Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
Department of Emergency Medicine, Keimyung University School of Medicine, Daegu, South Korea.
Sci Rep. 2022 Mar 23;12(1):4972. doi: 10.1038/s41598-022-09110-2.
Altered levels of consciousness (ALCs) is a challenging issue; however, data describing its etiology and frequency are lacking. This study aimed to clarify and classify the etiologies of ALCs in the emergency room (ER) and to evaluate their destinations and the form of discharge. This retrospective study included patients with an ALC who visited the ER of a university hospital between January 2018 and December 2020. The cause and classification of the ALCs were carefully determined by a consortium of board-certified faculty members in emergency medicine, internal medicine, and neurology. The reference point for determining the etiology of ALC was discharge from the ER. In total, 2028 patients with ALCs were investigated. More than half (1037, 51.1%) visited the ER between 9:00 and 18:00. The most common etiology was systemic infection (581, 28.6%), followed by metabolic causes (455, 22.4%), and stroke (271, 13.4%). The two leading etiologies were extracranial and had a majority of the cases (1036, 51.5%). The overall mortality rate was 17.2%. This study provides fundamental information on ALC in the ER. Although intracranial etiologies have been foregrounded, this study demonstrated that extracranial etiologies are the main cause of ALC in the ER.
意识水平改变（ALC）是一个具有挑战性的问题；然而，缺乏描述其病因和频率的数据。本研究旨在阐明和分类急诊科（ER）中 ALC 的病因，并评估其去向和出院形式。本回顾性研究包括 2018 年 1 月至 2020 年 12 月期间在一所大学医院 ER 就诊的 ALC 患者。由急诊医学、内科和神经病学的认证教员组成的联合会仔细确定了 ALC 的原因和分类。确定 ALC 病因的参考点是从 ER 出院。共调查了 2028 例 ALC 患者。超过一半（1037，51.1%）在 9:00 至 18:00 之间访问 ER。最常见的病因是全身感染（581，28.6%），其次是代谢原因（455，22.4%）和中风（271，13.4%）。两个主要病因是颅外的，且多数为（1036，51.5%）。总体死亡率为 17.2%。本研究提供了 ER 中 ALC 的基本信息。尽管颅内病因已成为焦点，但本研究表明，颅外病因是 ER 中 ALC 的主要原因。
