J Korean Med Sci.  2015 Dec;30(12):1889-1895. 10.3346/jkms.2015.30.12.1889.

The Relationship between Clinical Outcome in Subarachnoidal Hemorrhage Patients with Emergency Medical Service Usage and Interhospital Transfer

• Lee SH
• Song KJ
• Shin SD
• Ro YS
• Kim MJ
• Holmes JF

• KMID: 2359976
• DOI: http://doi.org/10.3346/jkms.2015.30.12.1889

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.

Keyword

Subarachnoid Haemorrhage; Emergency Medical Services; Interhospital Transfer; Mortality

MeSH Terms

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

Figure

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  Fig. 1 Study population and their group.

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