区域医疗中心咳嗽患者临床特征及就诊流向的大数据挖掘分析

  目的  分析区域医疗中心门诊有咳嗽症状患者的临床特征及就诊流向，了解其临床特点，为相关研究提供流行病学依据，同时为区域医疗中心优化咳嗽患者分诊提供参考。  方法  收集2017年1月1日—2019年12月31日上海市某区域医疗中心3年的门诊数据，分析其中有咳嗽症状患者的症状、主要诊断及就诊流向。  结果  该医疗中心3年共接诊有咳嗽症状的门诊患者110 240人次，占总门诊量的5.85%，2017—2019年门诊有咳嗽症状的患者数量和占比均呈增长趋势。患者年龄为51.0(21.5, 64.0)岁，女性57 868人次(52.49%)，男性52 372人次(47.51%)，女性占比高于男性(χ2=274.002, P＜0.001)。按咳嗽病程分类，急性咳嗽(时间＜3周)103 702人次(94.07%)，亚急性咳嗽(时间3~8周)3 343人次(3.03%)，慢性咳嗽(时间＞8周)3 195人次(2.90%)，不同咳嗽类型在不同年龄组、性别组中分布差异均有统计学意义(均P＜0.05)。咳嗽患者伴随症状前3位分别为咳痰、发热和流涕，主要诊断前3位分别为呼吸道感染、急性咽炎和急性上呼吸道感染，此外，咳嗽伴随症状和主要诊断在不同咳嗽类型分组和不同年龄分组中的分布不同。咳嗽患者就诊流向较集中，主要为急诊内科、儿科和呼吸内科。  结论  门诊就诊患者中有咳嗽症状的数量呈增长趋势，各类型咳嗽在不同人群分组中分布存在差异。 

Big data mining analysis of the clinical characteristics and direction in seeking medical service of cough patients in regional medical centres

  Objective  To analyse the clinical characteristics and direction in seeking medical service of patients with cough symptoms in regional medical centres, understand the clinical characteristics of cough patients, provide epidemiological basis for related clinical research, and offer a reference for regional medical centres to optimise the triage of cough patients.  Methods  This study collected three-year outpatient data of a regional medical centre in Shanghai from January 1, 2017 to December 31, 2019 and analysed the symptoms, main diagnosis and direction in seeking medical service of patients with cough symptoms.  Results  A total of 110 240 outpatients with cough symptoms were received from 2017 to 2019, accounting for 5.85% of the total outpatients. The number and proportion of outpatients with cough symptoms showed an increasing trend. The average age of patients was 51.0 (21.5, 64.0) years old, with 57 868 female (52.49%) and 52 372 male (47.51%) patients. The proportion of female patients was higher than that of male (χ2=274.002, P < 0.001). According to the classification of cough duration, 94.07% (103 702) had acute cough (cough time < 3 weeks), 3.03%(3 343) had subacute cough (cough time 3-8 weeks), and 2.90% (3 195) had chronic cough (cough time > 8 weeks). The distributions of different types of coughs in age and gender groups differed (all P < 0.05). The top three associated symptoms of cough patients were expectoration, fever and runny nose. The top three main diagnoses were respiratory tract infection, acute pharyngitis and acute upper respiratory tract infection. The distributions of cough associated symptoms and main diagnosis in different cough types and different age groups were different. In addition, the main departments receiving patients with cough were Emergency Department, Paediatrics and Respiratory Medicine.  Conclusion  The number of outpatients with cough symptoms shows an increasing trend, and the distributions of different types of coughs in the population group is different.