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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12.	邵良, 凌峰, 付丰平. 株洲市 2017 年院前急救疾病谱调查. 临床急诊杂志, 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.	刘永欣, 韩壮. 沈阳市创伤院前急救情况分析. 中国实用医药, 2018, 13(8): 197-198.
15.	肖锋. 灾害医学· 院前急救·急诊流行病. 中华急诊医学杂志, 2014, 23(9): 1068-1072.
16.	申志祥, 郑卉, 殷钢, 等. 老年体检人群心脑血管疾病患者健康状况综合评估. 实用预防医学, 2018, 25(8): 905-910.
17.	唐雨萌, 李茜, 张岚, 等. 湖北省慢性阻塞性肺疾病流行病学调查及影响因素. 中华疾病控制杂志, 2018, 22(7): 721-725.
18.	李兴革, 张建芳, 杨乐, 等. 酒精中毒并严重创伤相关性分析及护理. 海南医学, 2011, 22(10): 152-154.
19.	廖纪华, 闫辉, 唐锦程. 186 例猝死患者临床及流行病学特征分析. 岭南急诊医学杂志, 2014, 19(5): 401-403.
20.	张在其, 骆福添, 陈兵, 等. 我国大中城市院前心脏性猝死流行病学调查分析. 中国临床实用医学, 2010, 4(9): 5-7.
21.	隋辉, 陈伟伟, 王文. 《中国心血管病报告解读 2015》要点解读. 中国心血管杂志, 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, 于鲁明, 张进军, 等. 急性心血管疾病发病与气象因素关系的研究. 中华急诊医学杂志, 2014, 23(4): 465-469.
26.	俞捷, 龚磊, 黄厚今, 等. 心脑血管与呼吸疾病就诊人数与气象因素关系. 现代预防医学, 2011, 38(23): 4822-4825, 4829.
27.	张海宏, 曹钰. 睹始知终, 明察秋毫—再论急诊患者病情评估. 华西医学, 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. 中华人民共和国中央人民政府. 中共中央国务院印发《" 健康中国 2030”规划纲要》. (2016-10-25)[2019-06-03]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
4. 成都市老龄工作委员会办公室. 成都市 2017 年老年人口信息和老龄事业发展状况报告. (2018-05-22)[2019-06-03]. http://sc.people.com.cn/n2/2018/0522/c345167-31607894.html.
5. 廖凯, 阳世雄, 张剑锋, 等. 南宁市老年患者院前急救疾病谱分析. 临床急诊杂志, 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. 毕忠鹏. 新人口年龄分组的理论依据与实证观测. 昆明: 云南大学, 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. 吴晓华, 赖伟林, 仲芳玉, 等. 2012-2016 年赣州市中心城区院前急救调查分析. 江西医学, 2018, 53(4): 359-361.
11. 陈唯, 梁永晴, 张湛, 等. 46 336 例老年患者院前急救流行病学分析. 中国卫生统计, 2017, 34(4): 629-631.
12. 邵良, 凌峰, 付丰平. 株洲市 2017 年院前急救疾病谱调查. 临床急诊杂志, 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. 刘永欣, 韩壮. 沈阳市创伤院前急救情况分析. 中国实用医药, 2018, 13(8): 197-198.
15. 肖锋. 灾害医学· 院前急救·急诊流行病. 中华急诊医学杂志, 2014, 23(9): 1068-1072.
16. 申志祥, 郑卉, 殷钢, 等. 老年体检人群心脑血管疾病患者健康状况综合评估. 实用预防医学, 2018, 25(8): 905-910.
17. 唐雨萌, 李茜, 张岚, 等. 湖北省慢性阻塞性肺疾病流行病学调查及影响因素. 中华疾病控制杂志, 2018, 22(7): 721-725.
18. 李兴革, 张建芳, 杨乐, 等. 酒精中毒并严重创伤相关性分析及护理. 海南医学, 2011, 22(10): 152-154.
19. 廖纪华, 闫辉, 唐锦程. 186 例猝死患者临床及流行病学特征分析. 岭南急诊医学杂志, 2014, 19(5): 401-403.
20. 张在其, 骆福添, 陈兵, 等. 我国大中城市院前心脏性猝死流行病学调查分析. 中国临床实用医学, 2010, 4(9): 5-7.
21. 隋辉, 陈伟伟, 王文. 《中国心血管病报告解读 2015》要点解读. 中国心血管杂志, 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, 于鲁明, 张进军, 等. 急性心血管疾病发病与气象因素关系的研究. 中华急诊医学杂志, 2014, 23(4): 465-469.
26. 俞捷, 龚磊, 黄厚今, 等. 心脑血管与呼吸疾病就诊人数与气象因素关系. 现代预防医学, 2011, 38(23): 4822-4825, 4829.
27. 张海宏, 曹钰. 睹始知终, 明察秋毫—再论急诊患者病情评估. 华西医学, 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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