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救护车响应时间和30天死亡率:哥本哈根 (丹麦) 注册研究研究
Alexander Andrew Matthew Mills1, Elisabeth Helen Anna Mills2, Stig Nikolaj Fasmer Blomberg3
1Aalborg University.
概括
快速的救护车响应时间没有显著影响30天死亡率,除了医院外心脏骤停的情况下. 这一发现挑战了人们普遍认为,更短的紧急医疗服务响应时间总是挽救生命的信念.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
- 医疗服务研究 医疗服务研究
背景情况:
- 救护车响应时间对于患者的结果至关重要,但它们的优化是复杂和昂贵的.
- 普遍认为更短的响应时间直接挽救生命的假设缺乏强有力的经验证据.
研究的目的:
- 调查救护车响应时间 (灯和警报) 与30天死亡率之间的关系.
- 分析这种关联在各种患者条件和紧急情况的亚型.
主要方法:
- 一个大规模的,基于登记册的队列研究,利用2014-2018年的数据在丹麦.
- 包括超过182,000个人和266,000辆救护车.
- 使用后勤回归分析来检查30天死亡率的主要结果.
主要成果:
- 未经调整的分析显示,反应时间和死亡率之间存在反向关系,较短的时间与较高的死亡率相关.
- 这种反向趋势在诸如胸痛,呼吸障碍和无意识等子组中观察到.
- 多变量分析显示,年龄,性别,并发症和症状等因素与死亡率有关,但救护车响应时间没有 (OR:1.00).
- 在更长的反应时间和增加的死亡率之间发现了显著的关联,特别是在医院外的心脏骤停.
结论:
- 在一般患者群体中,救护车响应时间与30天死亡率没有显著关联.
- 医院外心脏骤停是一个关键的例外,更长的反应时间与更高的死亡率相关.
- 这些发现表明,需要对紧急医疗服务响应时间的影响有细微的了解.
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