现场急救时间的变化及不同性别之间现场时间差异的程度:沙特阿拉伯利雅得省基于人群的回顾性登记研究。
Variation in on-scene time of emergency medical services and the extent of the difference of on-scene time between genders: a retrospective population-based registry study in Riyadh Province, Saudi Arabia.
机构信息
Health Services Management, Jazan University Faculty of Public Health and Tropical Medicine, Jazan, Saudi Arabia
Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands.
出版信息
BMJ Open. 2022 Mar 16;12(3):e052481. doi: 10.1136/bmjopen-2021-052481.
OBJECTIVES
To identify the intergender variation of on-scene time (OST) for highly urgent emergency cases conveyed by emergency medical services (EMS) in Saudi Arabia and to assess other predictors of OST and hypothesise for possible factors delaying OST.
DESIGN
A retrospective population-based registry study.
SETTING
Riyadh Province is the largest province in terms of population and the second in terms of geographical area.
PARTICIPANTS
All highly urgent transported patients from the scene to emergency departments, be they medical emergencies or trauma emergencies during 2018.
OUTCOME MEASURE
OST difference between men and women transported by EMS.
RESULTS
In total, 21 878 patients were included for analysis: 33.9% women and 66.1% men. The median OST for women was 22 min (IQR 15-30) and 18 min (IQR 11-26) for men (p<0.001); for medical cases, median OST was 23 min (IQR 16-31) for women compared with 20 min (IQR 13 - 29) for men (p<0.001); for trauma cases, the median OST of both sexes was equal. We found the following additional predictors of OST: factors of emergency type, sex, age category, geographical areas, type of ambulance vehicle and hospital type were all significantly associated with OST in the crude or adjusted analyses. Factors of emergency type, sex, age category, geographical areas, type of ambulance vehicle and hospital type were also significantly associated with the odds of OST of more than 15 min in the crude and adjusted regression analyses.
CONCLUSIONS
The median OST was longer than 15 min for more than half of transported cases. For medical cases, women had a longer median OST than men. Additional predictors associated with prolonged OST were the patient's age, area (ie, urban vs rural), type of ambulance vehicle and season. These findings are hypothesis generating and require further studies.
目的
确定在沙特阿拉伯由紧急医疗服务(EMS)转运的高度紧急情况下现场时间(OST)的性别间差异,并评估 OST 的其他预测因素,并假设可能导致 OST 延迟的因素。
设计
回顾性基于人群的登记研究。
设置
利雅得省是人口最多的省份,也是面积第二大的省份。
参与者
2018 年所有从现场转运到急诊部的高度紧急患者,无论是医疗紧急情况还是创伤紧急情况。
结果测量
由 EMS 转运的男女患者的 OST 差异。
结果
共纳入 21878 例患者进行分析:女性占 33.9%,男性占 66.1%。女性的中位 OST 为 22 分钟(IQR 15-30),男性为 18 分钟(IQR 11-26)(p<0.001);对于医疗病例,女性的中位 OST 为 23 分钟(IQR 16-31),男性为 20 分钟(IQR 13-29)(p<0.001);对于创伤病例,男女的中位 OST 相等。我们还发现了其他与 OST 相关的预测因素:紧急类型、性别、年龄类别、地理区域、救护车类型和医院类型等因素在粗分析或调整分析中均与 OST 显著相关。在粗分析和调整回归分析中,紧急类型、性别、年龄类别、地理区域、救护车类型和医院类型等因素也与 OST 超过 15 分钟的几率显著相关。
结论
超过一半的转运病例的中位 OST 超过 15 分钟。对于医疗病例,女性的中位 OST 长于男性。与 OST 延长相关的其他预测因素包括患者年龄、地区(即城市与农村)、救护车类型和季节。这些发现只是假设,需要进一步研究。
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