A Retrospective Clinical Analysis of 1,485 Patients Who Visited the Emergency Room of Korean Medical Hospital with Musculoskeletal Disorders

Article information

Acupunct. 2015;32(3):95-105
Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University
*Corresponding author : Department of Acupuncture & Moxibustion Medicine, Kyung Hee University, Korean Medicine Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea, Tel : +82-2-958-9205, E-mail : choi4532@unitel.co.kr
Received 2015 August 11; Revised 2015 September 02; Accepted 2015 September 09.

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

Fig. 2

Classified by time zone

Fig. 3

Classified by day of the week

Fig. 4

Classified by month

Fig. 5

Classified by day of progress

Fig. 6

Classified by how they were followed up

* : outpatient department.

Classified by Diagnostic Coding System

Classified by Sex and Age

Classified by Symptom Sites

Classified by the Treatment Methods

Classified by the Methods of Collaborative Treatment

Classified by whether the Patients Got Western Medicine Treatment

Classified by the Western Medicine Treatment Methods

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Article information Continued

Fig. 1

Flowchart

Fig. 2

Classified by time zone

Fig. 3

Classified by day of the week

Fig. 4

Classified by month

Fig. 5

Classified by day of progress

Fig. 6

Classified by how they were followed up

* : outpatient department.

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.