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Long-Term Mortality of Emergency Medical Services Patients.
- Source :
-
Annals of emergency medicine [Ann Emerg Med] 2017 Sep; Vol. 70 (3), pp. 366-373.e3. Date of Electronic Publication: 2017 Mar 25. - Publication Year :
- 2017
-
Abstract
- Study Objective: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark.<br />Methods: We analyzed linked EMS, hospital, and vital status data from 3 of 5 geographic regions in Denmark. We included events from July 1, 2011, to December 31, 2012. We classified EMS events according to primary dispatch category (unconsciousness/cardiac arrest, accidents/trauma, chest pain, dyspnea, neurologic symptoms, and other EMS patients). The primary outcome was 1-year mortality adjusted for age, sex, and Charlson comorbidity index.<br />Results: Among 142,125 EMS events, primary dispatch categories were unconsciousness or cardiac arrest 5,563 (3.9%), accidents or trauma 40,784 (28.7%), chest pain 20,945 (14.7%), dyspnea 9,607 (6.8%), neurologic symptoms 17,804 (12.5%), and other EMS patients 47,422 (33.4%). One-year mortality rates were unconscious or cardiac arrest 54.7% (95% confidence interval [CI] 53.4% to 56.1%), accidents or trauma 7.8 (95% CI 7.5% to 8.1%), chest pain 8.5% (95% CI 8.1% to 9.0%), dyspnea 27.7% (95% CI 26.7% to 28.7%), neurologic symptoms 14.1% (95% CI 13.6% to 14.7%), and other EMS patients 11.1% (95% CI 10.8% to 11.4%). Compared with other EMS conditions, adjusted 1-year mortality was higher in unconsciousness or cardiac arrest (risk ratio [RR] 2.6; 95% CI 2.5 to 2.7), dyspnea (RR 1.5; 95% CI 1.4 to 1.5), and in neurologic symptoms (RR 1.1; 95% CI 1.0 to 1.1), but lower in chest pain (RR 0.6; 95% CI 0.6 to 0.7) and accidents or trauma (RR 0.8; 95% CI 0.8 to 0.8).<br />Conclusion: EMS patients with unconsciousness or cardiac arrest, dyspnea, and neurologic symptoms are at highest risk of long-term mortality. Our results suggest a potential for outcome improvement in these patients.<br /> (Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Denmark epidemiology
Emergency Medical Services statistics & numerical data
Female
Health Care Surveys
Humans
Male
Middle Aged
Prognosis
Regional Medical Programs statistics & numerical data
Time Factors
Treatment Outcome
Cardiopulmonary Resuscitation mortality
Dyspnea mortality
Emergency Medical Services organization & administration
Nervous System Diseases mortality
Out-of-Hospital Cardiac Arrest mortality
Regional Medical Programs organization & administration
Unconsciousness mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6760
- Volume :
- 70
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Annals of emergency medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28347554
- Full Text :
- https://doi.org/10.1016/j.annemergmed.2016.12.017