소아 아나필락시스 상병등록의 적절성
Accuracy for registration of disease codes in pediatric anaphylaxis
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Purpose: The aim of this study was to survey the accuracy of registration as anaphylaxis codes and the clinical characteristics of anaphylaxis registered correctly and incorrectly in pediatric anaphylaxis. Methods: This study was conducted retrospectively using the medical records of patients under 15 years who visited a training hospital Emergency Department (ED) for 5 years. The study subjects were divided into the correct group (registered as anaphylaxis codes correctly) and the incorrect group (registered as other anaphylaxis related codes). Results: Of the 133 patients, 14 belonged to the correct group and 119 to the incorrect group. The median age of the correct group was 9 years old and that of the incorrect group was 2 years old. Sex, transportation to the ED, elapsed time from exposure to ED arrival, past history of allergy, causes of anaphylaxis except drug, severity of symptom, mental status, and antihistamine use were not different between the 2 groups. Drugs as the cause of anaphylaxis and cardiovascular/neurologic symptoms were more common in the correct group. Gastrointestinal symptoms were more frequent in the incorrect group. Intravenous fluid, steroid, bronchodilator, and epinephrine were more commonly used as the treatment for anaphylaxis in the correct group. The pediatric patients treated with epinephrine tended to be registered anaphylaxis correctly. Conclusion: More patients were registered incorrectly as other anaphylaxis-related disease codes rather than correctly as the anaphylaxis disease codes in pediatric anaphylaxis. Epinephrine use was the associated factor for being registered correctly as the anaphylaxis disease codes in pediatric anaphylaxis.
Abstract
Purpose: The aim of this study was to survey the accuracy of registration as anaphylaxis codes and the clinical characteristics of anaphylaxis registered correctly and incorrectly in pediatric anaphylaxis. Methods: This study was conducted retrospectively using the medical records of patients under 15 years who visited a training hospital Emergency Department (ED) for 5 years. The study subjects were divided into the correct group (registered as anaphylaxis codes correctly) and the incorrect group (registered as other anaphylaxis related codes). Results: Of the 133 patients, 14 belonged to the correct group and 119 to the incorrect group. The median age of the correct group was 9 years old and that of the incorrect group was 2 years old. Sex, transportation to the ED, elapsed time from exposure to ED arrival, past history of allergy, causes of anaphylaxis except drug, severity of symptom, mental status, and antihistamine use were not different between the 2 groups. Drugs as the cause of anaphylaxis and cardiovascular/neurologic symptoms were more common in the correct group. Gastrointestinal symptoms were more frequent in the incorrect group. Intravenous fluid, steroid, bronchodilator, and epinephrine were more commonly used as the treatment for anaphylaxis in the correct group. The pediatric patients treated with epinephrine tended to be registered anaphylaxis correctly. Conclusion: More patients were registered incorrectly as other anaphylaxis-related disease codes rather than correctly as the anaphylaxis disease codes in pediatric anaphylaxis. Epinephrine use was the associated factor for being registered correctly as the anaphylaxis disease codes in pediatric anaphylaxis.
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