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Tytuł:
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Epidemiology of Shortness of Breath in Prehospital Patients in Andhra Pradesh, India.
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Autorzy:
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Mercer MP; Department of Emergency Medicine, University of California San Francisco, San Francisco, California.
Mahadevan SV; Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California.
Pirrotta E; Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California.
Ramana Rao GV; GVK-Emergency Management Research Institute, Hyderabad, India.
Sistla S; GVK-Emergency Management Research Institute, Hyderabad, India.
Nampelly B; GVK-Emergency Management Research Institute, Hyderabad, India.
Danthala R; GVK-Emergency Management Research Institute, Hyderabad, India.
Strehlow AN; Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California.
Strehlow MC; Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California.
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Źródło:
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The Journal of emergency medicine [J Emerg Med] 2015 Oct; Vol. 49 (4), pp. 448-54. Date of Electronic Publication: 2015 May 23.
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Typ publikacji:
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Journal Article; Observational Study
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Język:
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English
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Imprint Name(s):
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Publication: <2010>- : New York : Elsevier
Original Publication: New York : Pergamon Press, c1983-
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MeSH Terms:
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Dyspnea/*epidemiology
Emergency Medical Services/*statistics & numerical data
Adult ; Aged ; Cardiopulmonary Resuscitation/statistics & numerical data ; Chest Pain/epidemiology ; Dyspnea/etiology ; Dyspnea/mortality ; Dyspnea/therapy ; Female ; Humans ; India/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data ; Socioeconomic Factors ; Survival Analysis ; Young Adult
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Contributed Indexing:
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Keywords: international EMS; prehospital; shortness of breath
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Entry Date(s):
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Date Created: 20150528 Date Completed: 20160708 Latest Revision: 20151013
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Update Code:
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20240104
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DOI:
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10.1016/j.jemermed.2015.02.041
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PMID:
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26014761
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Background: Shortness of breath is a frequent reason for patients to request prehospital emergency medical services and is a symptom of many life-threatening conditions. To date, there is limited information on the epidemiology of, and outcomes of patients seeking emergency medical services for, shortness of breath in India.
Objective: This study describes the characteristics and outcomes of patients with a chief complaint of shortness of breath transported by a public ambulance service in the state of Andhra Pradesh, India.
Methods: This prospective, observational study enrolled patients with a chief complaint of shortness of breath during twenty-eight, 12-h periods. Demographic and clinical data were collected from emergency medical technicians using a standardized questionnaire. Follow-up information was collected at 48-72 h and 30 days.
Results: Six hundred and fifty patients were enrolled during the study period. The majority of patients were male (63%), from rural communities (66%), and of lower socioeconomic status (78%). Prehospital interventions utilized included oxygen (76%), physician consultation (40%), i.v. placement (15%), nebulized medications (13%), cardiopulmonary resuscitation (5%), and bag-mask ventilation (4%). Mortality ratios before hospital arrival, at 48-72 h, and 30 days were 12%, 27%, and 35%, respectively. Forty-six percent of patients were confirmed to have survived to 30 days. Predictors of death before hospital arrival were symptoms of chest pain (16% vs. 12%; p < 0.05) recent symptoms of upper respiratory infection (7.5% vs. 4%; p < 0.05), history of heart disease (14% vs. 7%; p < 0.05), and prehospital hypotension, defined as systolic blood pressure <90 mm Hg (6.3% vs. 3.7%; p < 0.05).
Conclusions: Among individuals seeking prehospital emergency medical services in India, the chief complaint of shortness of breath is associated with a substantial early and late mortality, which may be in part due to the underutilization of prehospital interventions.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
