Factors Associated with Mortality Rate in Trauma Patients Transported by the Advanced Life Support Unit of Chiangrai Prachanukroh Hospital, Chiang Rai Province, Thailand

Abstract

Emergency Department, Chiangrai Prachanukroh Hospital, Chiang Rai Pfrovince, Thailand The objective of this study was to identify factors related to death among trauma patients receiving advanced emergency care services (EMS) through the Chiang Rai Emergency Medical Dispatch Center and Ambulance Operation Center (AOC). The study was conduct as a retrospective cohort study through a review of pre-hospital care forms of trauma patient forms in the Chiang Rai Emergency Medical Dispatch Center and Ambulance Operation Center from January 2017 to December 2018. Data collected for analysis included the response time, on scene time, operation time, age, sex, and mechanism of injury among the dead and survivor groups up to 24 hours after hospitalization. The study patients were those who exhibited symptoms 21 to 25 of Criteria-Based Dispatch (CBD) and Emergency Severity Index (ESI) screening level 1. Multiple logistic regression analysis was applied to determine the variables associated with the survival. As for the results, there were 218 critical emergency patients: 58 deaths (26.6%) and 160 survivors (73.4%). In the dead group, the response time was ≤8 minutes for 34 people (58.6%), and the on-scene time was ≤10 minutes for 7 people (12.1%), and there was no statistical significance in regard to mortality rate. On the other hand, the operation time was found to be significantly associated with the survival since 44 people (75.9%) with an operation time of less than 40 minutes survived (p<0.05). In conclusion, among the patients were delivered by the advanced life support unit (ALS), there was no correlation between the mortality and the response time over 8 minutes. However, higher mortality rate was found to be correlated with operation time over 40 minutes.