Factors Associated with Patients Delivered Through Phra Nakhon Si Ayutthaya Hospital’s Emergency Medical System Dying Within 24 Hours
Keywords:
emergency medical service system, prehospital, operation timeAbstract
Background: Diseases and accidents were major public health problems that can cause disability or death
Objective: This study was to identify factors associated with 24 hours mortality rate in patients transported by Phra Nakhon Si Ayutthaya Hospital’s Emergency Medical Service.
Material and methods: This study was retrospective. Data collection for analysis included the dispatch time, activation time, response time, scene time, operation time, age, sex, and mechanism of injury among the dead and survivor groups up to 24 hours after hospitalization
Result: From 625 critically emergency patients, there were 70 deaths (11.2%). An operation time more than 40 minutes was found to be significantly associated with death in non trauma patients group with incidence risk ratio 4.28 [ 95% confidence interval 2.33 – 7.86, p-value<0.001].
Conclusion: There was no correlation between mortality rate and dispatch time, activation time, response time, scene time among the patients who were transported through advanced life support unit (ALS). However, higher mortality rate was found to be correlated with operation time over 40 minutes. This study can be used to improve quality of Advanced life support prehospital care services and could lead to policy or indicator for emergency care in the future.
References
National Association of Emergency Medical Technicians. PHTLS: pre-hospital trauma life support. 8th ed. Clinton, MS: Jones & Bartlett Learning; 2016.
Gruen RL, Gabbe BJ, Stelfox HT, Cameron PA. Indicators of the quality of trauma care and the performance of trauma systems. BJS 2012; 99(S1): 97-104.
Pons PT, Markovchick VJ. Eight minutes or less: does the ambulance response time guideline impact trauma patient outcome. J. Emerg. Med. 2002; 23: 43-8.
McCoy CE, Menchine M, Sampson S, Anderson C, Kahn C. Emergency medical services out-of-hospital scene and transport times and their association with mortality in trauma patients presenting to an urban level i trauma center. Ann. Emerg. Med. 2013; 61: 167- 74.
Newgard CD, Schmicker RH, Hedges JR, Trickett JP, DavisDP,BulgerEM,etal.Emergency medical services intervals and survival in trauma: assessment of the “golden hour” in a North American Prospective Cohort. Ann. Emerg. Med. 2010; 55: 253-46.
Lerner EB, Moscati RM. The golden hour: scientific fact or medical ‘‘urban legend’’? Acad. Emerg. Med. 2001; 8:758-60.
Byrne JP, Mann NC, Dai M, Mason SA, Karanicolas P, Rizoli S, et al. Association between emergency medical service response time and motor vehicle crash mortality in the United States. JAMASurgery 2019;154:286- 93.
Lichtveld RA, Panhuizen IF, Smit RBJ, Holtslag HR, van der Werken C. Predictors of death in trauma patients who are alive on arrival at hospital. Eur J Trauma Emerg Surg. 2007; 33: 46-51.
Esmaeiliranjbar A, Mayel M, Movahedi M, Emaeiliran- jbar F, Mirafzal A. Pre-hospital time intervals in trauma patient transportation by emergency medical service: association with the first 24-hour mortality. J. Emerg. Pract. Trauma 2016; 2: 37-41.
Sampalis JS, Lavoie Andre, Williams JI, Mulder DS, Kalina M. Impact of onsite care, prehospital time, and level of in-hospital care on survival in severity injured patients. J Trauma. 1993; 34: 252-61.
โรงพยาบาลนครพิงค์. ระบบรายงานตัวชี้วัดสาขาอุบัติหตุและฉุกเฉิน เขตบริการสุขภาพที่ 1 [อินเทอร์เน็ต ]. 2562 [สืบค้น 10 มิย. 2565]. แหล่งข้อมูล: http://mis. nkp-hospital.go.th/kpi/trauma/
กองยุทธศาสตร์และแผนงาน สeนักงานปลัดกระทรวงสาธารณสขุ. สถิติสาธารณสุข พ.ศ.2559[อินเทอร์เน็ต]. 2562 [สืบค้นเมื่อ 10ม.ค.2562]. แหล่งข้อมูลhttp://bps. moph.go.th/new_bps/sites/default/files/health_strate- gy2559.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Thammasat University Hospital Journal Online
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
