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J Korean Neurol Assoc. 1995;13(3):453-463.
- Clinical Analysis on Patients Presenting with Altered ?Consciousness in the Emergency Room of S. N. U. H
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Sun Uck Dwon, M.D., Jae Kyu Roh, M.D.
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Department of Neurology, Seoul National University, College of Medicine
- 의식 변화를 주소로 서울대학교병원 응급실을 내원한 환자들에 대한 ?임상연구
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권순억, 노재규
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서울대학교 신경과
- Abstract
- OBJECT. To analyze clinical'data about the patients presenting with altered consciousness in the emergency room and to plan adequate evaluations and managements.
BACKGROLTND. Clinical analysis of comatose patients is necessary. We have a few
reports but they don't give enough clues to evaluate the patients rapidly and
systematically.
METHOD. We included the patients with altered consciousness on the base of the
daily reports of emergency room, and reviewed the medical records of the patients. We
analyzed the age, sex, visiting date, the patterns of discharge of emergency room,
underlying causes, and consequences of the patients. The validity of the contents of
daily reports was tested by pilot study. In pilot study, we examined all patients
entering emergency room for a week, and compared contents of daily reports with the
data acquired from direct examination.
RESULTS
. The pilot study revealed that the method of patient selection had no
problem statistically. The nwnber of patients with altered consciousness entering
emergency room, was 594 for one year. The causes of altered consciousness consisted
of metabolic problem (35.4%), hemorrhagic stroke (21.2%), malignancy (9.26%),
nonhemorrhagic stroke (8. 1%), and others. The causes of metabolic coma werehepatic
encephalopathy (69.5%), glucose and electrolyte problem (12.9/o), drug intoxication
(6.67%), uremic encephalopathy (6.19%) and alcohol related illness (4.76%). Metabolic
coma patients showed better prognosis than others, and hemorrhagic stroke and
malignancy showed poor prognosis. The ischemic stroke patients were older than
others. Considering the age of the patients, the younger men had better clinical courses
than elderly. Significant seasonal variation was notfound.
CONCLUSION
. The patients visitmg emergency room with altered consciousness had
various causes. The most common cause was metabolic origin followed by hemorrhagic
stroke. Under the influence of the improvement of socioeconomic status and longevity,
the distributions of the underlying disease have changed. The prognosis and
consequence of them relied on underlying diseases and age.
Key Word : Emergency room, ER, Coma, Altered mentality
Keywords :
- 초록
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