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Association between Association between Response time and Response time and
Mortality in Drowning Mortality in Drowning Patients Patients
in Thailandin Thailand Mr.Phichet Nongchang
Dr PH 567110001-5Faculty of Public Health, Khon Kaen University
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Drowning is defined as the process of experiencing respiratory impairment from
submersion/immersion in liquid
BACKGROUNDBACKGROUND
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BACKGROUNDBACKGROUND• Drowning is a leading cause of accidental death worldwide• Injuries account for nearly 10% of total global mortality. Drowning is the 3rd leading cause of unintentional injury death, accounting for 7% of all injury-related deaths, low- and middle-income countries account for 96% of unintentional drowning deaths(WHO)
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BACKGROUNDBACKGROUND
• In Thailand 2008, drowning was the second cause of death in injuries (4,065 cases)• Emergency medical services (EMS) • Response time effected improving patient outcomes. • It is not yet clear for Thailand
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To determine association between response times and mortality in drowning patientsin Thailand
OBJECTIVEOBJECTIVE
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MATERIALS AND METHODS
• Cross sectional analytical • Thailand EMS database.•National Institute for Emergency Medicine (NIEM)•Across country (except Bangkok)•2011-2012
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Study Outcome
The primary outcome:•mortality of drowning on emergent patients (out-of-hospital)
Independent variables:•response time •Scene time, Transport time•CPR, Gender, Age, Region
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Statistical Analysis
• Statistical analysis by Stata version 12.0
• Descriptive statistics (frequency and percentage)
• multiple logistic regression Odds Ratios, 95%
Confidence Intervals, and p-value.
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RESOULTRESOULT
Exclude with other case (435,723)
Excluded with Urgent, Non-urgent and other (792)
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Demographic CharacteristicsDemographic Characteristics
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Demographic CharacteristicsDemographic Characteristics
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Demographic CharacteristicsDemographic Characteristics
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Demographic Characteristics Demographic Characteristics
Characteristic N %Response times (Mean: SD)
1,23814.0: 16.8
Scene times(Mean: SD)
1,058 9.7: 19.8
Transport times(Mean: SD)
1,18211.3: 10.8
Death on drowning (Out-of-hospital) 1,243 13.8
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Factor OR adj
95%CI P-value
Response times 1.01 0.99 - 1.03
0.255
Scene times 1.01 1.01 - 1.02
0.001
Transport times 1.03
0.99 - 1.07
0.169
Gender Female 1 0.575 Male 1.23 0.60 -
2.51
Age Less or equal 12
1
0.014
13 - 24 0.39 0.11 - 1.32
25 - 36 1.41 0.56 - 3.46
37 – 48 1.19 0.52 - 2.71
49 – 54 0.87 0.20 - 3.72
55 – 66 1.70 0.68 - 4.26
67 or greater 0.92 0.19 - 4.44
Region South 1 0.008
East 0.64 0.15 - 2.69
North 0.45 0.07 - 2.73
Northeast 1.67 0.53 - 5.24
Central 3.06 0.94 - 9.98
CPR No 1
Yes
4.532.36 -
8.71<0.001
1 2 3 4 5 6 7 8 9 10
0 0.5
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DISSCUSSIONDISSCUSSION
• This study did not show significant increase in mortality of drowning patients form increase response times• OR adj = 1.01 • 95 % CI (0.99 - 1.03) P-value=0.255
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DISSCUSSIONDISSCUSSION
• Response times association survival in out-of-hospital cardiac arrest (OHCA) by drowning• Response times affected patient mortality and associated with higher mortality rates• response times no associated mortality with in Acute Heart Failure Patients
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DISSCUSSIONDISSCUSSION
• Did not demonstrated association between scene time and transport times and mortality• Transportation time correlate with mortality in Acute Heart Failure Patients• No association between transport interval and outcome OHCA• Cardiopulmonary resuscitation (CPR)associated mortality in drowning patients
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CONCLUSIONSCONCLUSIONS
• The study could not demonstrate that Response times association
mortality in emergent drowning
Patients in Thailand• Further study should be
conducted to the pre-hospital factors effect survival of drowning, and the effectiveness of CPR for drowning survival
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THANK YOUTHANK YOUfor your attentionfor your attention
THANK YOUTHANK YOUfor your attentionfor your attention