Internal and emergency medicine
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Demand for emergency ambulances has been increasing in developmentally advanced countries, and in Japan demand has been increasing due to the aging population since 2008, when the total population began to decrease. However, we do not know how acceleration of the aging population relates to the demand for emergency ambulances. Thus, we estimated future demand for emergency ambulances in Japan. ⋯ The number of emergency ambulance dispatches has increased since 2008, and it is expected to continue to increase until around 2023 or 2024, when it will reach a peak of ~6.2 million per year. Similarly, the number of emergency transports is expected to continue to increase until 2022 or 2023, when it will reach a peak of ~5.3 million per year. Although we need to be careful when evaluating numbers predicted for the remote future due to methodological limitations, the findings might be useful for updating emergency medical care systems to prepare for future increases in demand.
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Current data suggest that up to 60 % of patients presenting to the emergency department with syncope leave the hospital without a defined etiology. Prior studies suggest a prevalence of psychiatric disease as high as 26 % in patients with syncope of unknown etiology. The objective of this study was to determine whether psychiatric disease is associated with an increased incidence of syncope of unknown etiology. ⋯ However, among women with syncope of unknown etiology, there was no significant difference between those with and without psychiatric disease (34.4 vs. 32.7 %) with p = 0.77. Our results suggest that men with psychiatric disease have an increased incidence of syncope of unknown etiology. Given this relationship, clinicians might consider screening for psychiatric disorders in syncopal patients when no clear etiology can be identified.