连接9-1-1调度类别与死亡登记册的新方法:选择调度类别的死亡率
Karl A Sporer1, Kristen M Bascombe2, Tarak K Trivedi3
1Department of Emergency Medicine, UCSF, San Francisco, California.
Prehospital emergency care
|June 27, 2024
概括
医疗优先调度系统 (MPDS) 显示,随着优先级的提高,成人呼吸道疾病的死亡率更高. 这一与年龄相关的趋势表明,MPDS可以预测紧急医疗服务 (EMS) 的患者结果.
科学领域:
- 紧急医疗服务 紧急医疗服务
- 公共卫生 公共卫生
- 医疗系统分析 医学系统分析
背景情况:
- 医疗优先调度系统 (MPDS) 根据优先级 (Alpha-Echo) 分类911-1医疗呼叫.
- 了解MPDS代码在预测患者死亡率中的有效性对于资源配置和患者护理改进至关重要.
研究的目的:
- 评估将MPDS代码与县死亡登记处匹配的方法.
- 评估选择的MPDS代码 (跌倒,呼吸道,病人,腹部疼痛) 在EMS遭遇后30天死亡率的预测能力.
主要方法:
- 从2011年11月1日到2016年11月1日的阿拉米达县EMS遭遇的回顾性审查.
- 将EMS数据与阿拉米达县公共卫生死亡登记处联系起来,以确定48小时,7天和30天后的死亡率.
- 分析了202,431个不同年龄组的独特患者遭遇.
主要成果:
- 患有呼吸道疾病的患者在所有年龄组中表现出最高的死亡率 (0.23%在<18,2.7%在18-65,14.55%在>65).
- 在增加MPDS优先级 (Alpha-Echo) 对于呼吸道投诉和成人患者 (18+) 中30天死亡率的增加之间观察到显著的相关性.
- 在18岁以下的患者中,没有发现MPDS代码和死亡率之间的相关性.
结论:
- 越来越多的MPDS优先指定与成人呼吸道投诉的死亡率增加有关.
- 研究队列中的死亡率随着年龄的增长而增加.
- 大多数死亡发生在最初的EMS遭遇后7天以上.
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