The Relationship between Clinical Outcome in Subarachnoidal Hemorrhage Patients with Emergency Medical Service Usage and Interhospital Transfer.
10.3346/jkms.2015.30.12.1889
- Author:
Sang Hwa LEE
1
;
Kyoung Jun SONG
;
Sang Do SHIN
;
Young Sun RO
;
Min Jung KIM
;
James F HOLMES
Author Information
1. Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea. skciva@gmail.com
- Publication Type:Observational Study ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Subarachnoid Haemorrhage;
Emergency Medical Services;
Interhospital Transfer;
Mortality
- MeSH:
Adult;
Aged;
Emergency Medical Services/*utilization;
Female;
Humans;
Logistic Models;
Male;
Middle Aged;
Outcome Assessment (Health Care);
Patient Transfer/*utilization;
Republic of Korea/epidemiology;
Retrospective Studies;
Subarachnoid Hemorrhage/mortality/*therapy
- From:Journal of Korean Medical Science
2015;30(12):1889-1895
- CountryRepublic of Korea
- Language:English
-
Abstract:
Prompt diagnosis and appropriate transport of patients with subarachnoid hemorrhage (SAH) is critical. We aimed to study differences in clinical outcomes by emergency medical services (EMS) usage and interhospital transfer in patients with SAH. We analyzed the CAVAS (CArdioVAscular disease Surveillance) database which is an emergency department-based, national cohort of cardiovascular disease in Korea. Eligible patients were adults with non-traumatic SAH diagnosed between January 2007 and December 2012. We excluded those whose EMS use and intershopital transfer data was unknown. The primary and secondary outcomes were mortality and neurologic status at discharge respectively. We compared the outcomes between each group using multivariable logistic regressions, adjusting for sex, age, underlying disease, visit time and social history. Of 5,461 patients with SAH, a total of 2,645 were enrolled. Among those, 258 used EMS and were transferred from another hospital, 686 used EMS only, 1,244 were transferred only, and 457 did not use EMS nor were transferred. In the regression analysis, mortality was higher in patients who used EMS and were transferred (OR 1.40, 95% CI 1.02-1.92), but neurologic disability was not meaningfully different by EMS usage and interhospital transfer. In Korea, SAH patients' mortality is higher in the case of EMS use or receiving interhospital transfer.
