A classification system for identifying patients dead on ambulance arrival: a prehospital medical record review.

Autor: Petersen M; Centre for Prehospital and Emergency Research, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Gistrup, Denmark., Kjeldtoft FG; Centre for Prehospital and Emergency Research, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Gistrup, Denmark., Christensen EF; Centre for Prehospital and Emergency Research, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Gistrup, Denmark.; Department of Emergency and Trauma Care, Clinic of Internal and Emergency Medicine, Aalborg, Denmark., Bøggild H; Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University, Gistrup, Denmark.; Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark., Lindskou TA; Centre for Prehospital and Emergency Research, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Gistrup, Denmark. tim.l@rn.dk.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2023 Dec 21; Vol. 31 (1), pp. 107. Date of Electronic Publication: 2023 Dec 21.
DOI: 10.1186/s13049-023-01171-0
Abstrakt: Background: Patients dead before arrival of the ambulance or before arrival at hospital may be in- or excluded in mortality analyses, making comparison of mortality difficult. Often only physicians are allowed to declare death, thereby impeding uniform registration of prehospital death. Many studies do not report detailed definitions of prehospital mortality. Our aim was to define criteria to identify and categorize prehospital patients' vital status, and to estimate the proportion of these groups, primarily the proportion of patients dead on ambulance arrival.
Methods: Prehospital medical records review for patients receiving an ambulance in the North Denmark Region from 2019 to 2021 and registered dead on the same or the following day. We defined three vital status categories: (1) Dead on Ambulance Arrival (DOAA), (2) Out-of-Hospital Cardiac Arrest (OHCA) divided into OHCA Basic Life Support (OHCA BLS) and OHCA Advanced treatment, and 3) Alive on Ambulance Arrival.
Results: Among 3 174 dead patients, DOAA constituted 28.8%, OHCA BLS 13.4%, OHCA Advanced treatment 31.3%, and Alive on Ambulance Arrival 26.6%.
Conclusion: We defined exhaustive and mutually exclusive criteria to define vital status, DOAA, OHCA, and Alive on Ambulance Arrival based on prehospital medical records. More than one out of four patients receiving an ambulance and registered dead on the same or the following day were dead already at ambulance arrival. Adding OHCA BLS where resuscitation was terminated without defibrillation or other treatment, increased the proportion of patients dead on ambulance arrival to 42%. We recommend reporting similar categories of vital status to improve valid comparisons of prehospital mortality rates.
(© 2023. The Author(s).)
Databáze: MEDLINE
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