Epidemiological analysis of pre-hospital emergency elderly and non-elderly patients in Chengdu_West China Medical Journal

Authors：

YANG Wentao ¹ , Lü Xiaoxia ² , HE Yarong ¹ , YAO Peng ¹ , YAO Rong ¹ ,  CAO Yu ¹ , HOU Yufei ³ , LIU Yimin ⁴

1. Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Health Management Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Chengdu First-aid Command Center, Chengdu, Sichuan 610041, P. R. China;
4. Chengdu Municipal Health Commission Emergency Office, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

CAO Yu, Email: yuyuer@126.com

Keywords：

Pre-hospital care; Elderly patients; Epidemiological analysis

DOI：

10.7507/1002-0179.201906022

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Objective To investigate the epidemiological situation of pre-hospital emergency elderly and non-elderly patients in Chengdu and explore the characteristics of pre-hospital care in the city.Method All pre-hospital care records in the Chengdu 120 Emergency System Database in 2017 were retrospectively collected. According to the age of the patients, they were divided into the elderly group (≥60 years old) and the non-elderly group (<60 years old). The disease spectrum, the trends of the number of emergency help calls, the changes in different diseases over time, as well as the disease composition of the patients who died in the two groups were compared.Results A total of 179 387 pre-hospital emergency patients were enrolled, including 59 980 elderly patients and 119 407 non-elderly patients. Most of them were male patients in both groups. Patients in the elderly group were mainly between 60 to 89 years old, and the ones in the non-elderly group were mainly between 18 to 59 years old. The pre-hospital emergency patients in the elderly group presented with trauma, nervous system, symptoms and signs, and cardiovascular system diseases mainly, accounting for 29.19%, 14.64%, 13.82%, and 12.86%, respectively. In the non-elderly group, trauma, acute poisoning, and symptoms and signs were predominant, accounting for 50.89%, 10.98%, and 10.08%, respectively. Among the pre-hospital deaths, the number in the elderly group was the larger, accounting for 69.61% (7 043 cases); the mortality rate was 11.74%, with sudden death (28.70%), cardiovascular diseases (25.95%), and respiratory diseases (16.07%) being the major causes. The pre-hospital mortality rate of non-elderly patients was 2.58%, mainly including traumatic diseases (35.41%), sudden death (unknown cause of death) (25.33%), and cardiovascular diseases (17.56%). The number of emergency help calls in the elderly group began to increase gradually from September, reaching a peak in December and hitting the trough in February. While in the non-elderly group, the peak of the emergency help calls appeared in July, and it also fell to the lowest in February. The proportion of the number of emergency help calls in the elderly group was higher in January to February and October to December; while the peak in non-elderly group was in July. The number of emergency help calls in the elderly group were mainly concentrated in the daytime (08:00 to 20:00). In the non-elderly group, the changes in the number of emergency help calls were similar to that of the elderly, however, with another peak (20:00 to 24:00). The proportion of the number of emergency help calls in the elderly group was 06:00 to 09:59, and the peak time of the non-elderly group was in the early morning (00:00 to 04:59) and night (20:00 to 23:59).Conclusions The number of pre-hospital care for elderly and non-elderly patients has its own characteristics in terms of the time and the distribution of disease spectrum. Trauma and cardiovascular diseases are the most common causes of pre-hospital care and death in Chengdu. And the pre-hospital mortality in the elderly group is much larger than that in non-elderly group. Relevant departments can allocate emergency resources rationally, and focus on improving the on-site rescue capacity towards related diseases.

Citation： YANG Wentao, Lü Xiaoxia, HE Yarong, YAO Peng, YAO Rong, CAO Yu, HOU Yufei, LIU Yimin. Epidemiological analysis of pre-hospital emergency elderly and non-elderly patients in Chengdu. West China Medical Journal, 2019, 34(11): 1244-1250. doi: 10.7507/1002-0179.201906022 Copy

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10.	吳曉華, 賴偉林, 仲芳玉, 等. 2012-2016 年贛州市中心城區院前急救調查分析. 江西醫學, 2018, 53(4): 359-361.
11.	陳唯, 梁永晴, 張湛, 等. 46 336 例老年患者院前急救流行病學分析. 中國衛生統計, 2017, 34(4): 629-631.
12.	邵良, 凌峰, 付豐平. 株洲市 2017 年院前急救疾病譜調查. 臨床急診雜志, 2018, 19(8): 548-550.
13.	Burrows S, van Niekerk A, Laflammle L. Fatal injurban among urban children in South Africa: risk distribution and potential for reduction. Bull World Health Organ, 2010, 88(4): 267-272.
14.	劉永欣, 韓壯. 沈陽市創傷院前急救情況分析. 中國實用醫藥, 2018, 13(8): 197-198.
15.	肖鋒. 災害醫學· 院前急救·急診流行病. 中華急診醫學雜志, 2014, 23(9): 1068-1072.
16.	申志祥, 鄭卉, 殷鋼, 等. 老年體檢人群心腦血管疾病患者健康狀況綜合評估. 實用預防醫學, 2018, 25(8): 905-910.
17.	唐雨萌, 李茜, 張嵐, 等. 湖北省慢性阻塞性肺疾病流行病學調查及影響因素. 中華疾病控制雜志, 2018, 22(7): 721-725.
18.	李興革, 張建芳, 楊樂, 等. 酒精中毒并嚴重創傷相關性分析及護理. 海南醫學, 2011, 22(10): 152-154.
19.	廖紀華, 閆輝, 唐錦程. 186 例猝死患者臨床及流行病學特征分析. 嶺南急診醫學雜志, 2014, 19(5): 401-403.
20.	張在其, 駱福添, 陳兵, 等. 我國大中城市院前心臟性猝死流行病學調查分析. 中國臨床實用醫學, 2010, 4(9): 5-7.
21.	隋輝, 陳偉偉, 王文. 《中國心血管病報告解讀 2015》要點解讀. 中國心血管雜志, 2016, 21(4): 259-261.
22.	Ro YS, Shin SD, Song KJ, et al. A trend in epidemiology and outcomes of out-of-hospital cardiac arrest by urbanization level: a nationwide observational study from 2006 to 2010 in South Korea. Resuscitation, 2013, 84(5): 547-557.
23.	Cournoyer A, Notebaert é, de Montigny L, et al. Impact of the direct transfer to percutaneous coronary intervention-capable hospitals on survival to hospital discharge for patients with out-of-hospital cardiac arrest. Resuscitation, 2018, 125: 28-33.
24.	Kiyohara K, Kitamura T, Sakai T, et al. Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan. Resuscitation, 2016, 106: 70-75.
25.	崔甍甍, 于魯明, 張進軍, 等. 急性心血管疾病發病與氣象因素關系的研究. 中華急診醫學雜志, 2014, 23(4): 465-469.
26.	俞捷, 龔磊, 黃厚今, 等. 心腦血管與呼吸疾病就診人數與氣象因素關系. 現代預防醫學, 2011, 38(23): 4822-4825, 4829.
27.	張海宏, 曹鈺. 睹始知終, 明察秋毫—再論急診患者病情評估. 華西醫學, 2017, 32(6): 801-803.

1. American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, et al. Geriatric emergency department guidelines. Ann Emerg Med, 2014, 63(5): e 7-e25.
2. Carpenter CR, Bromley M, Caterino JM, et al. Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine. J Am Geriatr Soc, 2014, 62(7): 1360-1363.
3. 中華人民共和國中央人民政府. 中共中央國務院印發《" 健康中國 2030”規劃綱要》. (2016-10-25)[2019-06-03]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
4. 成都市老齡工作委員會辦公室. 成都市 2017 年老年人口信息和老齡事業發展狀況報告. (2018-05-22)[2019-06-03]. http://sc.people.com.cn/n2/2018/0522/c345167-31607894.html.
5. 廖凱, 陽世雄, 張劍鋒, 等. 南寧市老年患者院前急救疾病譜分析. 臨床急診雜志, 2017, 18(8): 597-599.
6. Goldstein J, Jensen JL, Carter AJ, et al. The epidemiology of prehospital emergency responses for older adults in a provincial EMS system. CJEM, 2015, 17(5): 491-496.
7. Vaartjes I, Hendrix A, Hertogh EM, et al. Sudden death in persons younger than 40 years of age: incidence and causes. Eur J Cardiovas Prev Rehabil, 2009, 16(5): 592-596.
8. 畢忠鵬. 新人口年齡分組的理論依據與實證觀測. 昆明: 云南大學, 2018.
9. Aboueljinane L, Sahin E, Jemai Z. A review on simulation models applied to emergency medical service operations. Comput Ind Eng, 2013, 66(4): 734-750.
10. 吳曉華, 賴偉林, 仲芳玉, 等. 2012-2016 年贛州市中心城區院前急救調查分析. 江西醫學, 2018, 53(4): 359-361.
11. 陳唯, 梁永晴, 張湛, 等. 46 336 例老年患者院前急救流行病學分析. 中國衛生統計, 2017, 34(4): 629-631.
12. 邵良, 凌峰, 付豐平. 株洲市 2017 年院前急救疾病譜調查. 臨床急診雜志, 2018, 19(8): 548-550.
13. Burrows S, van Niekerk A, Laflammle L. Fatal injurban among urban children in South Africa: risk distribution and potential for reduction. Bull World Health Organ, 2010, 88(4): 267-272.
14. 劉永欣, 韓壯. 沈陽市創傷院前急救情況分析. 中國實用醫藥, 2018, 13(8): 197-198.
15. 肖鋒. 災害醫學· 院前急救·急診流行病. 中華急診醫學雜志, 2014, 23(9): 1068-1072.
16. 申志祥, 鄭卉, 殷鋼, 等. 老年體檢人群心腦血管疾病患者健康狀況綜合評估. 實用預防醫學, 2018, 25(8): 905-910.
17. 唐雨萌, 李茜, 張嵐, 等. 湖北省慢性阻塞性肺疾病流行病學調查及影響因素. 中華疾病控制雜志, 2018, 22(7): 721-725.
18. 李興革, 張建芳, 楊樂, 等. 酒精中毒并嚴重創傷相關性分析及護理. 海南醫學, 2011, 22(10): 152-154.
19. 廖紀華, 閆輝, 唐錦程. 186 例猝死患者臨床及流行病學特征分析. 嶺南急診醫學雜志, 2014, 19(5): 401-403.
20. 張在其, 駱福添, 陳兵, 等. 我國大中城市院前心臟性猝死流行病學調查分析. 中國臨床實用醫學, 2010, 4(9): 5-7.
21. 隋輝, 陳偉偉, 王文. 《中國心血管病報告解讀 2015》要點解讀. 中國心血管雜志, 2016, 21(4): 259-261.
22. Ro YS, Shin SD, Song KJ, et al. A trend in epidemiology and outcomes of out-of-hospital cardiac arrest by urbanization level: a nationwide observational study from 2006 to 2010 in South Korea. Resuscitation, 2013, 84(5): 547-557.
23. Cournoyer A, Notebaert é, de Montigny L, et al. Impact of the direct transfer to percutaneous coronary intervention-capable hospitals on survival to hospital discharge for patients with out-of-hospital cardiac arrest. Resuscitation, 2018, 125: 28-33.
24. Kiyohara K, Kitamura T, Sakai T, et al. Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan. Resuscitation, 2016, 106: 70-75.
25. 崔甍甍, 于魯明, 張進軍, 等. 急性心血管疾病發病與氣象因素關系的研究. 中華急診醫學雜志, 2014, 23(4): 465-469.
26. 俞捷, 龔磊, 黃厚今, 等. 心腦血管與呼吸疾病就診人數與氣象因素關系. 現代預防醫學, 2011, 38(23): 4822-4825, 4829.
27. 張海宏, 曹鈺. 睹始知終, 明察秋毫—再論急診患者病情評估. 華西醫學, 2017, 32(6): 801-803.

West China Medical Journal

Epidemiological analysis of pre-hospital emergency elderly and non-elderly patients in Chengdu

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