CharacteristicsofFrequentEmergencyDepartmentUserswithType2DiabetesMellitusinKorea.

韩国对急诊就诊的2型糖尿病患者特征的研究

AIMS

Frequentemergencydepartment(ED)visitorsaremedicallyvulnerablesubjects.Weidentifiedthecharacteristicsof"frequentEDusers"amongKoreanpatientswithtype2diabetesmellitus(DM).

目的：研究频繁急诊就诊的2型糖尿病患者特点。

MATERIALSANDMETHODS

WeusedtheHealthInsuranceReviewandAssessmentServiceNationalPatientSampleHIRA-(NPS),whichisanationallyrepresentativesample.Subjects(n=,)withtype2DMasaprimaryorsecondarydiagnosisatoneoftheirvisitswereincluded.IndividualswereclassifiedintothreegroupsaccordingtothenumberofEDvisits:frequent(≥4visits),occasional(4visits)andnon-usersoftheED.Thecharacteristicsofthepatientsthatdistinguishedfrequentusersfromtheothergroupswereinvestigated.

方法：应用医疗保险和国家患者评服务样本（具有国家代表性样本）。纳入以第一诊断或第二诊断为2型糖尿病病人共，这些纳入患者根据就诊急诊次数被分为3组：频繁（=4次），偶尔（4次），从来没有。

RESULTS

FrequentEDusersweremainlymale(p0.),withlongertreatmentduration(p0.),morefrequentco-morbidities(cardiovascularandchronickidneydisease),andprimarydiagnosismadebysurgery(p=0.).Theyhadhighermortality(p=0.),longerhospitalizationduration(p0.),highercostspervisit(p0.),andmoreoftenrequiredmedicalprotection(p0.).Thesepatientsweretreatedmorefrequentlywithsulfonylurea,insulin,meglitinide,andalpha-glucosidaseinhibitors(p0.05).

结果：频繁急诊就诊的2型糖尿病患者主要为男性，治疗周期较长，多有合并症（心血管和慢性肾脏疾病），第一诊断通过手术发现。这些患者多有更高的死亡率，更长的住院时间，每日住院有更高的花费，更需要医疗保护。此外这些患者更多的是应用磺脲类、胰岛素、胰岛素促泌剂、a糖苷酶抑制剂控制血糖。

CONCLUSIONS

OurfindingssuggestthatfrequentusersoftheEDwithtype2DMhaveserioushealthconditions,apoorsocioeconomicsituation,andtendtotakesomemedicines(sulfonylurea,etc.),whichoftenareassociatedwithhypoglycemia.AttentionshouldbegiventotherapyandtopatientswithrenalandcardiovasculardiseasestodecreasethedependencyofthesepatientsontheED.

结论：我们研究表明频繁急诊就诊的2型糖尿病患者健康状况更差，较低的社会经济地位，更经常出现用药后低血糖。更多的







































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