Risk factors associated with mortality during ems care: a case-control study (in Vinnytsia region)
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Date
2020
Authors
Gaievskyi, Stanislav
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Abstract
Background: Emergency medical services (EMS) in Ukraine are currently under
increased scrutiny for the quality of care that they provide. The Government initiated
a set of policies to reform the EMS system. This study aimed to evaluate the EMS
system to provide evidence-based recommendations for its improvement.
Methods: A matched case-control study was used to determine risk factors associated
with death during prehospital care. Vinnytsia oblast EMS dispatch center data was used
to identify 898 patients that died during EMS care (cases), from January 17th, 2017 to
June 19th, 2019. Each case was paired with a control patient (matched on age and chief
complaint). A binary logistic regression was used to determine the association of risk
factors with prehospital mortality.
Results: The study found that ambulance response time (adjusted odds ratio 2.417;
95% confidence intervals 1.667 - 3.505; p = <0.001) and place of incident (adjusted
odds ratio 2.658; 95% confidence intervals 1.661 - 4.254; p = <0.001) are associated
with increased risk of mortality.
Implications: The study discussed possible explanations of increased mortality and
proposed strategies aimed at its reduction. However, further research is needed to
investigate other factors that can potentially influence the mortality of patients in
emergency conditions.
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Keywords
Emergency Medical Services, prehospital mortality, case-control, response time, master thesis