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

Min Soo Kwon; Jung Hwan Kim; Dae Hyun Jo; Ji Eun Choi; Ji Sun Han; Seung Min Lee; Dong Woo Nam; Do Young Choi

doi:10.13045/acupunct.2015042

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

Original Article

Acupuncture 2015; 32(3): 95-105.

DOI: https://doi.org/10.13045/acupunct.2015042

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

Min Soo Kwon, Jung Hwan Kim, Dae Hyun Jo, Ji Eun Choi, Ji Sun Han, Seung Min Lee, Dong Woo Nam, Do Young Choi^*

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 August 11, 2015 Revised September 02, 2015 Accepted September 09, 2015

See the Original "".

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.

Key Words: Clinical analysis; Musculoskeletal disorder; Emergency room; Korean medical hospital.

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.

VI.

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