一个用于识别救护车到达时死亡的患者的分类系统:医院前医疗记录审查
Markus Petersen1, Fredderick Georg Kjeldtoft1, Erika Frischknecht Christensen1,2
1Centre for Prehospital and Emergency Research, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Gistrup, Denmark.
Scandinavian journal of trauma, resuscitation and emergency medicine
|December 22, 2023
概括
由于定义不一致,医院前死亡率很难进行比较. 这项研究确定了生命状态的明确标准,发现超过28%的已故患者在救护车到达时已经死亡.
科学领域:
- 紧急医疗 紧急医疗
- 在医院前的护理.
- 公共卫生 公共卫生
背景情况:
- 比较医院前死亡率是具有挑战性的,因为在抵达之前或抵达时死亡的患者的定义和排除标准各不相同.
- 只有医生才能宣布死亡,这阻碍了医院前死亡的统一登记.
- 现有研究中缺乏有关医院前死亡率的详细定义,使分析复杂化.
研究的目的:
- 建立明确的标准来识别和分类医院前患者的生命状态.
- 估计不同生命状态类别中患者的比例,重点关注救护车到达时死亡的患者.
主要方法:
- 对2019-2021年北丹麦地区患者的医院前病历进行了审查,这些患者在同一天或第二天被登记为死亡.
- 定义了三个重要状态类别:救护车到达时死亡 (DOAA),医院外心脏骤停 (OHCA) (进一步分为基本生命支持和高级治疗) 和救护车到达时活着.
主要成果:
- 在3,174名已故患者中,28.8%的人在救护车到达时死亡 (DOAA).
- 医院外心脏骤停 (OHCA) 基本生命支持 (BLS) 占13.4%,OHCA高级治疗占31.3%,救护车到达时活着占26.6%.
- 包括停止复苏的OHCA BLS病例,救护车到达时死亡的患者比例增加到42%.
结论:
- 通过使用医院前记录,为医院前重要状态类别 (DOAA,OHCA,救护车到达时还活着) 定义了详尽和相互排斥的标准.
- 超过四分之一的被注册为死亡的患者在救护车到达时已经死亡.
- 建议对这些重要状态类别进行标准化报告,以使得医院前死亡率的有效比较.
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