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孕妇急诊就诊的流行状况和特征:一项全国急诊样本分析(2010-2020 年)。

Prevalence and Characteristics of Emergency Department Visits by Pregnant People: An Analysis of a National Emergency Department Sample (2010-2020).

机构信息

Stanford University School of Medicine, Department of Emergency Medicine, Stanford, California.

Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, California.

出版信息

West J Emerg Med. 2024 May;25(3):436-443. doi: 10.5811/westjem.60461.

Abstract

INTRODUCTION

The number and characteristics of pregnant patients presenting to the emergency department (ED) has not been well described. Our objective in this study was to determine the prevalence and characteristics of pregnant patients presenting to EDs in the US between 2010-2020.

METHODS

We completed a retrospective, cross-sectional study of patient encounters at hospital-based EDs in the US from 2010-2020. Using the ED subsample of the National Hospital Ambulatory Medical Care Survey (NHAMCS) we identified ED visits for female patients aged 15-44 years. We defined a subsample of these as visits for pregnant patients using discharge diagnosis codes specific to pregnancy. We compared this population of pregnant patient visits to those for non-pregnant patients and computed point estimates for nationally weighted values. Multivariable linear regression was used to determine factors independently associated with pregnant patient visits.

RESULTS

The 2010-2020 NHAMCS dataset included 255,963 ED visits. Of these visits 59,080 were for female patients 15-44 years old, and 6,068 of those visits were for pregnant patients. Pregnant patients accounted for 3% (95% confidence interval [CI] 2.7-3.2) of all ED visits and 8.6% (95% CI 8-9.3) of all visits among female patients 15-44 years. Weighting to a national sample, this equates to 2.77 million pregnant patients presenting for ED visits annually. Pregnant patients were more likely to be Black, Hispanic, or to use public insurance.

CONCLUSION

Pregnant patients make up a significant number of ED visits annually and are more likely to be people of color or publicly insured. Interventions to address the effects of changing abortion legislation on emergency medicine practice may benefit from consideration that certain populations of pregnant people are more likely to present to the ED for care.

摘要

简介

到急诊科(ED)就诊的孕妇数量和特征尚未得到很好的描述。我们在这项研究中的目的是确定 2010 年至 2020 年期间美国 ED 就诊的孕妇的患病率和特征。

方法

我们对美国医院 ED 基于患者的回顾性、横断面研究进行了研究。我们使用国家医院门诊医疗保健调查(NHAMCS)的 ED 子样本,确定了年龄在 15-44 岁的女性患者的 ED 就诊情况。我们使用特定于妊娠的出院诊断代码,将这些患者中的一部分定义为妊娠患者就诊。我们将该妊娠患者就诊人群与非妊娠患者就诊人群进行了比较,并计算了全国加权值的点估计值。多变量线性回归用于确定与妊娠患者就诊相关的独立因素。

结果

2010-2020 年 NHAMCS 数据集包括 255963 次 ED 就诊。这些就诊中,59080 次是 15-44 岁女性患者就诊,其中 6068 次是妊娠患者就诊。妊娠患者占所有 ED 就诊的 3%(95%置信区间 [CI] 2.7-3.2),占所有 15-44 岁女性患者就诊的 8.6%(95% CI 8-9.3)。全国范围内的权重相当于每年有 277 万例妊娠患者因 ED 就诊。妊娠患者更有可能是黑人、西班牙裔或使用公共保险。

结论

每年有大量的妊娠患者就诊 ED,而且更有可能是有色人种或公共保险人群。解决不断变化的堕胎立法对急诊医学实践的影响的干预措施可能会受益于考虑到某些孕妇群体更有可能因护理而到 ED 就诊。

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