Investigation of hospital emergency admissions of walk-in patients at a department of general medicine *
Emergency admission to the hospital of walk-in patients at the Department of General Medicine in the medical college hospital was investigated. Of 2,435 individuals (1,130 males and 1,305 females; 15 ? 92 years old; median age, 37 years), visiting (for the first time) the Department of General Medicine, Kawasaki Medical School Hospital between April 2010 and March 2011, 40 required emergency admission to the hospital (1.64% of all; 20 males and 20 females; 16 ? 88 years old; median age, 64 years). Among the causal diseases, acute inflammatory disease was the one most frequently observed, in 25 cases (62.5%), followed by malignant disease in 5, heart failure in 3, and others in 7 patients. Ultrasonography was the most frequent examination performed to determine admission, in 19 cases (47.5%), followedby chest X-ray in 7 and blood examinations in 5 cases. The gastroenterology department was the department that was most frequently in charge of treatment after admission, in 20 cases (50%), followed by the cardiology department in 5, nephrology and urology in 3, neurology in 3, and others in 9 cases. Regarding the age of the patients, the subjects were divided into a young group (15 ? 39 years), middle group (40 ? 64 years), and elder group (65 years or older). Emergency admission was necessary in 0.84% in the young group (11/1,302), 1.32% (9/682) in the middle group, and 4.43% (20/451) in the elder group, and it was necessary significantly more often in the elder group. The characteristic acute inflammatory diseases were biliary system disease and pneumonia in the elder group, which were different from those in the young group. Moreover, malignant disease and heart failure were also observed in the elder group. Taken together, attention should be paid to critical diseases that may require emergency admission among the walk-in patients, in particular, the elderly patients. In addition, it was thought possible to provide primary care in most cases by employing a minimally invasive chest X-ray and ultrasonography as well as history-taking and physical examinations. (Accepted on August 27, 2012)
