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首页> 外文期刊>Surgical Endoscopy >Emergency department visits by demented patients with malfunctioning feeding tubes.
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Emergency department visits by demented patients with malfunctioning feeding tubes.

机译：患有摄食管故障的痴呆患者前往急诊室就诊。

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BACKGROUND: Objective data indicate that feeding tubes in demented patients may not be efficacious and can have serious complications, but no study characterizes emergency department resource utilization for these patients. This study aimed to evaluate the incidence and resource utilization related to feeding tube malfunction in demented patients visiting the emergency department. METHODS: A retrospective chart review for all demented patients visiting the emergency department with malfunctioning feeding tubes from September 1999 to May 2001 was conducted. Demographic data, diagnoses, type of tube, length of emergency department stay, method of transportation to the emergency department, consultations, laboratory evaluation, x-ray data, and total hospital and ambulance charges were determined. RESULTS: A total of 138 emergency department visits by 33 patients occurred during this period (range of visits per patients, 1-21; mean, 4.1 +/- 4.3). Malfunctions occurred in 61 percutaneous endoscopically placed gastric tubes, 37 jejunostomy tubes, 34 gastric tubes, 4 endoscopically placed gastrostomy and jejunostomy tubes, and 2 percutaneous endoscopically placed jejunostomy tubes. This required 108 ambulance round-trips to and from the emergency department. The most frequent complication was unintentional dislodgement (n = 125). The average length of stay was 2.6 +/- 1.6 h. All the patients were seen by an emergency department physician. In addition, there were 99 surgical and 26 gastroenterology consultations about these patients. The total hospital charges, not including physician fees, were 86,234.48 dollars, and the total reimbursement (actual) from Medicare for ambulance charges was 57,664.00 dollars. During the same 21-month period, 42 feeding tubes were placed for dementia. CONCLUSIONS: The expense of emergency department visits for tube dislodgment or malfunction is a previously unreported issue involved in the tube feeding of demented patients. Extrapolation of our data yields an estimated health care charge of almost Dollars 11 million for the country per year.
机译：背景：客观数据表明，痴呆患者的饲管可能无效，并可能导致严重的并发症，但是尚无研究描述这些患者的急诊科资源利用情况。这项研究旨在评估痴呆患者就诊急诊室中与进食管故障相关的发生率和资源利用。方法：对1999年9月至2001年5月期间就诊的所有摄食管失灵的痴呆患者进行回顾性图表回顾。确定了人口统计学数据，诊断，管子类型，急诊科住院时间，向急诊科的运输方法，咨询，实验室评估，X射线数据以及医院和救护车的总费用。结果：在此期间，共有33位患者进行了138次急诊就诊（每位患者的就诊范围为1-21;平均值为4.1 +/- 4.3）。在61例经皮内窥镜放置的胃管，37例空肠造口管，34例胃管，4例经内镜放置的胃造口术和空肠造口管以及2例经皮内镜下放置的空肠管发生了故障。这需要往返急诊室的108辆救护车往返。最常见的并发症是无意脱臼（n = 125）。平均住院时间为2.6 +/- 1.6小时。所有患者均由急诊科医师看过。此外，针对这些患者进行了99次外科手术和26次胃肠病咨询。医院总费用（不包括医师费用）为86,234.48美元，而Medicare救护车费用的总报销（实际）为57,664.00美元。在相同的21个月中，放置了42个喂食管用于痴呆。结论：因痴呆患者的管饲而急诊就诊的费用是先前未报告的问题。根据我们的数据推算，该国每年的医疗保健费用估计接近1100万美元。

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