Pazarcık State Hospital, Emergency Service, Kahramanmaraş, Türkiye.
Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Emergency Service, Ankara, Türkiye.
BMC Emerg Med. 2024 Oct 10;24(1):185. doi: 10.1186/s12873-024-01101-y.
Vital signs and comorbid diseases are the first information evaluated in patients admitted to the emergency department (ED). In most EDs, triage of patients takes place with vital signs and admission complaints only. Comorbidities are generally underestimated when determining the patient's status at the triage area. This study aims to assess the relationship between initial vital signs, comorbid diseases, and medical emergency conditions (MEC) in patients admitted to the ED.
This prospective study was designed as a single-center observational study, including patients admitted to a tertiary ED between 16.06.2022 and 09.09.2022. Patients younger than 18, readmitted to the ED within 24 h, or absence of vital signs due to cardiac arrest were excluded from the study. Vital signs and comorbid diseases of all patients were recorded. The mortality within 24 h, the need for intensive care unit admission, emergency surgery, and life-saving procedures were considered "medical emergency conditions". The role of vital signs and comorbid diseases in predicting emergencies was analyzed by binary logistic regression.
A total of 10,022 patients were included in the study; 5056 (50.4%) were female, and 4966 (49.6%) were male. Six hundred four patients presented with an MEC. All vital signs -except diastolic hypertension and tachycardia- and comorbidities were found statistically significant. Hypoxia (Odd's Ratio [OR]: 1.73), diastolic hypotension (OR: 3.71), tachypnea (OR: 8.09), and tachycardia (OR: 1.61) were associated with MECs. Hemiplegia (OR: 5.7), leukemia (OR: 4.23), and moderate-severe liver disease (OR: 2.99) were the most associated comorbidities with MECs. In our study, an MEC was detected in 3.6% (186 patients) of the patients with no abnormal vital signs and without any comorbidities.
Among the vital signs, hypoxia, diastolic hypotension, tachypnea, and tachycardia should be considered indicators of an MEC. Hemiplegia, leukemia, and moderate-severe liver disease are the most relevant comorbidities that may accompany the MECs.
生命体征和合并症是急诊患者首先评估的信息。在大多数急诊室，仅通过生命体征和入院主诉进行患者分诊。在分诊区域确定患者病情时，通常会低估合并症。本研究旨在评估急诊患者初始生命体征、合并症与医疗紧急情况（MEC）之间的关系。
这是一项前瞻性单中心观察性研究，纳入 2022 年 6 月 16 日至 9 月 9 日期间在一家三级急诊就诊的患者。排除年龄小于 18 岁、24 小时内再次入院或因心脏骤停而无生命体征的患者。记录所有患者的生命体征和合并症。24 小时内死亡、需要入住重症监护病房、急诊手术和救生程序被视为“医疗紧急情况”。通过二元逻辑回归分析生命体征和合并症对预测紧急情况的作用。
共有 10022 名患者纳入研究；5056 名（50.4%）为女性，4966 名（49.6%）为男性。604 名患者出现 MEC。除舒张压高血压和心动过速外，所有生命体征和合并症均有统计学意义。低氧血症（优势比 [OR]：1.73）、舒张压低血压（OR：3.71）、呼吸急促（OR：8.09）和心动过速（OR：1.61）与 MEC 相关。偏瘫（OR：5.7）、白血病（OR：4.23）和中重度肝脏疾病（OR：2.99）是与 MEC 最相关的合并症。在我们的研究中，在无异常生命体征且无任何合并症的患者中，有 3.6%（186 名）患者检测到 MEC。
在生命体征中，低氧血症、舒张压低血压、呼吸急促和心动过速应视为 MEC 的指标。偏瘫、白血病和中重度肝脏疾病是可能伴随 MEC 的最相关合并症。
