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J Korean Soc Emerg Med > Volume 28(1); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(1): 1-16.
중증환자 이송 서비스가 환자의 생존에 미치는 향
박용주1, 이경원3, 정 주1, 장익완1, 안기옥2, 노영선2, 신상도1
1서울대학교병원 응급의학과
2서울대학교병원 의생명연구원 응급의료연구실
3인제대학교 서울백병원 응급의학과
Effect of Critical Care Transport on Patients’ Survival after Inter-Hospital Transport of Critically Ill Patients
Yong Joo Park1, Kyung Won Lee3, Joo Jeong1, Ik Wan Jang1, Ki Ok Ahn2, Young Sun Ro2, Sang Do Shin1
1Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
2Laboratory of Emergency Medical Services, Seoul National University Hospital, Seoul, Korea
3Department of Emergency Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
Correspondence  Kyung Won Lee ,Tel: 02-2270-0119, Fax: 02-2270-0586, Email: emkwlee@gmail.com,
Received: January 20, 2017; Revised: January 31, 2017   Accepted: February 6, 2017.  Published online: February 28, 2017.
ABSTRACT
Purpose:
Critical care transport (CCT) has been known to be beneficial for inter-hospital transport of critically ill patients. Seoul Mobile Intensive Care Unit (SMICU) has been established and provided CCT in Seoul Metropolitan City since 2015. We tested the association between SMICU transport and hospital outcome for critically ill patients.
Method:
This is a before and after intervention study. SMICU group with cardiac arrest, acute myocardial infarction, acute stroke, major trauma, respiratory failure, and shock who were transported by SMICU from January to July 2016 were collected as an intervention group. Non-SMICU group with the same above diagnosis criteria who were transported by private ambulance services during same period in 2015. By National Emergency Department Information System (NEDIS), demographics were compared for original data and sampling data. Multivariable logistic regression analysis was done to calculate the adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) adjusting for potential confounders.
Results:
Total 1,837 patients (128 SMICU and 1,709 non-SMICU group) for original dataset and 180 patients (60 SMICU and 120 non-SMICU group) for sampling dataset were finally analyzed. Hospital mortality rates are 22.7% in SMICU and 11.8% in non-SMICU in original dataset (p<0.001), 26.7% in SMICU and 31.7% in non-SMICU in sampling dataset (p=0.490), respectively. AOR (95% CIs) for hospital mortality by SMICU in original and sampling dataset were 0.80 (0.481.35) and 0.71 (0.33-1.51), respectively.
Conclusion:
The CCT for critically ill patients did not show significantly better hospital mortality in the pilot study.
Key words: Emergency medical services, Transportation of patients, Critical care, Mortality
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