Song Byeong Geun, Woo Jung Han, Yoon Hyeon Kyung, Cho Byeongwook, Lee Hyun Jae, Jung Moonki, Jang Yoonhyuk
Department of Internal Medicine, Armed Forces Seoul District Hospital, Seoul, Korea.
Department of Radiology, Armed Forces Seoul District Hospital, Seoul, Korea.
Encephalitis. 2022 Jul;2(3):73-82. doi: 10.47936/encephalitis.2021.00185. Epub 2022 Mar 11.
PURPOSE: Chest pain, abdominal pain, and headache are common symptoms associated with critical illness. Here, we aimed to evaluate predictors associated with critical illness in young males of the Republic of Korea Army. METHODS: We retrospectively reviewed previously healthy young males with chest pain, abdominal pain, or headaches who visited Armed Forces Seoul District Hospital between January 2019 and December 2020. Critical illness was defined as a condition that required hospitalization, a procedure or surgery, or referral to a tertiary hospital. The symptoms and signs of critical illness were evaluated. RESULTS: Of the 762 enrolled patients, a critical illness was diagnosed in 45 patients (5.9%). Among chest pain signs, palpitation (odds ratio [OR], 22.8; 95% confidence interval [CI], 5.08-102.4; p < 0.001), exertional dyspnea (OR, 16.3; 95% CI, 3.38-78.8; p = 0.001), duration (> 5 minutes) (OR, 7.54; 95% CI, 1.93-29.49; p = 0.004), and squeezing type (OR, 5.28; 95% CI, 1.11-25.11; p = 0.037) were significantly associated with critical illness. Among abdominal pain signs, right-lower-quadrant tenderness (OR, 11.87; 95% CI, 4.671-31.87; p < 0.001) was an alarming sign. For headaches, criticality was low (1.5%), and half of patients with critical illness were diagnosed incidentally regardless of headache. CONCLUSION: We identified symptoms and signs significantly associated with critical illness in young male patients. This study might serve as a reference for deciding when to transfer soldiers in the field to a rear hospital, thereby contributing to the welfare and combat power of soldiers.
目的:胸痛、腹痛和头痛是危重症常见的伴随症状。在此,我们旨在评估韩国陆军年轻男性危重症的相关预测因素。 方法:我们回顾性分析了2019年1月至2020年12月期间因胸痛、腹痛或头痛前往首尔地区武装部队医院就诊的既往健康年轻男性。危重症定义为需要住院、进行手术或转诊至三级医院的情况。对危重症的症状和体征进行了评估。 结果:在762名登记患者中,45名患者(5.9%)被诊断为危重症。在胸痛体征中,心悸(比值比[OR],22.8;95%置信区间[CI],5.08 - 102.4;p < 0.001)、劳力性呼吸困难(OR,16.3;95% CI,3.38 - 78.8;p = 0.001)、持续时间(> 5分钟)(OR,7.54;95% CI,1.93 - 29.49;p = 0.004)和压榨样(OR,5.28;95% CI,1.11 - 25.11;p = 0.037)与危重症显著相关。在腹痛体征中,右下腹压痛(OR,11.87;95% CI,4.671 - 31.87;p < 0.001)是一个警示体征。对于头痛,危重症发生率较低(1.5%),且半数危重症患者无论有无头痛均为偶然诊断。 结论:我们确定了年轻男性患者中与危重症显著相关的症状和体征。本研究可为决定何时将战场上的士兵转至后方医院提供参考,从而有助于士兵的福利和战斗力。
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