ABSTRACT
Objective To study the time extended for getting emergency intervention in different modes of transportation and factors influencing the modes of transportation of patients with ST elevation myocardial infarction (STEMI).Methods A total of 564 consecutive patients with STEMI admitted from September 2013 to June 2016 were enrolled in the study.The clinical data about time consumed for getting emergency intervention and modes of transportation were collected.Results According to the mode of transportation,patients were divided into three groups:emergency care system (EMS) transportation group (n =96),self-transportation group (n =206) and referral group in which the patients were sent in from other hospitals (n =262).EMS transportation group had significantly shorter total ischemic time before emergency treatment than self-transportation group (229 rin vs.418 min,P ＜ 0.05) and referral group (229 min vs.512 rin,P ＜ 0.05),and significantly shorter length of pre-hospital time than self-arrival group (55 min vs.110 min;P＜0.05) and referral group (55 min vs.372 min;P＜0,05).The referral group had longer pre-hospital time and the self-transportation group had longer door-to-balloon time,but there was no difference in total ischemic time between the self-arrival and referral group (Z =-1.882,P =0.068).Multivariate logistic regression was used to analyze influence factors in mode of transportation:(1) patients characterized with high school or university education,profession of civil service,and their transportation distance more than 30 km were greater in number than referral group (P ＜ 0.05);(2) patients identified with senior middle school education,staff member of public sectors or company,their transportation distance less than 30 km,and with killip grade above Ⅱ were more likely to have EMS transport (P ＜ 0.05);(3) patients defined as businessmen without taking out new rural cooperative medical insurance,taking up transportation distance less than 80 km,and subjecting to killip grade Ⅰ had a higher proportion of individuals of this kind taking self-transportation (P ＜ 0.05).Conclusion Mode of transportation is an important factor that affects the time extended to get emergency intervention.Education level,occupation,medical insurance type,transportation distance,killip grade are associated with modes of transport.
ABSTRACT
Road traffic injuries are a major but neglected global public health problem, requiring concerted efforts for effective and sustainable prevention. Of all the systems that people have to deal with on a daily basis, road transport is the most complex and the most dangerous. Objectives: To study the patterns of injuries in the road traffic accidents and days of hospitalization. Materials and Methodology: The study was retrospective record based study and included cases reported and recorded from October 2007 to March 2008. Results: The present study was designed to study the patterns of injuries in RTA (Road Traffic Accidents) in Anand district of Gujarat. The results showed that out of total 423 RTA cases, 327(77.3%) of the victims were males and the rest 96(22.7%) were females. Two wheeler riders and pedestrians form twothird of the total victims. Total 232 fractures were noticed and of these maximum numbers occurred in the lower limb region (53.86%) followed by fractures in the upper limb (24.54%) and 10.77% fractures were in the skull. Abrasions were seen most commonly on lower limbs (34.31%), lacerations were seen mostly on head (41.07%) and internal injuries were noticed more in the head region (31.48%). 74.2% of the victims were hospitalized and the rest 25.8% took treatment at the trauma centre. 51.1% of RTA victims were hospitalized for 1-5 days while patients who did not require hospitalization were 109(25.8%).