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J Acupunct Res > Volume 32(3); 2015 > Article
Kwon, Kim, Jo, Choi, Han, Lee, Nam, and Choi: A Retrospective Clinical Analysis of 1,485 Patients Who Visited the Emergency Room of Korean Medical Hospital with Musculoskeletal Disorders

Abstract

Objectives:

The purpose of this study is to review the characteristics of patients who visited the emergency room of a Korean medical hospital with musculoskeletal disorders during the last 5 years and to provide a potential basis for future studies and emergency medical practice.

Methods:

Patient visit records between May 1st, 2010 and February 28th, 2015 were reviewed and patients with musculoskeletal disorders were included in a retrospective analysis.

Results:

A total of 5,218 patient visit records were initially reviewed and 1,485 patients (28.46 %) were included in the analysis. S code group was the most frequently diagnosed coding group of Korean Standard Classification of Diseases. The male to female ratio was 1.05:1 and patients in their thirties represented the highest age group. When classified by time of visit, the distribution of patients was similar from 10:00 to 22:59. The most frequently visited day and month were Sunday and September. 879 patients (59.19 %) visited the emergency room within 24 hours from onset of symptoms. The most common symptom site was the low back (45.59 %), followed by ankle (13.94 %) and neck (13.80 %). The most frequently used treatment method was acupuncture (92.32 %), followed by infrared (45.45 %), TENS (30.03 %) and herbal medication (29.02 %). The follow-up and admission rates were 30.24 % and 13.00 % respectively. 343 patients (23.10 %) received Western medical treatment within a day before visiting the emergency room of the Korean medical hospital.

Conclusions:

This analysis provides the latest information on the characteristics of patients who visited the emergency room of a Korean medical hospital with musculoskeletal disorders. The results can provide the basis for further studies and for other attempts to improve the clinical setting of the emergency room.

Fig. 1
Flowchart
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Fig. 2
Classified by time zone
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Fig. 3
Classified by day of the week
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Fig. 4
Classified by month
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Fig. 5
Classified by day of progress
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Fig. 6
Classified by how they were followed up
* : outpatient department.
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Table 1
Classified by Diagnostic Coding System
Code Number of patients
S code 1,094(73.67 %)
M code 347(23.37 %)
G code 22(1.48 %)
R code 12(0.81 %)
T code 9(0.61 %)
V code 1(0.07 %)

Total 1,485(100 %)
Table 2
Classified by Sex and Age
Age\Sex Male Female Number of patients
0 ~ 9 0 5 5(0.34 %)
10 ~ 19 16 32 48(3.23 %)
20 ~ 29 107 102 209(14.07 %)
30 ~ 39 206 146 352(23.70 %)
40 ~ 49 190 108 298(20.07 %)
50 ~ 59 147 172 319(21.48 %)
60 ~ 69 49 74 123(8.28 %)
70 ~ 79 31 60 91(6.13 %)
80 ~ 89 12 24 36(2.42 %)
over 90 1 3 4(0.27 %)

Total 759 726 1,485(100 %)
Table 3
Classified by Symptom Sites
Symptom site Number of patients
Total patients* 1,485(100 %)

Low back 677(45.59 %)
Ankle 207(13.94 %)
Neck 205(13.80 %)
Shoulder 107(7.21 %)
Leg 83(5.59 %)
Arm 45(3.03 %)
Knee 39(2.63 %)
Wrist 29(1.95 %)
Hip joint 29(1.95 %)
Upper back 24(1.62 %)
Hand 23(1.55 %)
Multiple sites** 61(4.11 %)
Etc 77(5.19 %)

* 121 patients suffered from 2 sites.

** patients with more than 3 sites.

Etc : consists of flank, foot, finger, toe, coccyx, elbow, chest, head, face, pelvic region and inguinal region.

Table 4
Classified by the Treatment Methods
Treatment Number of patients
Treated patients 1,404(94.55 %)

Acupuncture 1,371(92.32 %)
Infrared 675(45.45 %)
TENS 446(30.03 %)
Herbal medication for discharge 431(29.02 %)
Warm/Fire needling 259(17.44 %)
Prickling-cupping bloodletting 246(16.57 %)
Bee venom/Herbal acupuncture 184(12.39 %)
Hot pack 153(10.30 %)
Retained cupping 85(5.72 %)
Collaborative treatment 36(2.42 %)
Etc 107(7.21 %)

Nontreatment 81(5.45 %)

TENS : transcutaneous electrical nerve stimulation.

Etc : consists of pain relief patch, electroacupuncture, manipulation therapy, intradermal needle and aroma therapy.

Table 5
Classified by the Methods of Collaborative Treatment
Treatment Number of patients
Treated patients 36(2.42 %)

X-ray 9(0.61 %)
CT 9(0.61 %)
Blood sugar test 7(0.47 %)
Electrocardiography 6(0.40 %)
Elastic bandage 6(0.40 %)
MRI 1(0.07 %)
Oxygen saturation 1(0.07 %)
Urethral catheterization 1(0.07 %)

CT : computed tomography.

MRI : magnetic resonance imaging.

Table 6
Classified by whether the Patients Got Western Medicine Treatment
Treatment place Number of patients
Before visiting ER-K

ER-WS or OPD-WS(the very day) 237(15.96 %)
ER-WS or OPD-WS(the previous day) 8(0.54 %)
ER-WO or LC-W(the very day) 52(3.50 %)
ER-WO or LC-W(the previous day) 24(1.62 %)
Adm-O(until the very day) 19(1.28 %)
Adm-O(until previous day) 3(0.20 %)

Total 343(23.10 %)

After visiting ER-K

ER-WS or OPD-WS(the very day) 45(3.03 %)
ER-WS or OPD-WS(the next day) 9(0.61 %)

Total 54(3.64 %)

ER-K : emergency room of Korean medical hospital. ER-WS : emergency room of western medical in the same medical center.

OPD-WS : outpatient department of western medicine in the same medical center.

ER-WO : emergency room of western medicine in an other hospital.

LC-W : local clinic of western medicine.

Adm-O : admitted to an other hospital.

Table 7
Classified by the Western Medicine Treatment Methods
Items Number of patients

Treated patients* 369(25.79 %)
Imaging examination

X-ray 306(20.61 %)
CT 56(3.77 %)
MRI 7(0.47 %)

Other examinations

Urinalysis 66(4.44 %)
Blood sugar test 65(4.38 %)
Blood test 58(3.91 %)
Electrocardiography 49(3.30 %)
Oxygen Saturation 26(1.75 %)
Electromyogram 2(0.13 %)

Medications

Fluid therapy 164(11.04 %)
Non-narcotic analgesics 171(11.52 %)
Narcotic analgesics 27(1.82 %)
Muscle relaxant 133(8.96 %)
Other medications** 20(1.35 %)
Oral medication for discharge 180(12.12 %)

Other treatments

Splint 32(2.15 %)
Suture 8(0.54 %)
Physiotherapy 8(0.54 %)
Philadelphia collar 4(0.27 %)
Elastic bandage 3(0.20 %)
Trigger point injection 3(0.20 %)
Sling 3(0.20 %)
Closed reduction of fracture 1(0.07 %)
Etc 11(0.74 %)

Notes

Admission 4(0.27 %)
CPR 1(0.07 %)
Nontreatment 35(2.36 %)

* 6 patients had the western medicine treatment twice, before and after visiting the ER of Korean medical hospital.

** drugs for digestive system, antispasmodics, antibiotics and so on.

Etc: oxygen therapy, urethral catheterization and so on.

CPR: cardiopulmonary resuscitation.

VI.
VI.

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