Background: Cipto Mangunkusumo Hospital (CMH) is a national referral center in Indonesia. Most of the patients come with multiple and complicated diagnosis.
Objective: To describe clinical profiles and in-hospital prognosis in adult medical patients admitted to Emergency Room in CMH. Methods: A prospective cohort study was performed on adult medical patients in Emergency Department (ED) of CMH between October and December 2012. Acute presenting symptoms and diagnosis were made by in-charge resident of Internal Medicine Department. Outcome was assessed when the patients were discharge from the hospital (alive or dead). Patients’ confidentiality was maintained throughout the study.
Results: A total of 815 non-surgical patients attended the study (51.7% were male). Mean age was 47.3 (SD
15.2) year old, mean arterial pressure was 91.7 (22.0) mmHg, mean heart rate was 101.3 (SD 23.4) bpm, mean respiratory rate was 25.0 (SD 6.8) bpm, mean body temperature was 36.9 (SD 1.1)oC, mean peripheral O2 saturation
96.2 (SD 4.2)%, median Glasgow Coma Scale was 15 (3-15). The most frequent chief complaints were shortness of breath (25.1%), general weakness (16.2%) and loss of consciousness (12.7%). Frequent diagnosis found included pneumonia (35.6%), dyspepsia (33.2%), hypertension (28.5%), renal failure (27.7%), malignancy (24.7%), sepsis (23.1%), anemia (22.0%) and diabetes mellitus (17.3%). Median length of stay was 5 (0-63) days. Mortality was observed in 145 patients (17.8%). The causes of death were irreversible septic shock (53.8%), respiratory failure (24.8%), cardiac arrest (11.0%), cardiogenic shock (6.9%) and pulmonary embolism (3.4%).
Conclusions: Clinical profile and outcome of adult medical emergency patients in Cipto Mangunkusumo Hospital differ from those of other hospitals in Indonesia. Long length of stay and high mortality was observed. Further research in CMH care system must be done for future improvements.
Key words: Clinical profile, outcome, medical emergency patients