Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Age-specific considerations in aetiology of paediatric out-of-hospital cardiac arrest.","authors":"Deliah Bockemuehl, Alexander Fuchs, Roland Albrecht, Robert Greif, Martin Mueller, Urs Pietsch","doi":"10.1186/s13049-025-01385-4","DOIUrl":"https://doi.org/10.1186/s13049-025-01385-4","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"70"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of post-induction hypotension following emergency rapid sequence induction with ketamine: a systematic review and meta-analysis.","authors":"Pedro Vila de Mucha, Stephen Thomas","doi":"10.1186/s13049-025-01374-7","DOIUrl":"https://doi.org/10.1186/s13049-025-01374-7","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid sequence induction (RSI) is a potentially-life saving intervention in critically ill patients. An important adverse effect of this procedure is post-induction hypotension (PIH), which is associated with worsened patient outcomes. Choice of induction agent can affect incidence of PIH, although the optimal drug has yet to be determined. Ketamine is postulated to reduce PIH incidence in emergency RSI when used instead of alternative agents.</p><p><strong>Aims: </strong>This systematic review and meta-analysis aims to evaluate the effect on PIH incidence of inducing anaesthesia with ketamine during emergency RSI.</p><p><strong>Methods: </strong>A systematic search was conducted to identify a sample of studies fulfilling criteria for population (emergency RSI), intervention (ketamine), comparator (any alternative induction agent) and outcome (PIH). No single definition of PIH was required for eligibility. A random-effects model was used to produce a pooled effect size estimate from the extracted data. The study question was also tested in pre-specified subgroups, including by specific comparator induction agent and by indication for RSI (medical vs trauma).</p><p><strong>Results: </strong>27 studies, including 6 randomised controlled trials, were eligible for inclusion, with total n = 31,956. There was considerable methodological heterogeneity. The pooled estimate of odds ratio (OR) of PIH when ketamine is used for emergency RSI is 1.10, with 95% confidence interval 0.78-1.56. Excluding data from the 6 studies (1 randomised and 5 observational) at greater risk of bias, the pooled OR is 0.99 (0.69-1.43). There was no significant difference between ketamine and comparators in any subgroup, although significance was approached when comparing ketamine to etomidate, with OR 1.38 (0.99-1.94) and p = 0.058.</p><p><strong>Conclusions: </strong>Choice of ketamine to carry out emergency RSI did not affect the incidence of PIH incidence in this diverse sample of studies. Given the breadth of inclusion criteria, applicability of this result is not necessarily universal. It is likely that optimal choice of induction agent varies according to specific circumstances in a manner as yet incompletely understood.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"71"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on mortality in out-of-hospital cardiac arrest patients with return of spontaneous circulation: a retrospective cohort study.","authors":"Nai-Chen Shih, Han-Wei Yeh, Shun-Fa Yang, Yu-Hsun Wang, Chung-Hsien Chaou, Chao-Bin Yeh","doi":"10.1186/s13049-025-01395-2","DOIUrl":"https://doi.org/10.1186/s13049-025-01395-2","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the mortality rates of OHCA patients with and without COVID-19 infection across different follow-up periods and explores the factors may play a significant role in determining OHCA outcomes.</p><p><strong>Methods: </strong>This study utilized data from the US Collaborative Network in TriNetX. A total of 25,271 hospitalized OHCA patients were recruited from records spanning from January 1, 2020, to December 31, 2023. Study population divided into two groups, COVID-19 positive and COVID-19 negative groups. The mortality risk of the two groups was observed based on different follow-up periods. Subgroup analyses on sex, age, antivirals use, COVID-19 virus variant epidemic period were also conducted.</p><p><strong>Results: </strong>Our study included 2,776 patients in each group (COVID vs. non-COVID). The primary outcome was mortality at 14-day and 90-day follow-ups. COVID-19 patients had a lower 14-day mortality (HR 0.82, 95% CI: 0.76-0.88) but higher 90-day mortality (HR 1.16, 95% CI: 1.09-1.24) compared to non-COVID-19 patients. Secondary outcomes included higher mortality in COVID-19 patients under 65, and this trend persisted in those aged 65 and over. Male COVID-19 patients had elevated mortality risk. The Alpha and Delta variant period showed a higher mortality rate for COVID-19 patients than non-COVID-19 patients.</p><p><strong>Conclusion: </strong>COVID-19 was associated with a higher risk of mortality in OHCA patients.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"75"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Creation and validation of a roadside rescue skills scale for training pre-hospital medical teams: the RoadRes-Q scale.","authors":"Killien Lavabre, Nicolas Marjanovic, Denis Oriot, Mathilde Chenu, Adrien Gransagne, Michel Gentilleau, Anthony Moreau, Paul Contal, Olivier Mimoz, Bertrand Drugeon","doi":"10.1186/s13049-025-01389-0","DOIUrl":"10.1186/s13049-025-01389-0","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"69"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between urgency level and hospital admission, mortality and resource utilization in three emergency department triage systems: an observational multicenter study.","authors":"Marit E van Wegen, Laura F C Fransen, Wendy A M H Thijssen, Georgios Alexandridis, Bas de Groot","doi":"10.1186/s13049-025-01392-5","DOIUrl":"10.1186/s13049-025-01392-5","url":null,"abstract":"<p><strong>Background: </strong>Effective triage systems are crucial for prioritizing patients based on urgency and optimizing resource utilization. An ideal triage system is expected to have low resource utilization, hospitalization and mortality among patients classified at low urgency levels. Furthermore, it should exhibit an increase in the risk of hospitalization and mortality as urgency levels increase, ensuring the most critically ill patients receive priority care first. However, it is unclear which triage system performs best.</p><p><strong>Objective: </strong>To compare the performance of the Manchester Triage System (MTS), the Emergency Severity Index (ESI), and the Netherlands Triage Standard (NTS) by investigating the association between urgency levels and resource utilization, hospitalization and in-hospital mortality in Emergency Department (ED) patients.</p><p><strong>Methods: </strong>Observational multicenter cohort study using data from the Netherlands Emergency department Evaluation Database, comprising seven representative EDs in six Dutch hospitals. All consecutive ED patients with a registered urgency level were included. Resource utilization, hospitalization and mortality were measured across all urgency levels. In each triage system, multivariable logistic regression was used to assess the association between urgency level and in-hospital mortality and hospitalization, adjusting for age, sex, presenting complaints and hospital type.</p><p><strong>Results: </strong>A total of 696,518 ED visits (MTS 320,406 (46.1%), ESI 214,267 (30.8%), NTS 161,845 (23.3%) patients) were included. Resource utilization was substantially lower in the lowest urgency level of the ESI compared to the MTS and NTS. Hospitalization to a regular ward, cardiac, medium or intensive care unit in the least urgent level was 3.9% in the ESI, considerably lower than in the MTS (23.1%) and NTS (34.3%) (P < 0.05). Mortality in the lowest urgency level of the ESI was 0.8%, while in the MTS and NTS this was 6.3% and 12.4%, respectively (P < 0.05). In the ESI, the risk (Adjusted Odds Ratios) for hospitalization and mortality increased much more with increasing urgency levels compared to the MTS and NTS.</p><p><strong>Conclusion: </strong>This study suggests that the ESI may be more effective in distinguishing between patients with low and high urgency, with a reduced risk of undertriage when compared to the MTS and NTS.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"72"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of point of care viscoelastic haemostatic assays for trauma patients in the emergency department.","authors":"Andrew Richard Coggins, Vinh Dat David Nguyen, Leonardo Pasalic, Murari Ramesh, Kush Wangoo","doi":"10.1186/s13049-025-01388-1","DOIUrl":"https://doi.org/10.1186/s13049-025-01388-1","url":null,"abstract":"<p><strong>Background and objectives: </strong>Traumatic haemorrhage often requires initiation of a massive haemorrhage protocol (MHP). The primary aim of this exploratory Emergency Department (ED) study was to examine the utility of point of care Viscoelastic Haemostatic Assays (VHA) in terms of accuracy. The primary outcome was prediction of the need for massive transfusion (MT) at 24-hours.</p><p><strong>Methods: </strong>Prospective observational study of consecutive trauma patients investigated with reported using STARD guidelines. Patients in an Australian ED setting < 1-hour from triage enrolled in a three-year window. The point-of-care device used was a TEG6s™ (Haemonetics, Braintree, MA, USA). The primary outcome was accuracy VHA testing for predicting MT delivery at 24-hours (an internationally recognised of massive transfusion was used). Other trauma outcomes such as product transfusion, injury severity score (ISS) and demographics were recorded. For analysis of accuracy the cohort was divided into VHA-normal (n = 44) and VHA-abnormal (n = 70) binary groups. Secondary outcomes included utility of TEG6s™ individual components and accuracy of VHA when combined with validated MHP decision scores.</p><p><strong>Results: </strong>Among eligible cases (n = 114) in-patient mortality was 7.0% with 91.2% receiving transfusion. Presence of (any) abnormal VHA result provided a 73.6% (95%CI 59.7-84.7) sensitivity and 49.3% (95%CI 36.1-62.3) specificity for predicting MT. Citrated Functional Fibrinogen (CFF) component had a higher performance for MT \"rule-in\" specificity (86.9%). When VHA was combined with validated MHP decision scores performance was increased. For example, normal VHA with Trauma Associated Severe Haemorrhage score < 8.5 was observed to yield a sensitivity of 96.2% for MT requirement rule-out. Further studies should examine if VHA test parameters can be added or (replace INR) in the existing clinical scores used to make decisions about transfusion in ED patients.</p><p><strong>Conclusion: </strong>The standalone performance of early VHA testing in the ED setting was insufficient to reliably for predict a need for massive transfusion.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"68"},"PeriodicalIF":3.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive ventilation for preoxygenation during prehospital anaesthesia - a prospective observational study.","authors":"Harry Ljungqvist, Jouni Nurmi","doi":"10.1186/s13049-025-01386-3","DOIUrl":"10.1186/s13049-025-01386-3","url":null,"abstract":"<p><strong>Background: </strong>Preoxygenation is used to prevent hypoxia during anaesthesia and intubation. In a prehospital setting, preoxygenation is usually performed using a non-rebreather mask or a bag-valve-mask. These methods are however not sufficient for some critically ill patients. Non-invasive ventilation (NIV) has been shown to be more effective than other methods for preoxygenation of these patients in a hospital setting. Despite this, the use of NIV for preoxygenation has not been reported in a prehospital setting. The purpose of this study is to describe the prehospital use of, and experience with, NIV as a preoxygenation technique in patients undergoing prehospital emergency anaesthesia (PHEA).</p><p><strong>Methods: </strong>In this prospective observational study, we included 42 patients preoxygenated with NIV for PHEA by one Finnish helicopter emergency medical services unit. We gathered data on, among other things, patient characteristics, vital signs, success of preoxygenation, post-intubation complications and mortality. In addition, we conducted a semi-structured survey on experiences of the use of NIV for preoxygenation among the prehospital physicians in the study unit. Descriptive analyses were performed as well as calculating confidence intervals.</p><p><strong>Results: </strong>During the study period from October 2022 to May 2023, a total of 115 PHEAs were performed and NIV preoxygenation was used in 42 (n = 42/115, 37%) of these. Preoxygenation using NIV was technically successful in 100% of cases (n = 42/42, 95% CI 92-100). The median (IQR) oxygen saturation at HEMS arrival was 98% (95-99) and preoxygenation with NIV achieved a median (IQR) oxygen saturation post-intubation of 99% (97-100). No complications of hypoxia were documented, and the rate of pneumonia and mortality did not exceed what was expected based on literature. In the survey, 40% (n = 4/10) of physicians reported using NIV routinely for all patients while 60% (n = 6/10) only used it for those considered susceptible to desaturation.</p><p><strong>Conclusions: </strong>This study demonstrates that NIV for preoxygenation has been implemented and is frequently used in prehospital settings in Finland, and that the intervention seems technically successful without clear adverse events.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"67"},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early fluid balance and mortality following extracorporeal cardiopulmonary resuscitation: a high volume, single center study.","authors":"Humphrey Gm Walker, Alexander S Richardson, Arne Diehl, Brooke Riley, Eldho Paul, Aidan Burrell","doi":"10.1186/s13049-025-01381-8","DOIUrl":"https://doi.org/10.1186/s13049-025-01381-8","url":null,"abstract":"<p><strong>Background: </strong>For patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO), a positive cumulative fluid balance at day three has been associated with increased mortality. However, there is limited evidence examining this association in patients requiring extracorporeal cardiopulmonary resuscitation (ECPR). The aims of this study were to (1) to describe contemporary fluid practice in patients requiring ECPR and (2) assess the relationship between early cumulative fluid balance and 28-day mortality.</p><p><strong>Methods: </strong>This was a retrospective, single centre, observational study using data collected from the EXCEL registry and the hospital electronic medical record. All patients undergoing ECPR from January 2017 until December 2022 were identified using a prospectively collected database. Patients aged < 18 years old or had extra-corporeal support ceased prior to arrival to the intensive care unit were excluded. Fluid data was collected for days 1,2,3 and 7; and cumulative balances reported for day 3 and day 7.</p><p><strong>Results: </strong>104 patients were identified, of which 100 were included. The mean age was 48.9 (SD 14.1) years, 72 (72%) were male. 54 (54%) were out-of-hospital cardiac arrests. Median low flow time was 43 (IQR 39-76) minutes. 51 (51%) had died by day 28. After adjusting for location of cardiac arrest, return of spontaneous circulation and duration of ECMO, a 1 L increase in cumulative fluid balance to the end of day 3 was not independently associated with 28-day mortality (adjusted OR 1.09 [95% CI 0.97-1.22]), however by day 7 this was independently associated with an 11% increased risk of 28-day mortality (adjusted OR 1.11 [95% CI 1.001-1.23]).</p><p><strong>Conclusion: </strong>A one litre increase in CFB at the end of day 3 was not associated with 28-day mortality; but a one litre increase in CFB by the end of day 7 was associated with an 11% increase in the odds of day 28 mortality. The impact of restrictive fluid management strategies in those requiring ECPR should be assessed in prospective trials.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"66"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Early Warning Score in interhospital ambulance care: a pilot study exploring feasibility and impact.","authors":"Marie Luijmes, Jikke Stevens, Nicolette Diets, Rudolf Tolsma, Janke de Groot, Joris Fuijkschot","doi":"10.1186/s13049-025-01383-6","DOIUrl":"https://doi.org/10.1186/s13049-025-01383-6","url":null,"abstract":"<p><strong>Background: </strong>Pediatric Early Warning Scores (PEWS) are commonly used for early recognition of clinical deterioration in hospitalized children and timely intervention. In 2019, a national Dutch PEWS was developed for pediatric hospital care in the Netherlands. To improve communication during interhospital transfers, using Dutch PEWS in interhospital ambulance care might be of added value in the chain of care. Therefore, this pilot study aimed to explore the feasibility and impact of the Dutch PEWS in interhospital ambulance care.</p><p><strong>Methods: </strong>Using the Plan-Do-Study-Act cycle, a four-step model for carrying out change, the Dutch PEWS system was first adopted for use in interhospital ambulance care, resulting in Dutch-Ambulance-PEWS (DA-PEWS) (Plan). This system was implemented in one ambulance region: the Regional Ambulance Service Utrecht (RAVU) (Do). Feasibility for implementing DA-PEWS nationwide and impact were evaluated. To do so, one baseline questionnaire and semi-structured interviews at the start of and at three, six, and twelve months after implementation were used (Study). Based on the results, approaches were developed to disseminate the DA-PEWS to national ambulance care (Act).</p><p><strong>Results: </strong>Main impact themes that emerged included the enhancement of situational awareness, communication in the chain of care through improvements in uniformity and handovers and improved protocol adherence. Using the system in the interhospital care setting was considered feasible, but for future upscaling of the implementation and efficacy, determinants such as variation in organizational structures, the limited frequency of pediatric interhospital transfers and differences in individual attitudes toward using one system are first steps to consider.</p><p><strong>Conclusion: </strong>This pilot study showed impact of using the DA-PEWS in interhospital ambulance care in the Netherlands, while also revealing important lessons for the implementation of the DA-PEWS nationwide due to local contextual factors in the organization of ambulance care across regions.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"65"},"PeriodicalIF":3.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of characteristics and associated factors for re-contacts after EMS non-conveyance: a retrospective cohort study in the Netherlands.","authors":"Renate F Speijers, Remco H A Ebben, Ties Eikendal, Lobke Ruijs, Franciscus G M H M Cuppen, Rien de Vos","doi":"10.1186/s13049-025-01365-8","DOIUrl":"https://doi.org/10.1186/s13049-025-01365-8","url":null,"abstract":"<p><strong>Background: </strong>Non-conveyed patients are a significant population within ambulance care. To gain insight in patient safety for this population, ambulance re-contacts within 72 h are monitored. However, little is known about the background of these non-conveyance cases with a re-contact. This study aims to investigate the incidence of re-contacts, analyse characteristics, and identify factors associated with re-contacts following non-conveyance.</p><p><strong>Methods: </strong>This was a retrospective cohort study of all non-conveyance cases and all associated re-contacts in two EMS regions in the Netherlands, Gelderland-Zuid and Gelderland-Midden. Data was collected from 1 January 2022 till 31 December 2022. Characteristics of non-conveyance cases with and without a re-contact within 72 h were compared and differences were analysed univariately. Logistic regression analyses were used to quantify bivariate and multivariable associations between characteristics of non-conveyance cases and EMS re-contact within 72 h. Associations are expressed in odds ratios with 95% confidence interval.</p><p><strong>Results: </strong>In the analysis of 19.563 cases, the overall incidence for an EMS re-contact within 72 h was 5.0% (N = 984/19.563), with 3.4% (669/19.563) within 24 h, 1.0% (195/19.563) within 24-48 h and 0.6% (120/19.563) within 48-72 h. In a subset of 13.010 complete cases, significant multivariable associations were observed between re-contacts and age > 65 (OR 2.15, CI 1.82-2.53), male gender (OR 1.39, CI 1.18-1.63), and medical complaints related to specialism 'Pulmonology' (OR 2.45, CI 1.67-3.64), 'Neurology' (OR 1.81, CI 1.28-2.59) and 'Traumatology/surgery' (OR 0.51, CI 0.34-0.76). Other significant associations were noted with night-time cases (OR 1.49, CI 1.21-1.82) and cases in which consultation or handover to a general practitioner occurred (OR 1.25, CI 1.06-1.47).</p><p><strong>Conclusions: </strong>A low overall incidence of EMS re-contacts indicates that non-conveyance within the EMS system is relatively safe. The likelihood of re-contact is higher for age above 65, male gender, and medical complaints within the specialisms of 'Pulmonology' and 'Neurology'. Non-conveyance cases that involve consultation or handover to a GP and cases occurring at night are also more likely to have a re-contact. The findings inform non-conveyance decision-making, and could serve as a starting point to adapt EMS curricula, and develop guidelines and protocols. This may fuel the enhancement of non-conveyance decision-making, thereby improving the quality of healthcare within the EMS system.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"64"},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}