Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.
Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou, China.
Front Public Health. 2024 Feb 29;12:1330194. doi: 10.3389/fpubh.2024.1330194. eCollection 2024.
Prehospital emergency care is a critical but often understudied aspect of healthcare. Patient vulnerability in this setting can significantly impact outcomes. The aim of this study was to investigate the vulnerability status and to determine associated affect factors among prehospital emergency patients in China.
In this cross-sectional study conducted in China, from April 2023 to July 2023, we assessed the vulnerability of prehospital emergency patients using the Safety in Prehospital Emergency Care Index (SPECI) scale. We conducted a detailed questionnaire-based survey to gather demographic and disease-related information. We employed the SPECI scale, consisting of two subscales, to evaluate patient vulnerability. Statistical analyses, including t-tests, ANOVA, and multiple linear regression, were used to identify factors associated with vulnerability.
The study included a total of 973 prehospital emergency patients, with a response rate of 81.9%. These patients exhibited a low-to-moderate level of vulnerability, with an average SPECI score of 14.46 out of 40. Vulnerability was significantly associated with age (particularly those aged 60 and above), disease severity (severe conditions increased vulnerability), disease type (circulatory diseases correlated with higher vulnerability), alterations in consciousness, and chronic diseases. Unexpectedly, digestive system diseases were negatively correlated with vulnerability.
Addressing patient vulnerability in prehospital care is essential. Tailored interventions, EMS provider training, and interdisciplinary collaboration can mitigate vulnerability, especially in older patients and those with severe conditions.
院前急救是医疗保健中一个至关重要但往往研究不足的环节。患者在该环境下的脆弱性可能会对结局产生重大影响。本研究旨在调查中国院前急救患者的脆弱性状况，并确定相关影响因素。
本研究为 2023 年 4 月至 7 月在中国进行的横断面研究，我们使用院前急救脆弱性指数（SPECI）量表评估院前急救患者的脆弱性。我们采用详细的基于问卷的调查来收集人口统计学和疾病相关信息。我们使用 SPECI 量表，包含两个亚量表，来评估患者的脆弱性。采用 t 检验、方差分析和多元线性回归等统计分析方法，识别与脆弱性相关的因素。
本研究共纳入 973 名院前急救患者，响应率为 81.9%。这些患者的脆弱性处于低至中度水平，SPECI 评分为 40 分中的 14.46 分。脆弱性与年龄（特别是 60 岁及以上的患者）、疾病严重程度（严重疾病增加脆弱性）、疾病类型（循环系统疾病与更高的脆弱性相关）、意识改变和慢性疾病显著相关。出乎意料的是，消化系统疾病与脆弱性呈负相关。
解决院前急救中患者的脆弱性问题至关重要。针对特定患者的干预措施、EMS 提供者培训和跨学科合作可以减轻脆弱性，尤其是在老年患者和患有严重疾病的患者中。
