Background Compelling data on clinical emergency medicine is required for healthcare system management. The aim of this survey was to describe the nationwide status quo of emergency care in Germany at the healthcare system level using the Utstein reporting template as the guideline to measure the data collected. Methods This cross-sectional survey collected standardized data from German EDs in 2018. All 759 of the EDs listed in a previously collected ED Directory were contacted in November 2019 using the online-survey tool SoSci Survey. Exclusively descriptive statistical analyses were performed. Absolute as well as relative frequencies, medians, means, ranges, standard deviations (SD) and interquartile ranges (IQR) were reported depending on distribution. Main Results A total of 150 questionnaires of contacted EDs were evaluated (response rate: 19.8%). Hospitals had a median of 403 inpatient beds (n=147). The EDs recorded a median of 30,000 patient contacts (n=136). Eighty-three EDs (55%) had observation units with a median of six beds. The special patient groups were pediatric patients (< 5 years) and older patients (> 75 years) with a median of 1.7% and 25%, respectively. Outpatients accounted for 55%, while 45% were admitted (intensive care unit 5.0%, standard care unit 32.3%, observation unit 6.3%) and 1.2% transferred to another hospital. Conclusions The use of the Utstein reporting template enabled the collection of ED descriptive parameters in Germany. The data can provide a baseline for upcoming reforms on German emergency medicine, and for international comparisons on admission rates, initial triage categories, and patient populations.
ZusammenfassungEin 37-jähriger Patient stellte sich mit schmerzlosem Ikterus und Juckreiz vor. Laborchemisch wurden ein Bilirubin 30-fach über dem oberen Normwert sowie eine leicht erhöhte Alanin-Aminotransferase (ALT) mit ansonsten geringfügig erhöhten Cholestaseparametern gesehen. Bei unauffälliger Umfelddiagnostik mit Ausschluss häufiger Ursachen einer Hepatitis wurde eine Leberbiopsie durchgeführt. Diese ergab eine kanalikuläre Cholestase mit Duktopenie und periportaler Fibrose. Erst nach wiederholter, eindringlicher Anamnese konnte ein Ligandrol-Abusus als Ursache für die Symptomatik ermittelt werden. Ligandrol wird als Selektiver-Androgen-Rezeptor-Modulator zur Förderung des Muskelaufbaus eingesetzt. Dieser Fall stellt keinen Einzelfall für den Missbrauch anaboler Substanzen im Amateursport dar.
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