World Journal of Emergency Medicine ›› 2025, Vol. 16 ›› Issue (1): 43-50.doi: 10.5847/wjem.j.1920-8642.2025.008
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Jesús Jurado-Palomo1,2, José Luis Martín-Conty1, Begoña Polonio-López1, Cristina Rivera Picón1, Raúl López-Izquierdo3,4,5, Carlos del Pozo Vegas5,6, Pedro Ángel de Santos Castro6, Ancor Sanz-García1(), Francisco Martín-Rodríguez5,7(
)
Received:
2024-05-29
Accepted:
2024-11-20
Online:
2025-01-23
Published:
2025-01-01
Contact:
Ancor Sanz-García,Francisco Martín-Rodríguez
E-mail:ancor.sanz@gmail.com;francisco.martin.rodriguez@uva.es
Jesús Jurado-Palomo, José Luis Martín-Conty, Begoña Polonio-López, Cristina Rivera Picón, Raúl López-Izquierdo, Carlos del Pozo Vegas, Pedro Ángel de Santos Castro, Ancor Sanz-García, Francisco Martín-Rodríguez. Prehospital critical care drug-therapy and 30-day mortality in patients with acute respiratory disease[J]. World Journal of Emergency Medicine, 2025, 16(1): 43-50.
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URL: http://wjem.com.cn/EN/10.5847/wjem.j.1920-8642.2025.008
Table 1.
Baseline characteristics and other parameters of survivors and non-survivors
Parameters a | Survivors (n=793) | Non-survivors (n=168) | P-valueb |
---|---|---|---|
Epidemiological variables | |||
Sex at birth, female | 327 (41.2) | 68 (40.5) | 0.924 |
Age, year | 71.2±16.0 | 75.6±13.5 | <0.001 |
Ambulance, advanced life support | 437 (55.1) | 124 (73.8) | <0.001 |
Nursing home, yes | 139 (17.5) | 48 (28.6) | 0.001 |
Basal vital signs | |||
Respiratory rate, breaths/min | 26.5±9.0 | 28.5±11.0 | 0.026 |
Oxygen saturation, % | 88.3±11.0 | 81.4±14.2 | <0.001 |
Fraction of inspired oxygen, % | 0.4±0.2 | 0.6±0.3 | <0.001 |
SaO2/FiO2 ratio | 378±97 | 330±111 | <0.001 |
Systolic blood pressure, mmHg | 139±32 | 125±39 | <0.001 |
Diastolic blood pressure, mmHg | 79±20 | 72±24 | <0.001 |
Heart rate, beats/min | 98.1±25.5 | 104.0±32.8 | 0.044 |
Temperature, °C | 36.6±1.0 | 36.6±1.4 | 0.751 |
Glasgow Coma Scale, points | 14.1±2.5 | 11.4±4.5 | <0.001 |
Prehospital respiratory diagnosis | <0.001 | ||
Dyspnea | 312 (39.3) | 71 (42.3) | |
COPD | 128 (16.1) | 17 (10.1) | |
Respiratory infection | 173 (21.8) | 55 (32.7) | |
COVID-19 | 108 (13.6) | 13 (7.7) | |
Asthma crisis | 32 (4.0) | 0 (0.0) | |
Othersc | 40 (5.0) | 12 (7.1) | |
Outcomes | |||
Prehospital NIMV | 133 (16.8) | 56 (33.3) | <0.001 |
Prehospital IMV | 47 (5.9) | 50 (29.8) | <0.001 |
aCCI, points | 6.1±3.3 | 7.5±3.3 | <0.001 |
Inpatient | 567 (71.6) | 168 (100.0) | <0.001 |
ICU-admission | 74 (9.3) | 52 (31.0) | <0.001 |
Table 2.
Drug therapy by prehospital point-of-care in patients with acute respiratory disease, n (%)
Medications | Survivors (n=793) | Non-survivors (n=168) | P-valuea |
---|---|---|---|
Anti-convulsant | 6 (0.8) | 1 (0.6) | 0.998 |
Antiarrhythmic | 10 (1.3) | 4 (2.4) | 0.284 |
Antibiotic | 2 (0.3) | 0 (0.0) | 0.989 |
Antidote | 10 (1.3) | 7 (4.2) | 0.018 |
Antiemetic | 41 (5.2) | 14 (8.3) | 0.155 |
Antihypertensive | 16 (2.0) | 2 (1.2) | 0.754 |
Antiplatelet agent | 3 (0.4) | 3 (1.8) | 0.070 |
Anxiolytic | 82 (10.4) | 46 (27.4) | <0.001 |
Atropine | 2 (0.3) | 5 (3.0) | 0.002 |
Beta-2-agonist (inhaled) | 424 (53.5) | 85 (50.6) | 0.553 |
Beta-blocker | 7 (0.9) | 3 (1.8) | 0.392 |
Bicarbonate | 6 (0.8) | 16 (9.5) | <0.001 |
Diuretic | 183 (23.1) | 34 (20.2) | 0.485 |
Epinephrine | 10 (1.3) | 10 (6.0) | 0.001 |
Fibrinolytic | 0 (0.0) | 3 (1.8) | 0.005 |
Glucocorticoid | 418 (52.7) | 88 (52.4) | 0.997 |
Glucocorticoid (inhaled) | 231 (29.1) | 44 (26.2) | 0.502 |
Glucose 50% | 6 (0.8) | 5 (3.0) | 0.029 |
Heparin | 10 (1.3) | 7 (4.2) | 0.018 |
Hypnotics | 40 (5.0) | 47 (28.0) | <0.001 |
Insulin | 31 (3.9) | 11 (6.6) | 0.190 |
Ions | 14 (1.8) | 5 (3.0) | 0.354 |
Ipratropium bromide (inhaled) | 403 (50.8) | 70 (41.6) | 0.031 |
Major analgesics | 159 (20.1) | 83 (49.4) | <0.001 |
Minor analgesics | 206 (26.2) | 51 (30.4) | 0.311 |
Neuromuscular blocking agent | 23 (2.9) | 23 (13.7) | <0.001 |
Nitro-glycerine | 67 (8.5) | 11 (6.6) | 0.507 |
Norepinephrine | 11 (1.3) | 17 (10.1) | <0.001 |
Proton pump inhibitor | 60 (7.6) | 11 (6.6) | 0.767 |
Tranexamic acid | 3 (0.4) | 1 (0.6) | 0.537 |
Table 3.
Multivariate logistic regression (including variables with P<0.001 in the univariate analysis) for the whole cohort
Variables | Odds ratio (95% CI) | P-value |
---|---|---|
Age | 1.03 (1.02-1.05) | <0.001 |
Systolic blood pressure | 0.99 (0.98-0.99) | 0.009 |
Glasgow Coma Scale | 0.86 (0.82-0.90) | <0.001 |
Age-Charlson comorbidity index | 1.08 (1.02-1.14) | 0.017 |
Invasive mechanical ventilation | 7.21 (3.97-13.1) | <0.001 |
Non-invasive mechanical ventilation | 2.46 (1.66-3.63) | <0.001 |
Major analgesics | 2.26 (1.56-3.27) | <0.001 |
Hypnotics | 4.64 (2.44-8.98) | <0.001 |
Neuromuscular blocking agent | 0.17 (0.06-0.45) | 0.003 |
Bicarbonate | 5.23 (1.96-15.5) | 0.007 |
Table 4.
Multivariate logistic regression (including variables with P<0.001 in the univariate analysis) after excluding those patients with invasive mechanical ventilation
Variables | Odds ratio (95% CI) | P-value |
---|---|---|
Age | 1.03 (1.02-1.06) | <0.001 |
Systolic blood pressure | 0.99 (0.98-1.00) | 0.004 |
Glasgow Coma Scale | 0.81 (0.76-0.88) | <0.001 |
aCCI | 1.09 (1.01-1.18) | 0.026 |
Non-invasive mechanical ventilation | 2.32 (1.39-3.90) | 0.001 |
Major analgesics | 2.06 (1.22-3.47) | 0.007 |
Hypnotics | 7.45 (2.90-20.76) | <0.001 |
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