The epidemiology of minor surgical problems during specialists' absence: Single center, descriptive study

Background In Japan, even if physicians have not experienced surgical training, they face many instances in which they must provide initial surgical treatment, especially during off‐hours. This study aimed to identify the frequency and fields of commonly encountered problems in a Japanese emergency department. Methods A retrospective review was performed to identify walk‐in outpatients with exogenous problems visiting during off‐hours in the Japanese educational hospital providing primary to tertiary emergency care between January 1 and December 31, 2014. Diseases were aggregated according to International Classification of Primary Care (Second Edition; ICPC‐2). Results During the study period, 33 424 patients visited and 7476 were classified into the “exogenous” group. We analyzed the data of 7421 patients after excluding 55 who were deemed undiagnosable based on reviews of the charts. The median age of patients who visited the ED during off‐hours was 29 years (range: 0‐101 years, IQR: 8‐60 years). Altogether, 226 types of problems included in ICPC‐2 were identified during the study period. The majority fields of exogenous problems were ‘skin,’ ‘Musculoskeletal,’ and ‘eye.’ The 15 problems with the highest frequencies accounted for 50.2% of the total problems. Conclusions We identified surgical problems with high treatment frequencies among patients visiting the ED during off‐hours. Providing education focusing on these frequent surgical problems can help to improve the initial treatment quality and reduce the anxiety for those doctors who provide initial surgical treatment. We identified surgical diseases with high treatment frequencies among patients during off‐hours. The findings can help to develop more effective training programs based on frequency of problem.