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Adolescents Presenting to the Emergency Department with Heavy Menstrual Bleeding.
Journal of Pediatric and Adolescent Gynecology ( IF 1.7 ) Pub Date : 2019-11-22 , DOI: 10.1016/j.jpag.2019.11.010
Monica W Rosen 1 , Angela C Weyand 2 , Christine M Pennesi 1 , Victoria L Stoffers 3 , Charlotte M Bourdillon 3 , Jenny S George 1 , Elisabeth H Quint 1
Affiliation  

STUDY OBJECTIVE To describe the adolescent population that seeks care in the emergency department (ED) for heavy menstrual bleeding (HMB), and to compare those who are discharged to those who are admitted to the hospital. DESIGN Retrospective study. SETTING Emergency department and inpatient unit at a national tertiary care hospital from 2006-2018. PARTICIPANTS Adolescents 11-19 years old with ICD-9 and ICD-10 codes for HMB. INTERVENTIONS Chart abstraction for demographic data, symptoms, laboratory tests, outcomes, and treatments. MAIN OUTCOME MEASURE Adolescents who were admitted were compared to girls who were treated as outpatients. RESULTS There were 258 adolescents who sought care for HMB in the ED during the study period. A total of 44 patients (17%) were admitted to the hospital, whereas 214 (83%) were discharged. The average age of those admitted was 15 years, compared to 17 years for those discharged (P < .001). In the admitted group, the mean initial hemoglobin (Hgb) was 6.3 g/dL compared to 12.0 g/dL in the discharged group (P < .0001). Only 23% of the discharged patients were released with medications; the remainder did not receive treatment. Anovulation was the etiology of HMB in the majority (56%) of both inpatients and outpatients. Of the 44 adolescents admitted to the hospital for HMB, 12 (27%) had a bleeding disorder (BD) and 32 (73%) did not. CONCLUSION The majority of adolescents who presented to the emergency department for HMB were not anemic and did not receive any treatment. Of those admitted, almost one-third had an underlying BD, which is higher than previously reported.

中文翻译:

向急诊科就诊的月经期严重出血的青少年。

研究目的描述急诊科急诊中的月经严重出血(HMB)的青少年人群,并比较出院者与入院者。设计回顾性研究。设置2006-2018年间国家三级医院急诊科和住院部。参与者11-19岁的青少年,其IMB-9和ICD-10代号为HMB。干预针对人口统计数据,症状,实验室检查,结果和治疗的图表抽象。主要观察指标将入院的青少年与被视为门诊的女孩进行比较。结果在研究期间,有258名青少年在急诊室寻求HMB护理。共有44例患者(17%)入院,而214例(83%)已出院。入院者的平均年龄为15岁,而出院者的平均年龄为17岁(P <.001)。入院组的平均初始血红蛋白(Hgb)为6.3 g / dL,出院组为12.0 g / dL(P <.0001)。出院患者中只有23%释放了药物。其余未得到治疗。在住院患者和门诊患者中,绝大部分是HMB的病因(56%)。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取者中,几乎三分之一的人具有潜在的BD,高于先前的报告。而出院者则为17年(P <.001)。入院组的平均初始血红蛋白(Hgb)为6.3 g / dL,出院组为12.0 g / dL(P <.0001)。出院患者中只有23%释放了药物。其余未得到治疗。在住院患者和门诊患者中,绝大部分是HMB的病因(56%)。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取的人中,几乎三分之一的人具有潜在的BD,高于先前报道的水平。而出院者则为17年(P <.001)。入院组的平均初始血红蛋白(Hgb)为6.3 g / dL,出院组为12.0 g / dL(P <.0001)。出院患者中只有23%释放了药物。其余未得到治疗。在住院患者和门诊患者中,绝大部分是HMB的病因(56%)。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取的人中,几乎三分之一的人具有潜在的BD,高于先前报道的水平。放电组为0 g / dL(P <.0001)。出院患者中只有23%释放了药物。其余未得到治疗。在住院患者和门诊患者中,绝大部分是HMB的病因(56%)。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取的人中,几乎三分之一的人具有潜在的BD,高于先前报道的水平。放电组为0 g / dL(P <.0001)。出院患者中只有23%释放了药物。其余未得到治疗。在住院患者和门诊患者中,绝大部分是HMB的病因(56%)。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取的人中,几乎三分之一的人具有潜在的BD,高于先前报道的水平。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取的人中,几乎三分之一的人具有潜在的BD,高于先前报道的水平。在因HMB入院的44名青少年中,有12名(27%)有出血性疾病(BD),而32名(73%)没有。结论到HMB急诊科就诊的大多数青少年没有贫血,也未接受任何治疗。在被录取者中,几乎三分之一的人具有潜在的BD,高于先前的报告。
更新日期:2020-03-31
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