An ecological study on relationship between emergency response timeand mortality statistics for cardiovascular disease

我们利用2007年和2008年的25,713份救护车记录，根据地理分布回顾性分析了新泻市应急小组（EmAT）的响应时间。当将这些数据与特定地区的死亡率统计数据进行比较时，我们发现，在应急响应团队需要很长时间才能将患者转移到医院的地区，脑血管疾病（CbrVD）的死亡率风险很高。随后，我们从所有救护车记录中选择了1043例中风病例进行模拟研究。在新泻市，有9家主要的中风急救医院。我们假设中风患者会被这些医院中的任何一家收治，从而计算出转送到每家医院的估计EmAT （eEmAT）。将新泻市22个区域按eEmAT划分为4组，eEmAT最长的区域组的平均eEmAT比eEmAT最短的区域组高12分钟。如果在eEmAT时间最长的地区增设一家大医院，这一差距可平均缩短4.5分钟，从而使与埃博拉病毒相关的死亡率降低20%。

We retrospectively analyzed the response time of emergency teams(EmAT) in Niigata City according to geographical distribution using 25,713 ambulancerecords for 2007 and 2008. When these data were compared to the area-specific mortalitystatistics, we found that the risk of mortality from cerebrovascular disease (CbrVD) washigh in areas where emergency response teams took a long time to transfer patients tohospitals. Subsequently, we selected 1043 stroke cases from all ambulance records for oursimulation study. In Niigata City, there are 9 major emergency hospitals for strokemanagement. We presumed that patients who experienced stroke would be admitted to anyof these hospitals and thus calculated the estimated EmAT (eEmAT) for transfer to eachhospital. When 22 areas in Niigata City were classified into 4 groups on the basis of eEmAT,the average eEmAT in the area-group with the longest eEmAT was higher by 12 minutesthan that for the area-group with the shortest eEmAT. This disparity could be reduced byan average of 4.5 minutes if an additional major hospital would be established in the areaswith the longest eEmAT, which could result in the reduction of CbrVD-related mortalityrates by 20%.