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Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada
BACKGROUND: Ambulance use is a costly mode of transportation to the emergency department (ED). Syncope is a frequent presentation to the ED; however, no data exist regarding the proportion of hospitalized patients with syncope arriving by ambulance and their outcomes compared with self-presenters. M...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063639/ https://www.ncbi.nlm.nih.gov/pubmed/32159097 http://dx.doi.org/10.1016/j.cjco.2019.03.006 |
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author | Gupta, Arjun K. Savu, Anamaria Sheldon, Robert S. Raj, Satish Kaul, Padma Sandhu, Roopinder K. |
author_facet | Gupta, Arjun K. Savu, Anamaria Sheldon, Robert S. Raj, Satish Kaul, Padma Sandhu, Roopinder K. |
author_sort | Gupta, Arjun K. |
collection | PubMed |
description | BACKGROUND: Ambulance use is a costly mode of transportation to the emergency department (ED). Syncope is a frequent presentation to the ED; however, no data exist regarding the proportion of hospitalized patients with syncope arriving by ambulance and their outcomes compared with self-presenters. METHODS: The Canadian Institute for Health Information database was used to identify patients aged > 20 years hospitalized with a primary diagnosis of syncope (International Classification of Diseases 10th Revision code R55) in Canada, except Quebec, between April 2004 and March 2016. Logistic regression models (odds ratio and 95% confidence interval) were used to identify demographics, clinical factors, and province associated with ambulance use and whether ambulance use was associated with in-hospital mortality. RESULTS: Among 108,967 syncope hospitalizations, 64% of patients arrived by ambulance, and use increased from 58.8% to 66.1% over 12 years (P for trend < 0.01). Significant variations existed in ambulance use across provinces (P < 0.01). Predictors associated with higher odds of ambulance use were increasing age, male sex, urban residence, residing in areas with lower annual household income, and higher comorbidity burden. In multivariable-adjusted analysis, ambulance use was associated with a 1.7-fold higher odds of in-hospital mortality. CONCLUSIONS: Approximately two-thirds of patients hospitalized for syncope presented by ambulance, and use has increased over time. Hospitalized patients in syncope who are transported by ambulance have a worse prognosis. Further research on emergency medical services’ risk stratification of patients who are transported by ambulance may help to identify a low-risk population who may obviate the need for transport. |
format | Online Article Text |
id | pubmed-7063639 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-70636392020-03-10 Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada Gupta, Arjun K. Savu, Anamaria Sheldon, Robert S. Raj, Satish Kaul, Padma Sandhu, Roopinder K. CJC Open Original Article BACKGROUND: Ambulance use is a costly mode of transportation to the emergency department (ED). Syncope is a frequent presentation to the ED; however, no data exist regarding the proportion of hospitalized patients with syncope arriving by ambulance and their outcomes compared with self-presenters. METHODS: The Canadian Institute for Health Information database was used to identify patients aged > 20 years hospitalized with a primary diagnosis of syncope (International Classification of Diseases 10th Revision code R55) in Canada, except Quebec, between April 2004 and March 2016. Logistic regression models (odds ratio and 95% confidence interval) were used to identify demographics, clinical factors, and province associated with ambulance use and whether ambulance use was associated with in-hospital mortality. RESULTS: Among 108,967 syncope hospitalizations, 64% of patients arrived by ambulance, and use increased from 58.8% to 66.1% over 12 years (P for trend < 0.01). Significant variations existed in ambulance use across provinces (P < 0.01). Predictors associated with higher odds of ambulance use were increasing age, male sex, urban residence, residing in areas with lower annual household income, and higher comorbidity burden. In multivariable-adjusted analysis, ambulance use was associated with a 1.7-fold higher odds of in-hospital mortality. CONCLUSIONS: Approximately two-thirds of patients hospitalized for syncope presented by ambulance, and use has increased over time. Hospitalized patients in syncope who are transported by ambulance have a worse prognosis. Further research on emergency medical services’ risk stratification of patients who are transported by ambulance may help to identify a low-risk population who may obviate the need for transport. Elsevier 2019-04-12 /pmc/articles/PMC7063639/ /pubmed/32159097 http://dx.doi.org/10.1016/j.cjco.2019.03.006 Text en © 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Gupta, Arjun K. Savu, Anamaria Sheldon, Robert S. Raj, Satish Kaul, Padma Sandhu, Roopinder K. Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada |
title | Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada |
title_full | Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada |
title_fullStr | Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada |
title_full_unstemmed | Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada |
title_short | Twelve-Year Temporal Trends in Ambulance Use for Patients Hospitalized With a Primary Diagnosis of Syncope in Canada |
title_sort | twelve-year temporal trends in ambulance use for patients hospitalized with a primary diagnosis of syncope in canada |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063639/ https://www.ncbi.nlm.nih.gov/pubmed/32159097 http://dx.doi.org/10.1016/j.cjco.2019.03.006 |
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