EMERGENCY MEDICAL SERVICES RESPONSE TIME AND MORTALITY IN AN URBAN SETTING
EMERGENCY MEDICAL SERVICES RESPONSE TIME AND MORTALITY IN AN URBAN SETTING
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DOI：
10.3109/10903127.2011.614046
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发表时间：
2012-01-01
影响因子：
2.4
通讯作者：
Innes, Grant D.
中科院分区：
文献类型：
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作者：
Blanchard, Ian E.;Doig, Christopher J.;Innes, Grant D.
背景。紧急医疗服务（EMS）的一个共同原则是，更快的反应等同于更好的患者结果，一些EMS操作将其转化为对危及生命事件作出反应的高级生命支持（ALS）单位的反应时间为8分钟或更短的目标。目标。探讨8分钟EMS反应时间是否与死亡率相关。方法。这是一项为期一年的回顾性队列研究，研究对象是在911呼叫（医疗优先调度系统echo或delta级事件）时评估的危及生命事件的成年人。研究环境是一个为大约100万人口服务的城市全渐冻症EMS系统。响应时间定义为接到9-1-1电话到ALS单元到达现场，结果定义为出院时全因死亡率。潜在的协变量包括患者的视力、年龄、性别、场景和运输间隔时间。采用分层分析和逻辑回归来评估反应时间-死亡率的相关性。结果。有7760个单位反应符合纳入标准；>= 8分钟1865例（24%）。患者平均年龄为56.7岁（标准差= 21.5）。对于反应时间>= 8分钟的患者，死亡率为7.1%，而反应时间= 8分钟的患者死亡率为6.4%，为1.19 （95% CI: 0.97, 1.47）。一项探索性分析表明，反应可能会产生小的有益效果
Background. A common tenet in emergency medical services (EMS) is that faster response equates to better patient outcome, translated by some EMS operations into a goal of a response time of 8 minutes or less for advanced life support (ALS) units responding to life-threatening events. Objective. To explore whether an 8-minute EMS response time was associated with mortality. Methods. This was a one-year retrospective cohort study of adults with a life-threatening event as assessed at the time of the 9-1-1 call (Medical Priority Dispatch System Echo-or Delta-level event). The study setting was an urban all-ALS EMS system serving a population of approximately 1 million. Response time was defined as 9-1-1 call receipt to ALS unit arrival on scene, and outcome was defined as all-cause mortality at hospital discharge. Potential covariates included patient acuity, age, gender, and combined scene and transport interval time. Stratified analysis and logistic regression were used to assess the response time-mortality association. Results. There were 7,760 unit responses that met the inclusion criteria; 1,865 (24%) were >= 8 minutes. The average patient age was 56.7 years (standard deviation = 21.5). For patients with a response time >= 8 minutes, 7.1% died, compared with 6.4% for patients with a response time = 8 minutes was 1.19 (95% CI: 0.97, 1.47). An exploratory analysis suggested there may be a small beneficial effect of response