Association between Mode of Transport and Patient Outcomes in the Emergency Department following Out-of-Hospital Cardiac Arrest: A Single-Center Retrospective Study.
Prehosp Emerg Care
; 27(2): 196-204, 2023.
Article
in En
| MEDLINE
| ID: mdl-35333665
ABSTRACT
BACKGROUND:
Out-of-hospital cardiac arrest (OHCA) remains a health problem worldwide, carrying a high mortality rate. Comparison of emergency department (ED) return of spontaneous circulation (ROSC) after OHCA in relation to emergency medical services (EMS) and non-EMS modes of transportation to the hospital was conducted to assess the impact points of the EMS system in Thailand.METHODS:
This retrospective observational study enrolled all OHCA patients who visited the ED of Ramathibodi Hospital, a tertiary university hospital in Bangkok, between January 1, 2008, and May 31, 2020. Patients were differentiated into EMS and non-EMS groups according to mode of transportation to the ED. Patients' characteristics and comorbidities, witnessed arrests, bystander chest compression, initial rhythm, and resuscitation treatment were documented. ED-sustained ROSC, ED survival, 30-day survival, and 30-day survival with good cerebral performance category (CPC) scores were monitored and recorded. Multivariate logistic analyses were performed to assess factors influencing clinical outcomes.RESULTS:
A total of 339 patients were enrolled, 117 (34.51%) of whom were in the EMS transport group. There were no differences between the EMS and non-EMS groups in ED-sustained ROSC (adjusted odds ratio [aOR], 0.99; 95% confidence interval [CI], 0.58-1.70; P = 0.98), or ED survival (aOR, 0.99; 95% CI, 0.57-1.71; P = 0.97). There were also no differences in 30-day survival or 30-day survival with good CPC score between the two groups.CONCLUSIONS:
In our cohort data of OHCA, ED-sustained ROSC and ED survival outcomes were not superior in the EMS transportation group. Evidence to show that EMS transportation affected 30-day survival and 30-day good CPC score was also lacking. Thus, public promotion of Thailand's EMS system is advocated with a simultaneous improvement of EMS response to enhance OHCA outcomes.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiopulmonary Resuscitation
/
Emergency Medical Services
/
Out-of-Hospital Cardiac Arrest
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Prehosp Emerg Care
Journal subject:
MEDICINA DE EMERGENCIA
Year:
2023
Type:
Article
Affiliation country:
Thailand