Dallara J, Lee C, McIntosh L, Sloane P D, Morris D
Department of Emergency Medicine, Duke University Medical Center, Durham, NC 27710.
Am J Emerg Med. 1994 Jul;12(4):421-4. doi: 10.1016/0735-6757(94)90052-3.
Emergency department (ED) length of stay, illness severity, and patterns of ED-based testing can be used to compare different ED patient populations. To assess the relative significance of ED patients with dizziness and chest pain in emergency medicine practice, the investigators formed a retrospective chart review of 3,864 adults (age > or = 16 years) seen at the University of North Carolina Hospitals' ED during May and June of 1991. Patients were eligible if they had any complaint of dizziness (n = 259), nontraumatic chest pain (n = 168), or both (n = 18). ED length of stay and illness severity, as measured by Acute Physiology and Chronic Health Evaluation (APACHE) II score, were not significantly different between the two groups. Dizzy and chest-pain patients were both high users of ED-based testing, but management patterns were different. Chest-pain patients were more likely to undergo electrocardiogram and x-ray testing, whereas dizzy patients more often received testing such as brain computed tomography scanning (10.8% v 3.6%, P = .01). ED patients with dizziness and chest pain were similar with regard to ED length of stay. Given their overall similarities to the chest-pain group, dizzy patients appear to represent a significant population of ED patients and may warrant more clinical study.
急诊科（ED）的住院时间、疾病严重程度以及基于急诊科的检查模式可用于比较不同的急诊科患者群体。为了评估急诊科中头晕和胸痛患者在急诊医学实践中的相对重要性，研究人员对1991年5月和6月在北卡罗来纳大学医院急诊科就诊的3864名成年人（年龄≥16岁）进行了回顾性病历审查。如果患者有任何头晕主诉（n = 259）、非创伤性胸痛（n = 168）或两者皆有（n = 18），则符合入选标准。两组患者的急诊科住院时间和疾病严重程度（通过急性生理与慢性健康状况评估（APACHE）II评分衡量）无显著差异。头晕和胸痛患者都是基于急诊科检查的高使用者，但管理模式不同。胸痛患者更有可能接受心电图和X线检查，而头晕患者更常接受诸如脑部计算机断层扫描等检查（10.8%对3.6%，P = 0.01）。头晕和胸痛的急诊科患者在急诊科住院时间方面相似。鉴于头晕患者与胸痛组总体相似，他们似乎代表了急诊科患者中的一个重要群体，可能值得进行更多的临床研究。
