严重性驱动的死亡率趋势在一个大型区域化的重症监护运输服务中
David D Salcido1, Chase W Zikmund1, Leonard S Weiss1
1Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Air medical journal
|March 15, 2024
概括
美国的直升机紧急医疗服务 (HEMS) 随着时间的推移,患者死亡率和住院时间增加. 在这个大型的非营利性HEMS系统中,创伤患者和现场运行的比例有所下降.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
- 卫生系统研究 卫生系统研究
背景情况:
- 直升机紧急医疗服务 (HEMS) 流行病学随着系统的成熟而发展,特别是在欧洲.
- 美国的HEMS景观在地理上是分散的,使得系统层面的比较不清楚.
- 这项研究分析了美国最大的标准化私人非营利性HEMS系统 - - STAT MedEvac.
研究的目的:
- 提供HEMS运输的时间和流行病学特征.
- 分析患者人口统计,运输类型,干预措施和结果的趋势.
- 了解系统成熟对美国HEMS流行病学的影响.
主要方法:
- 使用了来自STAT MedEvac (2012-2021) 的医院前电子患者护理记录.
- 连接HEMS数据与医院电子健康记录,以确定住院时间和生命状况.
- 分析了来自90,960个运输的数据,与EHR相匹配62.8%.
主要成果:
- 患者平均年龄为58.6岁,57.9%为男性.
- 主要是设施间运输 (77.6%) 和非创伤病例 (72.7%).
- 医院死亡率为15%,平均LOS为8.8天.
- 随着时间的推移,观察到非创伤运输,严重程度和死亡率的增加.
- 病例严重程度和医疗类别与死亡率和LOS相关.
结论:
- 随着时间的推移,患者死亡率和医院LOS在这个美国大型非营利性HEMS系统中增加.
- 在研究期间,创伤患者和现场跑的比例下降.
- 这些发现突显了HEMS使用和患者群体的不断变化的趋势.
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