Sigvardt Emilie, Olsen Markus Harboe, Folke Fredrik, Aasvang Eske Kvanner, Meyhoff Christian Sylvest
Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Intern Emerg Med. 2025 Jan 6. doi: 10.1007/s11739-024-03852-9.
Identifying frequent users of Emergency Medical Services (EMS) in the post-discharge period can potentially direct interventions to prevent deterioration at home. This study aimed to describe the frequency of post-discharge emergency phone calls within 30 days after common medical and surgical categories of hospital admission. A retrospective cohort study retrieved data from the electronic medical record and the EMS Capital Region Denmark database after approval by the Danish Health Data Authority. The study investigated the number of 30-day EMS calls per 1000 days alive outside hospital in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD), colorectal surgery, and 18 other disease categories. We included 16,338 patients with a discharge from hospital between August 2021 and August 2022.The overall number of EMS calls was 4,263 with 9.1 (95% confidence interval (95% CI)): 8.8-9.4) calls per 1000 patient days within 30 days. Patients discharged after medical hospitalization due to AECOPD contacted EMS 15 (95% CI: 13-16) times per 1000 patient days only surpassed by sepsis with 19 calls per 1000 patient days (95% CI: 17-21). Patients undergoing colorectal surgery had an EMS call frequency of 7.5 (95% CI: 6.4-8.7) and highest among types of surgery was hip- and knee replacements with 12 (95% CI: 11-13) calls per 1000 patient days. Patients discharged after hospitalization due to AECOPD and sepsis had a higher 30-day EMS call frequency compared with other medical cohorts, whereas major orthopedic surgery was followed by more EMS calls than admissions for colorectal surgery.
识别出院后紧急医疗服务（EMS）的频繁使用者，有可能指导采取干预措施以预防在家中病情恶化。本研究旨在描述常见内科和外科住院类型出院后30天内紧急电话呼叫的频率。一项回顾性队列研究在获得丹麦卫生数据管理局批准后，从电子病历和丹麦首都地区EMS数据库中检索数据。该研究调查了因慢性阻塞性肺疾病急性加重（AECOPD）、结直肠手术和其他18种疾病类别住院的患者，每1000天院外存活时间内30天的EMS呼叫次数。我们纳入了2021年8月至2022年8月期间出院的16338例患者。EMS呼叫总数为4263次，30天内每1000患者日的呼叫次数为9.1次（95%置信区间（95%CI）：8.8 - 9.4）。因AECOPD内科住院后出院的患者，每1000患者日联系EMS 15次（95%CI：13 - 16），仅次于败血症患者，败血症患者每1000患者日呼叫19次（95%CI：17 - 21）。接受结直肠手术的患者EMS呼叫频率为7.5次（95%CI：6.4 - 8.7），在各类手术中，髋关节和膝关节置换术的呼叫频率最高，每1000患者日为12次（95%CI：11 - 13）。因AECOPD和败血症住院后出院的患者，其30天的EMS呼叫频率高于其他内科队列，而大型骨科手术后的EMS呼叫次数多于结直肠手术入院患者。
