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Long-Term Mortality in Patients Transferred by Emergency Medical Services: Prospective Cohort Study

Published online by Cambridge University Press:  05 June 2023

Rodrigo Enriquez de Salamanca Gambara ,
Ancor Sanz-García Open the ORCID record for Ancor Sanz-García [Opens in a new window] ,
José L. Martín-Conty ,
Begoña Polonio-López ,
Carlos del Pozo Vegas ,
Francisco Martín-Rodríguez  and
Raúl López-Izquierdo
Rodrigo Enriquez de Salamanca Gambara
Affiliation:
Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain
Ancor Sanz-García*
Affiliation:
Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, Spain
José L. Martín-Conty
Affiliation:
Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, Spain
Begoña Polonio-López
Affiliation:
Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina, Spain
Carlos del Pozo Vegas
Affiliation:
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain Emergency Department, Hospital Clínico Universitario, Valladolid, Spain
Francisco Martín-Rodríguez
Affiliation:
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain
Raúl López-Izquierdo
Affiliation:
Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
*
Correspondence: Dr. Ancor Sanz-García Faculty of Health Sciences Universidad de Castilla la Mancha Avda. Real Fábrica de Seda, s/n 45600 Talavera de la Reina, Toledo E-mail: ancor.sanz@gmail.com
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Abstract

Objective:

This study aimed to determine the long-term mortality (one-year follow-up) associated with patients transferred by Emergency Medical Services (EMS), and to reveal the determinants (causes and risk factors).

Methods:

This was a multicenter, prospective, observational, controlled, ambulance-based study of adult patients transferred by ambulance to emergency departments (EDs) from October 2019 through July 2021 for any cause. A total of six Advanced Life Support (ALS) units, 38 Basic Life Support (BLS) units, and five hospitals from Spain were included. Physiological, biochemical, demographic, and reasons for transfer variables were collected. A longitudinal analysis was performed to determine the factors associated to long-term mortality (any cause).

Results:

The final cohort included 1,406 patients. The one-year mortality rate was 21.6% (n = 304). Mortality over the first two days reached 5.2% of all the patients; between Day 2 and Day 30, reached 5.3%; and between Day 31 and Day 365, reached 11.1%. Low Glasgow values, elevated lactate levels, elevated blood urea nitrogen (BUN) levels, low oxygen saturation, high respiratory rate, as well as being old and suffering from circulatory diseases and neurological diseases were risk factors for long-term mortality.

Conclusion:

The quick identification of patients at risk of long-term worsening could provide an opportunity to customize care through specific follow-up.

Keywords

emergencylong-term mortalitypoint-of-care testingprehospitalrisk factors
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 3 , June 2023 , pp. 352 - 359
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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Footnotes

Both F. Martín-Rodríguez and R. López-Izquierdo are senior authors.

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