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院前急救快速反应车派出后取消任务的危险因素:一项单中心病例对照研究。

Risk factors for cancellation after dispatch of rapid response cars for prehospital emergency care: a single-center, case-control study.

作者信息

Inoue Juri, Hirano Yohei, Fukumoto Yuichi, Kudo Tomohiro, Usami Ryo, Kondo Yutaka, Matsuda Shigeru, Okamoto Ken, Tanaka Hiroshi

机构信息

Department of Emergency and Critical Care Medicine Juntendo University Urayasu Hospital Urayasu Chiba Japan.

出版信息

Acute Med Surg. 2021 Jul 26;8(1):e684. doi: 10.1002/ams2.684. eCollection 2021 Jan-Dec.

Abstract

AIM

The objective of this study is to identify the risk factors for cancellation after dispatch of rapid response cars (RRC) for prehospital emergency care.

METHODS

We retrospectively extracted data from all RRC cases dispatched from our hospital between April 2017 and March 2019. A total of 1,440 cases were included in our study and divided into either the "cancelled" group ( = 723) or the "treated" group ( = 717), based on the occurrence of cancellation. The variables obtained from the request calls for RRC included patient characteristics, distance from the hospital to the scene, and reasons for RRC request. The variables were compared between the two groups and logistic regression analysis was carried out to identify the risk factors for RRC cancellation.

RESULTS

Multivariable analysis showed that distance from the hospital to the scene (odds ratio [OR] 1.25; 95% confidence interval (CI), 1.21-1.28), suspicion of cardiopulmonary arrest with no witness information (OR 7.61; 95% CI, 4.13-14.00), dyspnea (OR 2.22; 95% CI, 1.19-4.11), and suicide by hanging (OR 3.49; 95% CI, 1.37-8.89) were independent risk factors for cancellation.

CONCLUSIONS

In our study, a greater distance from the hospital to the scene, suspicion of cardiopulmonary arrest with no witness information, dyspnea, and suicide by hanging were identified as independent risk factors for cancellation after dispatch of RRC. Evaluating the risk factors for cancellation at individual facilities could help hospitals adjust their dispatch criteria to allocate limited medical resources more effectively.

摘要

目的

本研究的目的是确定院前急救快速反应车(RRC)派出后取消任务的风险因素。

方法

我们回顾性提取了2017年4月至2019年3月期间我院派出的所有RRC病例的数据。本研究共纳入1440例病例,根据取消任务的情况分为“取消”组(n = 723)和“治疗”组(n = 717)。从RRC请求电话中获得的变量包括患者特征、医院到现场的距离以及RRC请求的原因。比较两组之间的变量,并进行逻辑回归分析以确定RRC取消的风险因素。

结果

多变量分析显示,医院到现场的距离(优势比[OR] 1.25;95%置信区间[CI],1.21 - 1.28)、怀疑心脏骤停但无目击者信息(OR 7.61;95% CI,4.13 - 14.00)、呼吸困难(OR 2.22;95% CI,1.19 - 4.11)和上吊自杀(OR 3.49;95% CI,1.37 - 8.89)是取消任务的独立风险因素。

结论

在我们的研究中,医院到现场的距离更远、怀疑心脏骤停但无目击者信息、呼吸困难和上吊自杀被确定为RRC派出后取消任务的独立风险因素。评估各机构取消任务的风险因素有助于医院调整其调度标准,以更有效地分配有限的医疗资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f5b/8312742/8f5dee83ed66/AMS2-8-e684-g004.jpg

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