응급실을 방문한 의식장애의 원인: 코로나바이러스감염증-19 이전과 이후
- Affiliated Author(s)
- 전재천; 김인철; 김예림; 조용원; 김근태
- Alternative Author(s)
- Jeon, Jae Cheon; Kim, In Cheol; Kim, Yae Rim; Cho, Yong Won; Kim, Keun Tae
- Journal Title
- 대한신경과학회지
- ISSN
- 2288--985X
- Issued Date
- 2021
- Keyword
- Consciousness disorders; Neurologic manifestations; Emergency medical services; Emergency medicine; COVID-19
- Abstract
- Background:
Altered level of consciousness (ALC) is a challenging condition in the emergency department (ED). We evaluated the clinical characteristics, causes, and prognosis of adult patients presenting with ALC at an ED of a university hospital.
Methods:
The medical records of patients with ALC who visited the ED of a university hospital from February 2019 to November 2020 were reviewed to compare before and after the outbreak of coronavirus disease-19 (COVID-19) in Daegu, South Korea. The cause of ALC, its classification, the patients' destinations, and prognosis were carefully decided and compared.
Results:
A total of 1,851 patients with ALC in ED consisted of 1,068 before COVID-19 (BC; to February 17th, 2020) and 783 after COVID-19 (AC; from February 18th, 2020) were investigated. The all-time leading cause of ALC in ED was systemic infection (29.2% in BC, 25.0% in AC), followed by metabolic cause (21.0%) in BC and stroke (18.4%) in AC. Extra-cerebral etiologies of ALC were 1,206 (65.1%). The overall mortality of ALC in ED was 12.3%, consisting of 11.0% in BC and 14.2% in AC. During the daytime (07:00 to 18:59), patients in overall 1,179 patients (63.7%) with ALC visited ED, consisted of 665 (62.3%) in BC and 514 (65.5%) in AC.
Conclusions:
This study demonstrated the extra-cerebral etiologies as the major causes of ALC in the ED. And there have been shifts in the etiology of ALC in ED.
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