Prehospital Assessment Units - a Matched Cohort Study

NCT05654909 | Completed

• 1 other identifier: PHV_2022
• Study Type: observational
• Target: 10,849
• Locations: 1 country
• Sites: 1

Brief Summary

This study aimed to evaluate the prehospital assessment unit (PAU) by admission within 48 hours, 7 days, respectively and on survival. The PAU should increase focus on a patient-centered approach with the capability to make advanced assessments of patients to reduce unnecessary transportation. Further, this paramedic assessment program could positively impact the healthcare system by reducing admissions to emergency departments. The PAU is operated by paramedics who have additional education, and they are capable of testing and monitoring certain conditions at the scene - in the home of the patients. The paramedics decide if the patient requires admission to the hospital or if the patient could stay at home. They are consulting physicians on call by phone. This retrospective cohort study included data from patients assessed by the PAU between November 1st 2021, and October 1st 2022. Non-PAU patients were selected from the 1-1-2 calls (the European version of 9-1-1) EMS and were collected based on the same criteria as the patients assessed by the PAU. The control ratio was 1:10 for cases to increase power. The non-PAU patients were matched on sex and age (within 5-year ranges). Matching was performed using incidence density sampling, where controls were selected for each case on the week of 1-1-2 call.

Conditions

Pneumonia; Urinary Tract Infections; Fall; Infections; GI Disorders; Orthopedic Disorder

Outcome Measures

Primary Outcomes (2)

• Admission within 48 hours

  Dichotomous variable of admission within two days after intial call

  48 hours

• Admission within 7 days

  Dichotomous variable of admission within seven days after intial call

  7 dats

Secondary Outcomes (2)

• Admission within 6 hours

  6 hours

• 30-day survival

  30-day

Study Arms (2)

PAU group

The PAU group were patients calling 1-1-2 assigned for the prehospital assessment unit,

Procedure: Prehospital assessment unit

non PAU group

The non PAU group were selected from the 1-1-2 calls (the European version of 9-1-1) EMS and were collected based on the same criteria as the patients assessed by the PAU. The control ratio was 1:10 for cases to increase power. Controls were matched on sex and age (within 5-year ranges). Matching was performed using incidence density sampling, where controls were selected for each case on the week of 1-1-2 call.

Interventions

Prehospital assessment unit PROCEDURE

The prehospital assessment unit was developed to provide a paramedic responding by car to 1-1-2 calls in the area of Region Zealand. Further details are mentioned in the description.

PAU group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All adult patients in the Region Zealand calling 1-1-2 during the study period

You may qualify if:

• expectations of undergoing an uncomplicated illness progression
• green or yellow level of triage based on the ABCDE approach (red, orange, yellow, green, blue levels of triage.

You may not qualify if:

• gynaecological disease

Sponsors & Collaborators

• Prehospital Center, Region Zealand: lead

Study Sites (1)

Prehospital Center

Næstved, Denmark

Location

Related Publications (3)

• Andersen MS, Johnsen SP, Sorensen JN, Jepsen SB, Hansen JB, Christensen EF. Implementing a nationwide criteria-based emergency medical dispatch system: a register-based follow-up study. Scand J Trauma Resusc Emerg Med. 2013 Jul 9;21:53. doi: 10.1186/1757-7241-21-53.

  PMID: 23835246 BACKGROUND

• Christensen EF, Bendtsen MD, Larsen TM, Jensen FB, Lindskou TA, Holdgaard HO, Hansen PA, Johnsen SP, Christiansen CF. Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014: a population-based cohort study from the North Denmark Region. BMJ Open. 2017 Aug 21;7(8):e014508. doi: 10.1136/bmjopen-2016-014508.

  PMID: 28827233 BACKGROUND

• Wolthers SA, Blomberg SNF, Breindahl N, Anjum S, Hagi-Pedersen D, Ersboll A, Andersen LB, Christensen HC. Association between using a prehospital assessment unit and hospital admission and mortality: a matched cohort study. BMJ Open. 2023 Sep 22;13(9):e075592. doi: 10.1136/bmjopen-2023-075592.

  PMID: 37739475 DERIVED

MeSH Terms

Conditions

Pneumonia; Urinary Tract Infections; Infections; Digestive System Diseases; Musculoskeletal Diseases

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: December 8, 2022
• First Posted: December 16, 2022
• Study Start: November 1, 2021
• Primary Completion: October 31, 2022
• Study Completion: January 1, 2023
• Last Updated: February 16, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)