Factors Associated with Deaths within the First 24 Hours in Referral Patients Transferred from Community Hospitals to Mae Sot Hospital, Tak Province
Keywords:
emergency care system, death within the first 24 hours, patients transferredAbstract
Patient referral constitutes a seamless health service network designed to maximize the efficient utilization of limited resources. The design aims to reduce the loss of function in vital organs and, consequently, decrease the overall mortality rate. The objective of this research was to study patient characteristics and factors associated with death within the first 24 hours after arrival. This retrospective analytical study focused on patients referred from four primary hospitals on the west of Tak Province. Data were collected from medical records and the database of Mae Sot Hospital during October 2022 to September 2023. A total of 592 patients were included in the sample, of whom 26 cases (4.4%) died within 24 hours, while 566 (95.6%) survived. Factors associated with death within the initial 24 hours included Glasgow Coma Scale (GCS) <8 (OR=3.08; 95%CI 1.000-9.510, p=0.050), receiving vasopressor (OR=5.62; 95%CI=1.837-17.212, p=0.002), and a DTX level <80 mg% (OR=5.07; 95%CI=1.226-21.034, p=0.025). Therefore, patients with these various conditions should be monitored in accordance with established patient care standards to reduce the mortality.
References
สถาบันการแพทย์ฉุกเฉินแห่งชาติ. พระราชบัญญัติการแพทย์ฉุกเฉิน พ.ศ. 2551. พิมพ์ครั้งที่ 2. นนทบุรี: สถาบันการแพทย์ฉุกเฉินแห่งชาติ; 2552.
Hsia RY, Thind A, Zakariah A, Hicks ER, Mock C. Prehospital and emergency care: updates from the disease control priorities, version 3. World J Surg 2015;39(9):2161-7.
Alabdali A, Trivedy CR, Aljerian N, Kimani PK, Lilford R. Incidence and predictors of adverse events and outcomes for adult critically ill patients transferred by paramedics to a tertiary care medical facility. J Health Spec 2017;5(4):206-11.
Srithong K, Sindhu S, Wanitkun N, Viwatwongkasem C. Incidence and risk factors of clinical deterioration during inter-facility transfer of critically ill patients; a cohort study. Arch Acad Emerg Med 2020;8(1):e65.
Droogh JM, Smit M, Absalom AR, Ligtenberg JJ, Zijlstra JG. Transferring the critically ill patient: are we there yet? Crit Care. 2015;19(1):62.
เศรษฐพงษ์ ธนูรัตน์, พรทิพา ตันติบัณฑิต. ลักษณะของผู้ป่วยที่เสียชีวิตภายใน 24 ชั่วโมงแรกในการส่งต่อจากโรงพยาบาลชุมชน: กรณีวิเคราะห์ข้อมูลระดับจังหวัด. วารสารกรมการแพทย์. 2564; 46(3):89-95.
Pintatham K, Plongniras W. Factors associated with 24 Hours mortality of traumatic patients in Chiang Rai Province, Thailand. Journal of Emergency Medical Services of Thailand 2022;2(1):66-76.
รัดเกล้า วงศ์ชัยสุริยะ, เกรียงศักดิ์ ปินตาธรรม, ยุทธนา โค้วจิริยะพันธุ์, พรธีรา พรหมยวง. ปัจจัยที่สัมพันธ์กับการเสียชีวิตของผู้ป่วยอุบัติเหตุที่นำส่งด้วยชุดปฏิบัติการฉุกเฉินระดับสูงของโรงพยาบาลเชียงรายประชานุเคราะห์. วารสารการแพทย์ฉุกเฉินแห่งประเทศไทย 2564;1(1):14-22.
Yamane T. Statistics, an introductory analysis. 2nd Ed. New York: Harper and Row; 1967.
Strauch U, Bergmans DC, Winkens B, Roekaerts PM. Short-term outcomes and mortality after interhospital intensive care transportation: an observational prospective cohort study of 368 consecutive transports with a mobile intensive care unit. BMJ Open 2015;5(4):e006801.
Niegelberg E, Pesce K, Cox L, Thode H, Singer AJ. 210: The impact of online medical direction on ambulance transport of patients initially refusing medical assistance. Annals of Emergency Medicine 2010;56(3):S69.
Atramont A, Lindecker-Cournil V, Rudant J, Tajahmady A, Drewniak N, Fouard A, et al. Association of age with short-term and long-term mortality among patients dis charged from intensive care units in France. JAMA Netw Open 2019;2(5):e193215.
Motiejunaite J, Deniau B, Blet A, Gayat E, Mebazaa A. Inotropes and vasopressors are associated with increased short-term mortality but not long-term survival in critically ill patients. Anaesth Crit Care Pain Med. 2022;41(1):101012.
Björk M, Melin EO, Frisk T, Thunander M. Admission glucose level was associated with increased short-term mortality and length-of-stay irrespective of diagnosis, treating medical specialty or concomitant laboratory values. Eur J Intern Med. 2020;75:71-8.
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