본문 바로가기
KERD
논문KCI 등재

병원전과 병원내의 복통환자 중증도 분류 및 진료결과 비교

Comparison of triage and treatment results of abdominal pain patients of pre-hospital and in-hospital conditions

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

Abstract

Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

참고문헌 (26)

  1. 황용, "비특이적 복통을 주소로 응급센터에 내원한 환자에서 추가 검사의 결과 분석", 대한응급의학회지, 21(2), pp.184~190 (2010), 대한응급의학회
  2. 이경숙, "응급의료센터를 내원한 환자의 주증상과 주진단 분포에 관한 연구", 디지털융복합연구, 10(10), pp.347~352 (2012), 한국디지털정책학회[DOI]
  3. 손정아, "한국형 응급환자 분류도구의 간호사-응급구조사 간 신뢰도 평가", 임상간호연구, 26(1), pp.107~116 (2020), 병원간호사회[DOI]
  4. Nawar EW, "National hospital ambulatory medical care survey", Emergency Department Summary Tables, 29, pp.1~32 (2005)
  5. 김마루, "급성 복증 환자에서 이상적인 수술 시간", Journal of Acute Care Surgery, 6(1), pp.7~10 (2016), 대한외상중환자외과학회[DOI]
  6. Christopher Macaluso, "Evaluation and management of acute abdominal pain in the emergency department", International Journal of General Medicine, 5, pp.789~797 (2012), Informa UK Limited[DOI]
  7. "National emergency department information system stat-istical yearbook in 2018/at:" (2019)[URL]
  8. Choi HJ, "Analysis of triage results of patients admitted with 119: overtriage or under triage", doctor, pp.2020
  9. 최희정, "한국형 응급환자 분류도구의 타당도 평가", Journal of Korean Academy of Nursing, 49(1), pp.26~35 (2019), 한국간호과학회[DOI]
  10. Akira Kuriyama, "Five-level emergency triage systems: variation in assessment of validity", Emergency Medicine Journal, 34(11), pp.703~710 (2017), BMJ[DOI]
  11. 박진옥, "119구급차로 이송된 환자의 병원 전 전문응급처치에 관한 조사", 한국응급구조학회지, 7(1), pp.127~134 (2003), 사단법인 한국응급구조학회
  12. Cha MI, "A comparison study of triage results between prehospital and hospital settings", master, pp.2017
  13. 오민택, "응급실 방문환자 중 낮은 우선순위를 가진 환자의 입원에 영향을 주는 요소", 대한응급의학회지, 29(5), pp.408~414 (2018), 대한응급의학회
  14. 박상욱, "119 구급대에 의한 출동구역 밖 이송의 적절성 분석", 대한응급의학회지, 21(5), pp.531~538 (2010), 대한응급의학회
  15. 박상규, "구급대 환자이송과 반응시간의 평가", 한국응급구조학회지, 22(3), pp.47~54 (2018), 사단법인 한국응급구조학회[DOI]
  16. Jo SE, "Factors for hospitalization of abdominal pain patients in pediatric emergency departments", master, pp.2020
  17. 정원숙, "응급실 내원 복통 환자의 특성과 NIC을 활용한 간호중재 분석", Global Health and Nursing (글로벌 건강과 간호), 8(1), pp.29~38 (2018), 간호과학연구소[DOI]
  18. Luigi Lusiani, "Prevalence, Clinical Features, and Acute Course of Atypical Myocardial Infarction", Angiology, 45(1), pp.49~55 (1994), SAGE Publications[DOI]
  19. Hakan Oguzturk, "The Evaluation of Electrocardiogram Findings in Acute Abdominal Pain Patients Admitted to the Emergency Department", Journal of Primary Care & Community Health, 2(3), pp.163~166 (2011), SAGE Publications[DOI]
  20. Sil Sung, "Correlation between the pre-hospital triage scale and emergency department triage scale", Hong Kong Journal of Emergency Medicine, 26(5), pp.281~287 (2019), SAGE Publications[DOI]
  21. "Development of pre-hospital korean triage and acuity scale" (2017)[URL]
  22. "Emergency medical vulnerable area/at:" (2019)[URL]
  23. 최준원, "119구급대를 통해 3차 병원으로 재이송된 환자분석", 한국응급구조학회지, 24(2), pp.79~88 (2020), 사단법인 한국응급구조학회[DOI]
  24. 이효기, "응급의료센터에 내원한 복부통증 노인 환자에 대한 간호기록 분석", 근관절건강학회지, 26(1), pp.27~34 (2019), 대한근관절건강학회[DOI]
  25. 류형선, "응급실 방문 당시 통증 정도와 computed tomography 기반충수염 진행 정도와의 상관관계", 대한응급의학회지, 29(6), pp.656~662 (2018), 대한응급의학회

관련 논문AI추천

이 간행물의 다른 논문 (17건)