Holder Peyton, Arthur Annette O, Thiems Grady, Redmon Travis, Thomas Matt, Goodloe Jeffrey M, Reginald T J, Thomas Stephen H
Department of Emergency Medicine, OU Schusterman Center, University of Oklahoma School of Community Medicine, 4502 East 41st Street Suite 2E14, Tulsa, OK 74135, USA.
Emerg Med Int. 2012;2012:905976. doi: 10.1155/2012/905976. Epub 2012 Feb 19.
Objective. Elderly patients are becoming an increasingly larger proportion of our population, and there is a paucity of data regarding the epidemiology of geriatric patients refusing transport. Treatment refusal rates range from 5% to 15% in many studies. This study sought to test the hypothesis that geriatric patients constituted an increasing proportion of those persons refusing prehospital transport. Methods. This study was a retrospective analysis of data from a query of a large urban EMS service. Results. There were a total of 22,347 adult transport refusals recorded during the 16-month study period. Multivariate logistic regression incorporating covariates for sex, race, season, chief complaint, metropolitan region, and whether any treatment occurred prior to transport refusal confirmed the increasing likelihood of Period 2 patients being geriatric, as compared with Period 1 (OR 1.24, 95% CI 1.14-1.35, Wald P < .001). Conclusion. This data shows that despite controlling for these covariates, patients refusing transport in the second period of this study were nearly 25% more likely to be geriatric as compared to those in the initial 8 months of the study.
目的。老年患者在我们的人口中所占比例越来越大，而关于拒绝转运的老年患者的流行病学数据却很匮乏。在许多研究中，治疗拒绝率在5%至15%之间。本研究旨在检验老年患者在拒绝院前转运的人群中所占比例不断增加这一假设。方法。本研究是对一家大型城市急救服务机构查询数据的回顾性分析。结果。在为期16个月的研究期间，共记录了22347例成人拒绝转运事件。纳入性别、种族、季节、主要诉求、大都市地区以及在拒绝转运前是否接受过任何治疗等协变量的多因素逻辑回归分析证实，与第1阶段相比，第2阶段的患者为老年患者的可能性增加（比值比1.24，95%置信区间1.14 - 1.35，Wald检验P <.001）。结论。这些数据表明，尽管对这些协变量进行了控制，但与研究最初8个月的患者相比，本研究第2阶段拒绝转运的患者为老年患者的可能性高出近25%。
