Outcomes of patients with unstable circulation transported by a physician-staffed helicopter using the keyword method in Japan.

Youichi Yanagawa, Hiroki Nagasawa, Chihiro Maekawa, Noriko Tanaka, Soichiro Ota, Hiromichi Ohsaka, Kazuhiko Omori
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Abstract

Purpose: This study aimed to investigate the efficacy of the keyword method in improving outcomes for patients with unstable circulation.

Methods: Patients with unstable circulation were selected from the Japan Doctor Helicopter (DH) Registry System (JDRS) database. Unstable circulation was defined as systolic blood pressure of less than 90 mmHg when emergency medical technicians (EMTs) contacted the patients. The following details of the dispatch activity were collected from the JDRS database: whether the request for the DH dispatch was made before (Keyword) or after (Control) the EMTs contacted the patient, time from first call to DH contact, age, sex, initial vitals, DH intervention, disease classification, and outcome.

Results: There were 650 subjects in the Keyword group and 1,085 patients in the Control group. All the participants were evacuated from the scene. The duration from the first call to contact, respiratory rate, and the ratio of tracheal intubation to transfusion were significantly smaller in the Keyword group than in the Control group. The average systolic blood pressure and survival ratio in the Keyword group were significantly higher than those in the Control group. After matching the analysis to align with the patients' backgrounds, the observed tendencies persisted.

Conclusion: This is the first report to describe the keyword method as a prognostic factor in patients with unstable circulation who were evacuated by the DH using the JDRS. Future prospective studies are required to determine the accuracy of these results.

日本用关键字法由医生配备的直升机运送的不稳定循环患者的结果。
目的:探讨关键词法改善循环不稳定患者预后的效果。方法:从日本医生直升机(DH)登记系统(JDRS)数据库中选择循环不稳定患者。当紧急医疗技术人员(EMTs)接触患者时,收缩压低于90 mmHg即为不稳定循环。从JDRS数据库中收集了以下调度活动的详细信息:要求卫生署调度的请求是在急救医生联系患者之前(关键词)还是之后(控制),从第一次呼叫到卫生署联系的时间,年龄,性别,初始生命体征,卫生署干预,疾病分类和结果。结果:关键词组650例,对照组1085例。所有参与者都从现场撤离。关键词组患者首次呼叫至接触时间、呼吸频率、气管插管与输血的比例均显著小于对照组。关键词组患者平均收缩压和生存率明显高于对照组。在将分析与患者的背景相匹配后,观察到的趋势仍然存在。结论:这是第一个将关键词法描述为血液循环不稳定患者使用JDRS的预后因素的报告。未来的前瞻性研究需要确定这些结果的准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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