| Abstract | Cilj: Glavni cilj ovoga rada bio je ispitati princip liječenje karcinomskog bola u izvanbolničkoj hitnoj pomoći ZZHMZŽ-a.
Ispitanici i metode: Istraživanje je provedeno u periodu od 1. 1. 2023. do 31. 12. 2023. godine. Retrospektivno se analizirala ukupna medicinska dokumentacija 24 152 hitne intervencije koje su zabilježene i provedene u informacijsko-komunikacijskom sustavu „e-hitne“ ZZHMZŽ-a na području Zagrebačke županije. Od ukupnog broja medicinskih dokumentacija za hitne intervencije izdvojilo se njih 1026 prema vodećoj dijagnozi C00-C99 MKB-a. Za 1026 medicinske dokumentacije za hitne intervencije analizirala se pojavnost prema spolu, dobi, vrsti primljene analgetske terapije, načinu primljene analgetske terapije te prema MKB podjeli.
Rezultati: U ispitivanom razdoblju ZZHMZŽ imao je 24 152 intervencije, a zbog karcinomskog bola 1026 (4 %). Hitnu intervenciju za karcinomski bol zatražilo je 61 % muškaraca i 39 % žena. Kod muškaraca je zabilježeno više hitnih intervencija u medicinskoj dokumentaciji (Mann-Whitneyev test, P = 0,015, χ2= 15,956). Raspodjela bolesnika prema dobnim skupinama pokazuje da je najveći broj bolesnika bio u dobi između 60. i 70. godine života – ukupno 425 (41 %). Prema MBK klasifikaciji bolesti najčešći uzrok bolova zbog kojih su bolesnici zatražili intervenciju hitne pomoći bile su šifre dijagnoze C15-C26 (probavni organi), s 515 (50,19 %) slučajeva. Najčešći farmakoterapijski odabir bio je neopoidni analgetik, odnosno 653 (63,64 %) puta (Kruskal-Wallis test, P = 0,001, χ2 = 21,943). Najčešća je bila intramuskularna primjena analgetika – 881 put (85,86 %, Kruskal-Wallis test, P = 0,009, χ2 = 6,741), dok je kod 145 (14,13 %) slučaja analgetska terapija primijenjena pod kožu.
Zaključak: Dobiveni rezultati potvrdili su da je više muškaraca zatražilo intervenciju hitne pomoći u vezi karcinomskog bola koji se najčešće liječi neopoidnim analgeticima primjenjujući ih intramuskularno. Nadziranjem, analiziranjem i vrednovanjem postojećih radnih procesa u hitnoj medicini unapređuje se zdravstvena skrbi, a time i cjelokupni zdravstveni sustav. |
| Abstract (english) | Objectives: The main objective of this work was to examine the principles of treatment of cancer pain in the outpatient emergency department of ZZHMZŽ.
Respondents and methods: The research was conducted in the time period from 01.01.2023. until 31.12.2023. years. The total medical documentation of 24,152 emergency interventions that were recorded and carried out in the "e-emergency" information and communication system of ZZHMZŽ in the area of Zagreb County is retrospectively analyzed. From the total number of medical documents for emergency interventions, 1,026 of them will be separated according to the leading diagnosis C00-C99 of the ICD. For 1,026 medical documents for emergency interventions, incidence is analyzed according to gender, age, type of analgesic therapy received, method of analgesic therapy received, and according to ICD division.
Results: In the examined period, ZZHMZŽ had 24,152 interventions, and 1,026 (4%) due to cancer pain. Emergency intervention for cancer pain was requested by 61% of men and 39% of women. In population, more emergency interventions were recorded in the medical documentation (Mann-Whitney test, P = 0.015, χ2= 15.956). The distribution of patients according to age groups shows that the largest number of patients were between the ages of 60 and 70: a total of 425 (41%). According to the MBK classification of diseases, the most common cause of pain for which patients requested emergency intervention were diagnosis codes C15-C26 (digestive organs) with 515 (50.19%) cases. The most common pharmacotherapeutic choice was a nonopoid analgesic, i.e. 653 (63.64%) times (Kruskal-Wallis test, P = 0.001, χ2=21.943). The most common was intramuscular administration of analgesics 881 times (85.86%, Kruskal-Wallis test, P = 0.009, χ2=6.741), while in 145 (14.13%) cases analgesic therapy was administered under the skin.
Conclusion: The obtained results confirmed that the more men requested an emergency intervention in connection with cancer, which is most often treated with nonopoid analgesics administered intramuscularly. Monitoring, analyzing and evaluating existing work processes in emergency medicine contributes to the improvement of health care for patients suffering from cancer pain. |
