Analysis of the newborns who transferred from other hospitals and occurrence of adverse outcomes from 2008 to 2011 / 中国小儿急救医学

Objective To analyze the characteristics of newborns in occurrence of adverse outcomes that transferred from other hospitals during the past four years,in order to improve the province's perinatal survival quality and reduce mortality.Methods The clinical data of 255 cases in occurrence of adverse outcomes in transit during January 2008 to December 2011 were analyzed retrospectively.According chronologically 255 cases were divided into group A (124 cases,January 2008 to December 2009) and group B (131 cases,January 2010 to December 2011).We analyzed the basic data,perinatal factors and major diseases of the newborns,and compared the changes of related characteristics in different periods.Results Adverse outcomes in male patients were significantly higher than female patients (male:female 3.05:1,192:63) ; there were higher proportion of premature infants (73.3％,187/255) and cesarean section (49％,125/255).The major diseases were respiratory system diseases (71.4％,182/255),followed by circulatory system diseases (40.4％,103/255),and severe congenital abnormalities (26.3 ％,67/255).Group B compared with group A:(1) the proportion of hospitalization time ＜ 24 hours increased (73/131 vs 50/124,P ＜ 0.05) ; (2) the proportion of more than two referrals increased (41 / 131 vs 23/124,P ＜ 0.05) ; (3) the proportion of very low birth weight infants (including extremely low birth weight) increased significantly (75/131 vs 43/124,P ＜ 0.05) ; (4) the proportion of respiratory system diseased (131 / 131 vs 124/124),asphyxia (9/131 vs 22/124) and hypoxic ischemic encephalopathy (6/131 vs 16/124) decreased significantly (P ＜ 0.05) ;(5) the proportion of circulation system diseased (60/131 vs 31 / 124) and congenital developmental abnormalities (51/131 vs 23/124) increased significantly (P ＜ 0.05) ;(6) the application of mechanical ventilation (115/131 vs 88/124) and pulmonary surfactant (85/131 vs 52/124) increased significantly (P ＜ 0.05) ;(7) the usage of blood products decreased significantly (39/131 vs 53/124,P ＜ 0.05) ; (8) giving up treatment due to economic reasons reduced significantly (22/131 vs 37/124,P ＜ 0.05).Conclusion For the grassroots medical institutions,the choice of transport time and referral hospital may affect the incidence of adverse outcomes; the high rate of cesarean section may increase the incidence of adverse outcomes; the treatment capacity of extremely low and very low birth weight infants may directly affect the incidence of adverse outcomes ; the respiratory system diseases greatly impact on adverse outcomes,but the accompanied circulatory system diseases impact on adverse outcomes increased in recent years.

Epidemiological features of 956 cases of patients needing emergency transport / 中华医院管理杂志

Objective To study the epidemiological features of patients for emergency transport so as to enhance the control level of pre hospital emergency treatment. Methods Investigations were made of 956 cases of patients for emergency transport in the authors hospital in 2000～2001 and their epidemiological features analyzed. Results Among the 956 cases, males outnumbered females, patients within the age group of 20 to 39 numbered 391, accounting for 40.9%, and patients within the age group of 50 to 69 numbered 400, accounting for 41.8%. Of all the cases, ordinary ones numbered 671(70.2%),critical ones numbered 241(25.2%), and cases that died numbered 44(4.6%). The first three diseases demanding emergency transport were successively craniocerebral wound(17.4%), cerebrovascular disease(16.0%), and cardiovascular disease(13.5%). The periods for emergency transport ranged mainly from 9:00 to 12:00 and from 15:00 to 18:00. The sources of emergency cases were successively township hospitals(53.8%), hospitals at the county level(26.0%), and hospitals at the city level(20.2%). Conclusion Control of pre hospital emergency treatment needs to be strengthened according to the epidemiological features of patients for emergency transport.