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ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 4  |  Page : 126-131

Prognostic predictors of patients admitted in Intensive Care Unit through emergency ambulance services


1 Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
2 Community Medicine, PIMS and RC, Sangli, Maharashtra, India

Correspondence Address:
Priya Yogesh Kulkarni
Community Medicine, SMBT Medical College, Nashik, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-9019.196793

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Background: Lot of progress has been made in emergency medical services (EMSs) in India in private and government sectors. Very few studies are done focusing the prognosis of patients utilizing EMSs. Aim: This study aimed to analyze the prognostic predictors of patients admitted in Intensive Care Unit (ICU) through EMSs. Materials and Methods: It was a hospital records-based study. EMS patients who were admitted in ICU were included in the study. Patients with a poor prognosis were defined as who died within 48 h of ICU admission, and patients who were stable and shifted to other wards after 48 h of ICU admission were defined to have a good prognosis. A person with medical background was trained to extract all the socioclinical information from hospital records from January 2013 to December 2014. Patients with incomplete records were excluded from the study. Data were entered in Microsoft Excel and imported in SPSS 15.0 software for analysis. Frequencies and proportions were enlisted. Associations were tested by Chi-squared test. Significant variables were entered in logistic regression model. Results: We included a total of 151 records in the study. Nearly 40.40% of the patients (61/151) had a poor prognosis while 59.60% (90/151) had a good prognosis. Baseline characteristics did not differ in both the groups (P > 0.294). In univariate analysis, breathlessness, anuria as purpose to call EMSs, severe condition as per Glasgow Coma Scale (GCS), and lifesaving interventions done during the transport were associated with a poor prognosis (P = 0.001, 0.029, <0.001, <0.001, and <0.001, respectively). Breathlessness as purpose of call and severe GCS of the patients were the independent predictors of poor prognosis after logistic regression analysis. Comorbidities were not associated with the poor prognosis. Conclusion: Assessment of GCS on call itself will help give highest priority to patients with severe condition and breathlessness, prescribe medicines before arrival of emergency team at the scene and to dispatch appropriate level of ambulance (advanced life support, basic life support, and specialty care transport) in resource-poor situations.


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