대한내과학회지

BACKGROUN: Chief complaint is the primary history, quoted from patient, and the starting point of medical service. Physicians need to know what complaints are in the society and how they would be going. We to described what symptoms patients had, what diagnoses were made, and how was the mortality of patients admitted in Seoul National University Hosptial (SNUH) during the past 7 years (1991.1~1997.12). METHODS: In the past 7 years, 235,426 admitted cases were in SNUH. We computerized demographic factors, chief complaints, diagnoses at discharge, and mortality of patients. We categorized chief complaints as 93 major groups, dissected further with modifiers. The diagnoses were coded as ICD-10 and the mortality data was gathered through access to the annual police mortality data. We figured out the estimated mortality rate according to the chief complaint and/or diagnosis, using life table analysis through SSPS version 10.0. RESULTS: The most frequent chief complaint was pain, followed by chemotherapy, mass, dyspnea, bleeding and so on. Upper 20 symptom-groups occupied over 80 percents. We described specific symptoms, demographic factors, diagnoses, and rates of mortality in a certain chief complaint group. For example, abdominal pain, chest pain, lumbar pain, pain on lower extremity, and headache were seen frequently in the pain category. Symptom which had the worst prognosis was swallowing difficulty because almost half of patients with it had malignancy. We showed descriptive data of liver cirrosis, diabetes mellitus, angina pectoris, chronic renal failure, and pulmonary tuberculosis. For example, we found the painless angina pectoris had worse prognosis than the painful cases. We also discussed the usefulness of these data to education, medical service, medical research, and quality improvement in medicine. CONCLUSION: We figured out clinically important chief complaints, their diagnoses, and their mortality rate of patients admitted in SNUH. We hope nation-wide survey like this study would be planned in near future. We could use it's data in many fields, such as educational renovation, medical reseasrch, medical quality control and so on.