exact test was used to compare binomial proportions; this presented as relative risk (RR) with 95% confidence intervals (95%CI).During COVID-19, ED attendances reduced by 32.7%, with a significant increase in the incidence of FA-MUS and FA-MUS ED visits compared to control; RR 1.5 (95%CI 1.1-1.8) p=0.0006, and RR 1.8 (95%CI 1.6-2.0), p<0.0001, respectively.Despite reduced ED attendances during COVID-19, there was a significant increase in the incidence of FA-MUS patients and corresponding ED visits by this cohort. This presents a challenge to ED clinicians who may feel underprepared to manage these patients effectively.
无法找到明确的器质性病因的症状被称为医学无法解释的症状（MUS）。我们的急诊部门（ED）在 COVID-19 期间注意到 MUS 出现频率增加。主要目的是比较 COVID-19 期间和对照期间频繁就诊者（FA）中 MUS 的发生率。
比较了 2019 年 3 月至 6 月（对照）和 2020 年 3 月至 6 月（COVID-19 期间）期间到我们 ED 就诊的 FA-MUS 的回顾性列表。使用 Fisher 确切检验比较二项式比例；这表现为相对风险（RR）和 95%置信区间（95%CI）。
在 COVID-19 期间，ED 就诊人数减少了 32.7%，与对照相比，FA-MUS 和 FA-MUS ED 就诊的发生率显著增加；RR 1.5（95%CI 1.1-1.8）p=0.0006，RR 1.8（95%CI 1.6-2.0），p<0.0001。尽管 COVID-19 期间 ED 就诊人数减少，但该队列中 FA-MUS 患者的发病率和相应的 ED 就诊人数显著增加。这对 ED 临床医生来说是一个挑战，他们可能觉得自己没有准备好有效地管理这些患者。
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