Abstract:
STUDY OBJECTIVES:Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database from ambulance and inpatient data and demonstrate the potential for linkage to facilitate evaluation of EMS responses resulting in hospital admission. METHODS:Statewide ambulance and inpatient hospital discharge records were available for 1994 through 1996. Ambulance records indicating admission to the emergency department or hospital (165,649 records) were linked to inpatient hospital records indicating emergency admission (146,292 records) by using probabilistic linkage. Out-of-hospital data (dispatch code, treatments rendered, and ages), linkage rates, and inpatient data (discharge status, charges, length of stay, and payer category) were analyzed. RESULTS:We linked 24,299 (14.7%) ambulance events to inpatient hospital discharges. If we had used exact linkage methods, we would have only linked 14,621 record pairs, a loss of nearly 40%. Linkage rates were relatively constant between years (approximately 15%) but differed by ambulance dispatch codes. Out-of-hospital dispatch codes with high linkage rates included breathing problems (22.6%), chest pain (21.5%), diabetic problems (16.9%), drowning incidents (14.9%), falls (19.2%), strokes (32.8%), and unconsciousness or fainting episodes (16.1%). Linkage to the hospital record provided access to hospital outcome data. Inpatient mortality was 6.8%. Survivors were discharged home (60.7%), transferred to other acute-care facilities (3.6%) or intermediate-care facilities (23.3%), or discharged with home health care provision (4.9%). The median length of stay was 3 days, and median charges were $6,620; total inpatient charges were $286,737,067. CONCLUSION:Probabilistic linkage enables ambulance and hospital discharge records to be linked together and potentially increases our ability to critically evaluate EMS by providing access to hospital-based outcomes. Such evaluation will be further improved by linking to ED, other outpatient, and other public health data sources.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Dean JM,Vernon DD,Cook L,Nechodom P,Reading J,Suruda Adoi
10.1067/mem.2001.115214subject
Has Abstractpub_date
2001-06-01 00:00:00pages
616-26issue
6eissn
0196-0644issn
1097-6760pii
S0196-0644(01)05754-7journal_volume
37pub_type
杂志文章abstract:STUDY OBJECTIVE:The primary objective is to compare total sedation time when ketamine/propofol is used compared with ketamine alone for pediatric procedural sedation and analgesia. Secondary objectives include time to recovery, adverse events, efficacy, and satisfaction scores. METHODS:Children (aged 2 to 17 years) re...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2010.08.032
更新日期:2011-05-01 00:00:00
abstract::The ingestion of the mushroom Amanita phalloides is associated with hepatic necrosis appearing clinically two to three days after ingestion. The mechanism of this toxicity is unknown, and no reliable antidote is available. Because of the similarity of Amanita poisoning to other toxins affecting cytochrome P450, we inv...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80472-9
更新日期:1987-10-01 00:00:00
abstract::We report an unusual presentation of solvent abuse. A 17-year-old boy was brought to the emergency department after he inhaled fumes from a rag soaked with a carburetor cleaner containing toluene, methylene chloride, and methanol. Considered to be intoxicated from the acute effects of sniffing toluene or methylene chl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82467-9
更新日期:1990-06-01 00:00:00
abstract::We report a case of a severe lower gastrointestinal hemorrhage caused by arterioenteric fistula formation in a pancreas transplant patient. A rare but potentially deadly complication of pancreas transplant surgery, arterioenteric fistulas should be considered in every transplant patient presenting with voluminous gast...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/s0196-0644(03)00388-3
更新日期:2003-10-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the presence of cocaethylene, an active metabolite of the combination of cocaine and ethanol, among trauma patients who test positive for cocaine. METHODS:We assembled a case series of 416 consecutive urban trauma center patients with major trauma. Urine was tested for the presence of the ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70266-4
更新日期:1996-03-01 00:00:00
abstract:STUDY OBJECTIVE:We identify factors that define frequent and highly frequent emergency department (ED) users. METHODS:Administrative health care records were used to define less frequent (1 to 6 visits), frequent (7 to 17 visits), and highly frequent (≥18 visits) ED users. Analyses were conducted to determine the most...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2011.11.036
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the potential usefulness of external cardiac pacing for the termination of sustained ventricular tachycardia in the emergency department setting. TYPE OF PARTICIPANTS:Five men and one woman (mean age, 57 years) who presented to the ED with a wide-complex, hemodynamically stable tachycardia...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80160-x
更新日期:1992-02-01 00:00:00
abstract:STUDY OBJECTIVE:Antithrombins are among standard treatment agents for patients with non-ST-segment elevation acute coronary syndromes. We aimed to determine the association between time from emergency department (ED) presentation to treatment with an antithrombin and adverse cardiac events. METHODS:The study cohort wa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2010.06.567
更新日期:2011-03-01 00:00:00
abstract::Stellate ganglion blockade has been previously suggested as a treatment option for intractable ventricular arrhythmia; however, its use in emergency department management of pulseless arrest with shockable rhythm has not been described. We report the case of a 65-year-old man brought in by ambulance who complained of ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.07.026
更新日期:2020-02-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate patients with shock and traumatic brain injury who were previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome. METHODS:This was a secondary analysis of patients with shock and traumatic brain injury who were aged 15 years o...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2014.12.004
更新日期:2015-07-01 00:00:00
abstract:STUDY OBJECTIVE:Availability of timely follow-up care is essential in emergency medicine. We describe nonprice barriers to care experienced by callers reporting to be emergency department (ED) patients in need of follow-up care. METHODS:This was a secondary analysis of data collected during a survey of ambulatory clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2007.10.027
更新日期:2008-05-01 00:00:00
abstract::The treatment of dyspepsia in the emergency department often consists of antacid in combination with viscous lidocaine, even though the specific etiology of the pain is frequently unknown. The efficacy of lidocaine as a component of symptomatic therapy was evaluated in a randomized, patient-blinded protocol. Patients ...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)81704-4
更新日期:1990-07-01 00:00:00
abstract::Several clinical studies have yielded conflicting results in examining the effectiveness of bystander CPR (BCPR). The purpose of this pilot study was to determine the effectiveness of BCPR in an animal model of cardiac arrest and resuscitation. Ten swine were instrumented for hemodynamic and regional blood flow measur...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81561-6
更新日期:1990-08-01 00:00:00
abstract::Many of the approximately 400,000 deaths that occur outside of hospitals or chronic care facilities each year in the United States are not only expected but also welcomed as relief from terminal disease. However, patients who lack decision-making capacity cannot communicate to emergency medical services system and eme...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81309-5
更新日期:1993-11-01 00:00:00
abstract::Latex allergy, an IgE-mediated reaction to proteins retained in finished natural rubber latex products, has become one of the most pervasive problems in medicine. Latex allergy has resulted in death, progressive asthma, severe food allergy from cross-reactivity, and disability of health care professionals with the acc...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(98)70073-3
更新日期:1998-12-01 00:00:00
abstract:STUDY OBJECTIVE:Data on poisoning with MCPA (4-chloro-2-methyl-phenoxyacetic acid) are limited to 6 case reports. Our objective is to describe outcomes from intentional self-poisoning with MCPA in a prospective case series of 181 patients presenting to hospitals in Sri Lanka. METHODS:Patient information was collected ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.03.016
更新日期:2005-09-01 00:00:00
abstract:STUDY OBJECTIVE:We describe and analyze a recent rapid deployment of disaster medical assistance teams and other government agencies to provide medical screening and anthrax prophylaxis to New York City US Postal Service employees potentially exposed to letters contaminated with anthrax spores. METHODS:A description o...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2003.105
更新日期:2003-04-01 00:00:00
abstract::The application of molecular biology to microbiology has led to a surge of new information about most infectious microorganisms, the pathogenesis of the infections they cause, and the specific microbial antigens involved in the immune response to these infections. The simultaneous application of the same techniques to...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(94)70187-3
更新日期:1994-09-01 00:00:00
abstract:STUDY OBJECTIVE:We assess the prevalences of bacterial meningitis and herpes simplex virus meningoencephalitis (HSV-ME) in children with a complex febrile seizure and determine these prevalences in the subgroup of children with a clinical examination result not suggestive of meningitis or encephalitis. METHODS:This mu...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2016.11.024
更新日期:2017-07-01 00:00:00
abstract:STUDY OBJECTIVE:We compare test characteristics of abdominal computed tomography (CT) with and without oral contrast for identifying intra-abdominal injuries. METHODS:This was a planned subanalysis of a prospective, multicenter study of children (<18 years) with blunt torso trauma. Children imaged in the emergency dep...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2015.01.014
更新日期:2015-08-01 00:00:00
abstract:STUDY OBJECTIVES:To reappraise Boehler's angle and evaluate factors, including centering of the central beam, sex of subjects, and side of the body, that may affect angle measurement. DESIGN:Retrospective clinical review. SETTING:Emergency department, Level I trauma center. TYPE OF PARTICIPANTS:120 consecutive patie...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81206-5
更新日期:1991-02-01 00:00:00
abstract::A survey completed by 265 emergency medical technicians (EMTs) who provide emergency prehospital care in a rural area included a stress inventory for health professionals and a job satisfaction scale. Logistic regression indicated that the 118 paid EMTs were more likely to be dissatisfied with the freedom they have on...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80070-7
更新日期:1987-06-01 00:00:00
abstract::Significant toxicity can result from ingestion of certain species of the Zigadenus plant, an herb occasionally confused with nontoxic wild onions. A 50-year-old man inadvertently ingested Z paniculatus and presented to the emergency department with profound gastrointestinal toxicity, hypotension, and bradycardia. The ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70336-5
更新日期:1995-02-01 00:00:00
abstract::We present a case of delay in diagnosis of diaphragmatic rupture and herniation in a pregnant 25-year-old woman. The diaphragmatic rupture was secondary to trauma sustained five months prior to presentation. Subsequent to her accident, she was provided medical care on multiple occasions for symptoms of intractable nau...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(88)80780-7
更新日期:1988-04-01 00:00:00
abstract::Gastrointestinal obstruction is a rare complication of multiple-dose administration of activated charcoal. Previous reports deal only with obstruction after ingestion of drugs that impair gastrointestinal motility. This patient developed a small-bowel obstruction associated with the administration of multiple doses of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70170-9
更新日期:1994-07-01 00:00:00
abstract::Two case reports of patients with anion gap metabolic lactic acidosis and hypoglycemia are presented. Both patients subsequently died of acute liver failure secondary to acetaminophen hepatotoxicity. The development of type B lactic acidosis with hypoglycemia might have been caused by a deficit in gluconeogenesis seco...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80674-5
更新日期:1984-10-01 00:00:00
abstract::Emergency thoracotomy has become a mainstay in the resuscitation of patients with major thoracic injuries. It also is occasionally useful in several other life-threatening conditions. The specific indications for emergency thoracotomy are reviewed, and expeditious thoracotomy in the emergency department, when necessar...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80057-1
更新日期:1981-05-01 00:00:00
abstract:STUDY OBJECTIVE:We describe and analyze the effectiveness and safety of etomidate for procedural sedation and evaluate the patient's perspective on effectiveness, side effects, and satisfaction. METHODS:We conducted an observational retrospective study of all patients who received etomidate for procedural sedation ove...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.123695
更新日期:2002-06-01 00:00:00
abstract::Emergency clinicians often care for patients with terminal illness who are receiving hospice care and many more patients who may be in need of such care. Hospice care has been shown to successfully address the multidimensional aspects of the end-of-life concerns of terminally ill patients: dying with dignity, dying wi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2010.06.569
更新日期:2011-03-01 00:00:00
abstract::In 1976 an independent department was established for the emergency treatment of patients in the county hospital in Szolnok, Hungary. The new system changed the traditional structure of patient flow and the work plan of other departments, and it influenced the curing and nursing activities of the departments. The reor...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80113-2
更新日期:1980-07-01 00:00:00