ข้อแตกต่างของระยะเวลาในห้วงก่อนถึงโรงพยาบาลในผู้ป่วยอุบัติเหตุของหน่วยบริการการแพทย์ฉุกเฉินโรงพยาบาลสวรรค์ประชารักษ์ในช่วงการระบาดของโควิด-19

Kanokwan Kongchampa

Authors

Kanokwan Kongchampa Sawanpracharak Hospital

Keywords:

COVID-19, Emergency medical systems, Prehospital time

Abstract

Objective : The study aimed to compare prehospital time before and during the coronavirus disease of 2019 (covid-19) pandemic in trauma patients admitted to the emergency medical services of Sawanpracharak Hospital. The first 24 hours-mortality-related factors between the two study periods were also analyzed.

Method : This retrospective cohort study was based on data from 820 trauma patients at the emergency medical services of Sawanpracharak Hospital from 1 December 2018 to May 2021. Two groups were 422 patients before the COVID-19 outbreak (December 2018 - February 2020) and 398 patients during the COVID-19 outbreak (March 2020 - May 2021). Variables related to the groups were analyzed using a t-test, Chi-squared, or Fisher's exact. The first 24 hours-mortality-related factors were explored using a multivariate binary logistic regression model. The level of statistical significance was determined at p-value < 0.05.

Results: Both groups had no differences in demographic characteristics. During the COVID-19 outbreak, on-scene and total prehospital time were significantly higher than those before the COVID-19 pandemic (7.6±5.0 minutes vs. 10.6±5.8 minutes, p <0.01 and 27.4±13.1 minutes vs. 30.1±13.6 minutes, p= 0.01). Regarding multivariable analysis, the factor that affected mortality in the first 24 hours between the two groups was the injury severity score. Patients with an injury severity score over 16 had a significantly higher mortality rate (Odds ratio: 7.8; 95% Confidence interval: 1.5-39.4, p=0.01). Prehospital time did not affect the mortality of trauma patients in the first 24 hours.

Conclusion: The COVID-19 pandemic affected prehospital time in the emergency medical services system, resulting in longer on-scene and total prehospital time. However, longer prehospital time did not affect trauma patients' mortality within the first 24 hours. The only factor related to patient mortality was the difference in the injury severity score.

Keywords : COVID-19, Emergency medical systems, Prehospital time

Running title: Traumatic emergency prehospital time and COVID-19

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