Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, 3010 Bern, Switzerland.
Department of Paediatric Emergency Medicine, University Children's Hospital, Inselspital, Bern University, 3010 Bern, Switzerland.
Int J Environ Res Public Health. 2021 Sep 11;18(18):9578. doi: 10.3390/ijerph18189578.
In many large hospitals in Switzerland, adolescents 16 years and older are treated in adult emergency departments (ED). There have been few publications about this specific patient population, especially in Switzerland. This study aims to provide an overview of emergency presentations of adolescents between 16-18 years of age when compared to adults and focuses on their principle complaints.
We conducted a single-centre, retrospective, cross-sectional study of all patients aged 16 years and older presenting to the adult ED at the University Hospital (Inselspital) in Bern, Switzerland, from 2013 to 2017. This analysis gives an overview of emergency presentations of adolescents between 16-18 years of age in this time period and compares their consultation characteristics to those of adult patients.
Data of a total of 203,817 patients who presented to our adult ED between 2013 and 2017 were analysed. Adolescents account for 2.5% of all emergency presentations. The number of ED presentations in the reviewed time period rose for adults (+2368, 95% CI: 1695, 3041, = 0.002 consultations more per year; +25% comparing 2013 with 2017), while adolescent presentations did not significantly increase ( = 0.420). In comparison to adult patients, adolescents presented significantly more often during the night (39.1% vs. 31.5%, < 0.001), as walk-ins (54.2% vs. 44.9%, < 0.001), or with less highly acute complaints at triage (21% vs. 31%, < 0.001). They were more likely to be discharged (70.8% vs. 52.2%, < 0.001). We found a significant association between the two age groups and principle complaints. In comparison to adults, trauma and psychiatric problems were significantly more common among adolescents.
Our data showed that complaints in adolescent patients under 18 years of age significantly differ from those in older patients. The artificial age cut-off therefore puts this vulnerable population at risk of receiving inadequate diagnostic testing and treatment adapted only for adults. Additional studies are needed on the reasons adolescents and young adults seek ED care, as this could lead to improvements in the care processes for this vulnerable population.
在瑞士的许多大医院中，16 岁及以上的青少年在成人急诊部（ED）接受治疗。关于这一特定患者群体的出版物很少，尤其是在瑞士。本研究旨在提供一个综述，比较 16-18 岁青少年与成年人在急诊时的表现，并重点关注他们的主要主诉。
我们对 2013 年至 2017 年期间在瑞士伯尔尼大学医院（Inselspital）成人 ED 就诊的所有 16 岁及以上患者进行了一项单中心、回顾性、横断面研究。该分析概述了这一时期 16-18 岁青少年的急诊表现，并将他们的就诊特征与成年患者进行比较。
对 2013 年至 2017 年期间我院成人 ED 的 203817 例患者的数据进行了分析。青少年占所有急诊就诊者的 2.5%。在研究期间，成年患者的 ED 就诊人数增加（+2368，95%CI：1695，3041，=每年增加 0.002 次就诊；2013 年与 2017 年相比增加 25%），而青少年就诊人数并未显著增加（=0.420）。与成年患者相比，青少年在夜间就诊的比例明显更高（39.1%比 31.5%，<0.001），作为非预约就诊者（54.2%比 44.9%，<0.001），或分诊时的高度急性主诉较少（21%比 31%，<0.001）。他们更有可能被出院（70.8%比 52.2%，<0.001）。我们发现两组患者的主要主诉之间存在显著关联。与成年人相比，青少年创伤和精神问题更为常见。
我们的数据表明，18 岁以下青少年患者的主诉与年龄较大患者明显不同。人为的年龄界限使这一脆弱人群面临接受不适当的诊断测试和仅适用于成年人的治疗的风险。需要进一步研究青少年和年轻成年人寻求急诊护理的原因，这可能会改善对这一脆弱人群的护理流程。
