Survival Rates of Life-Threatening Trauma Patients Transported by Advanced Life Support of Surgico Medical Ambulance and Rescue Team
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Abstract
This research aimed to investigate the survival rates of life-threatening trauma patients transported by the Advanced Life Support unit of a tertiary hospital in Bangkok. It was a retrospective cohort study involving 146 trauma patients, using data recorded in the high-level emergency medical service operation logs of the Erawan Center, Bangkok, and electronic databases of Vajira Hospital from January 1, 2019, to December 31, 2022. Data were analyzed using survival analysis. The study found that.
1. The survival group, comprising 107 individuals, was predominantly male, with a median age of 39 years. Survival rates were analyzed over a follow-up period of 180 days using the Kaplan-Meier method, revealing survival rates at 30, 60, 90, and 120 days to be 63.06%, and at 150 and 180 days to be 31.53%, with a median survival time of 120.79 days (95% CI: 65.20 - 176.38).
2. Factors significantly associated with survival at a .05 statistical significance level include: 1) Clinical characteristics and symptoms of the injured, such as Glasgow Coma Scale scores, pupillary light response, size of both pupils, systolic blood pressure, blood oxygen concentration, injury severity score, emergency critical level, and red blood cell concentration; 2) Pre-hospital care processes, including response time to the incident, treatment time at the scene, time from notification of the incident to hospital transport, airway management, cervical splint application; and 3) In-hospital treatment processes, such as activation of the emergency pathway, receiving significant volumes of blood and blood components, administration of tranexamic acid, and treatment in the intensive care unit.
Healthcare professionals can use these survival-related factors to improve the efficiency of both pre-hospital emergency medical services and in-hospital services, thereby increasing the survival rate for patients.
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