교도소 재소자의 응급진료 현황과 임상적 특성 = Emergency Care and Disposition of Prisoners in the Emergency Department

다국어 초록 (Multilingual Abstract)

Purpose: Most emergency departments (EDs) treat prisoners;
however, in so doing, there is often a disruption in the
normal routines of the ED and associated problems for the
treating physician. The current study was conducted to
describe the use of emergency medical care by the prison
population in an effort to better understand the needs of
prisoners and to plan specific services to care for prisoners.
Methods: We retrospectively analyzed 220 ED admissions
involving 188 prisoners at Konyang University Hospital
between August 2004 and January 2009. The medical
records of all prisoners admitted to the ED were collected
and analyzed from the ED computerized database. The following
data were extracted for each prisoner: time and reason
for admission, age, gender, Emergency Severity Index
(ESI), final diagnosis, and disposition.
Results: The 220 admissions (188 prisoners; mean age,
42.3 years; range, 20-78 years) consisted of the following:
medical illnesses (64.1%), self-injuries (16.8%), surgical
conditions (7.7%), injuries sustained from violence (6.4%),
accidental injuries (3.6%), sports injuries (0.9%), and miscellaneous
(0.5%). Eighty ED admissions (36.4%) had significant
medical histories, including hypertension, diabetes,
myocardial infarctions, and seizure disorders. Ninety-six ED
admissions (43.6%) were subsequently admitted to the
hospital as inpatients. Twenty prisoners visited the ED more
than 1 time (a total of 52 times), including 2 prisoners who
were admitted to the ED 5 times each. There were 19 ED
admissions for ingestion of foreign objects by 15 prisoners.
The most common foreign body was a metal wire. The
overall mortality rate was 6.9%.
Conclusion: Prisoners referred to the ED have serious
medical conditions with a high mortality rate that require
specific emergency management. In rendering care for a
confined prison population, the ED staff should be aware of
the increased risk of sudden cardiac death.

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