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精神障碍患者急诊就诊的最常见原因:一项美国全国性分析。

Most common reasons for emergency department presentation among patients with psychiatric disorders: A United States nationwide analysis.

机构信息

Department of Mental Health, University of Benin Teaching Hospital, Benin, Nigeria.

Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.

出版信息

J Affect Disord. 2023 Jun 15;331:145-148. doi: 10.1016/j.jad.2023.03.041. Epub 2023 Mar 21.

Abstract

BACKGROUND

There is a scarcity of national United States (U.S.) data on emergency department (ED) utilization among patients with psychiatric disorders (PD). This study aims to determine the most common reasons for ED visits among patients with PD, and baseline characteristics of patients who present to the ED due to PD.

METHODS

We obtained data from the Nationwide Emergency department Sample (NEDS), the largest all-payer ED database in U.S. Each ED visit in NEDS 2018, can have only 1 "principal" diagnosis, which is the main reason for the visit and up to 34 "secondary" diagnoses. We abstracted data for all ED visits with "any" diagnosis of a PD, using the ICD-10 code "F". We highlighted the 10 most common "principal" diagnoses based on organ-system involved, and most specific "principal" diagnoses for all ED visits by patients with "any" diagnosis of PD. We then highlighted baseline characteristics of ED visits with a "principal" diagnosis of PD.

RESULTS

A total of 38.4 million ED visits for patients with PD, among these, 5,911,984 had PD as the principal diagnosis. Patients who presented principally due to PD were more likely to come from lower income household. Mental disorders and injuries and poisoning were the most common principal diagnosis by organ system categories for patients with PD.

LIMITATIONS

Possibility of coding errors and absence of date on race.

CONCLUSIONS

Anxiety disorder, alcohol intoxication and major depressive disorder (MDD) were the most common specific psychiatric "principal" diagnosis for ED presentation among patients with PD.

摘要

背景

美国缺乏有关精神障碍患者急诊就诊的全国性数据。本研究旨在确定精神障碍患者急诊就诊的最常见原因,以及因精神障碍就诊于急诊的患者的基线特征。

方法

我们从全美急诊样本(NEDS)中获取数据,这是美国最大的所有支付者急诊数据库。NEDS 2018 年的每次急诊就诊只能有 1 个“主要”诊断,这是就诊的主要原因,最多可包括 34 个“次要”诊断。我们使用 ICD-10 编码“F”,从所有以任何精神障碍诊断的急诊就诊中提取数据。我们根据涉及的器官系统突出了 10 个最常见的“主要”诊断,并为所有以任何精神障碍诊断就诊的患者突出了最具体的“主要”诊断。然后,我们突出了以精神障碍为“主要”诊断的急诊就诊的基线特征。

结果

共有 3840 万例精神障碍患者的急诊就诊,其中 5911984 例以精神障碍为主要诊断。主要因精神障碍就诊的患者更有可能来自收入较低的家庭。精神障碍、损伤和中毒是精神障碍患者按器官系统分类的最常见主要诊断。

局限性

可能存在编码错误,且种族数据缺失。

结论

焦虑障碍、酒精中毒和重性抑郁障碍(MDD)是精神障碍患者急诊就诊时最常见的特定精神科“主要”诊断。

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