{"title":"自行转诊预约(SRW)与紧急医疗服务带来的Covid-19患者。","authors":"Navid Kalani, Naser Hatami, Sajed Ali, Neema John Mehramiz, Fatemeh Rahmanian, Esmaeil Raeyat Doost, Marzieh Haghbeen, Samaneh Abiri, Mahdi Foroughian, Mohsen Ebrahimi","doi":"10.30476/BEAT.2021.92229.1299","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the characteristics of the emergency medical services (EMS) brought COVID-19 patients versus self-referred walk-in patients.</p><p><strong>Methods: </strong>This was a Cross-sectional study of COVID-19 infected cases in Jahrom, south of Iran. Age, sex, the symptoms of beginning days' passing, respiratory distress, PO2 at arrival, admission length and in-hospital death were retrieved for confirming COVID-19 cases in the whole 2020 year. Respiratory distress was considered as the sign that agitates the patient to call EMS care. Survival analysis was used to evaluate the possible difference of the hospitalization outcome in EMS brought or Self-referred walk-in (SRW) patients.</p><p><strong>Results: </strong>There was 704 (27.1%) registries patients transfer to the hospital by EMS and 1895 (72.9%) cases with SRW referred to the hospital. The survival distributions for the EMS group were statistically significant and lower than SRW group (<i>p</i><0.05). Despite the SRW patients, respiratory distress was associated with lower survival in EMS group (<i>p</i><0.05). Days passing the symptom's beginning was significantly different between EMS group (6.1±5.3 days) and SRW group (6.9±4.6 days). Cox regression showed higher mortality rate in patients higher than 75 years old in both groups (<i>p</i><0.05). Higher PO2 at arrival was associated with lower mortality rate of Hazard Ratio of 0.959 (<i>p</i><0.001) and 0.903 (<i>p</i><0.001) in EMS and SRW groups, respectively. The history of heart disease and hypertension were associated with 1.011 and 1.088 times more than mortality risk in EMS group; while cancer history was associated with 2.74 times more of mortality risk in SRW group.</p><p><strong>Conclusion: </strong>It seems that severe acute respiratory syndrome occurs soon in some patients that lead to the need for an ambulance to transfer the patient to the hospital. Therefore, EMS transfer patients should be considered for more risk of severe COVID-19; considering comorbidities of heart disease and hypertension as red flags.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"10 1","pages":"21-26"},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818102/pdf/","citationCount":"4","resultStr":"{\"title\":\"Self-Referred Walk-in (SRW) versus Emergency Medical Services Brought Covid-19 Patients.\",\"authors\":\"Navid Kalani, Naser Hatami, Sajed Ali, Neema John Mehramiz, Fatemeh Rahmanian, Esmaeil Raeyat Doost, Marzieh Haghbeen, Samaneh Abiri, Mahdi Foroughian, Mohsen Ebrahimi\",\"doi\":\"10.30476/BEAT.2021.92229.1299\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare the characteristics of the emergency medical services (EMS) brought COVID-19 patients versus self-referred walk-in patients.</p><p><strong>Methods: </strong>This was a Cross-sectional study of COVID-19 infected cases in Jahrom, south of Iran. Age, sex, the symptoms of beginning days' passing, respiratory distress, PO2 at arrival, admission length and in-hospital death were retrieved for confirming COVID-19 cases in the whole 2020 year. Respiratory distress was considered as the sign that agitates the patient to call EMS care. Survival analysis was used to evaluate the possible difference of the hospitalization outcome in EMS brought or Self-referred walk-in (SRW) patients.</p><p><strong>Results: </strong>There was 704 (27.1%) registries patients transfer to the hospital by EMS and 1895 (72.9%) cases with SRW referred to the hospital. The survival distributions for the EMS group were statistically significant and lower than SRW group (<i>p</i><0.05). Despite the SRW patients, respiratory distress was associated with lower survival in EMS group (<i>p</i><0.05). Days passing the symptom's beginning was significantly different between EMS group (6.1±5.3 days) and SRW group (6.9±4.6 days). Cox regression showed higher mortality rate in patients higher than 75 years old in both groups (<i>p</i><0.05). Higher PO2 at arrival was associated with lower mortality rate of Hazard Ratio of 0.959 (<i>p</i><0.001) and 0.903 (<i>p</i><0.001) in EMS and SRW groups, respectively. The history of heart disease and hypertension were associated with 1.011 and 1.088 times more than mortality risk in EMS group; while cancer history was associated with 2.74 times more of mortality risk in SRW group.</p><p><strong>Conclusion: </strong>It seems that severe acute respiratory syndrome occurs soon in some patients that lead to the need for an ambulance to transfer the patient to the hospital. Therefore, EMS transfer patients should be considered for more risk of severe COVID-19; considering comorbidities of heart disease and hypertension as red flags.</p>\",\"PeriodicalId\":9333,\"journal\":{\"name\":\"Bulletin of emergency and trauma\",\"volume\":\"10 1\",\"pages\":\"21-26\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818102/pdf/\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bulletin of emergency and trauma\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.30476/BEAT.2021.92229.1299\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin of emergency and trauma","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.30476/BEAT.2021.92229.1299","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Self-Referred Walk-in (SRW) versus Emergency Medical Services Brought Covid-19 Patients.
Objective: To compare the characteristics of the emergency medical services (EMS) brought COVID-19 patients versus self-referred walk-in patients.
Methods: This was a Cross-sectional study of COVID-19 infected cases in Jahrom, south of Iran. Age, sex, the symptoms of beginning days' passing, respiratory distress, PO2 at arrival, admission length and in-hospital death were retrieved for confirming COVID-19 cases in the whole 2020 year. Respiratory distress was considered as the sign that agitates the patient to call EMS care. Survival analysis was used to evaluate the possible difference of the hospitalization outcome in EMS brought or Self-referred walk-in (SRW) patients.
Results: There was 704 (27.1%) registries patients transfer to the hospital by EMS and 1895 (72.9%) cases with SRW referred to the hospital. The survival distributions for the EMS group were statistically significant and lower than SRW group (p<0.05). Despite the SRW patients, respiratory distress was associated with lower survival in EMS group (p<0.05). Days passing the symptom's beginning was significantly different between EMS group (6.1±5.3 days) and SRW group (6.9±4.6 days). Cox regression showed higher mortality rate in patients higher than 75 years old in both groups (p<0.05). Higher PO2 at arrival was associated with lower mortality rate of Hazard Ratio of 0.959 (p<0.001) and 0.903 (p<0.001) in EMS and SRW groups, respectively. The history of heart disease and hypertension were associated with 1.011 and 1.088 times more than mortality risk in EMS group; while cancer history was associated with 2.74 times more of mortality risk in SRW group.
Conclusion: It seems that severe acute respiratory syndrome occurs soon in some patients that lead to the need for an ambulance to transfer the patient to the hospital. Therefore, EMS transfer patients should be considered for more risk of severe COVID-19; considering comorbidities of heart disease and hypertension as red flags.
期刊介绍：
BEAT: Bulletin of Emergency And Trauma is an international, peer-reviewed, quarterly journal coping with original research contributing to the field of emergency medicine and trauma. BEAT is the official journal of the Trauma Research Center (TRC) of Shiraz University of Medical Sciences (SUMS), Hungarian Trauma Society (HTS) and Lusitanian Association for Trauma and Emergency Surgery (ALTEC/LATES) aiming to be a publication of international repute that serves as a medium for dissemination and exchange of scientific knowledge in the emergency medicine and trauma. The aim of BEAT is to publish original research focusing on practicing and training of emergency medicine and trauma to publish peer-reviewed articles of current international interest in the form of original articles, brief communications, reviews, case reports, clinical images, and letters.
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