Survival Rates and Factors Related to the Survival of Traffic Accident Patients Transported by Emergency Medical Services

Abstract

Background: Traffic accident patients place a tremendous burden on health care services because they require substantial, rapid, and effective evaluation, management, and treatment by emergency medical services (EMS) to decrease morbidity and mortality rates. This study investigated the 1-month survival rate and factors related to the survival of traffic accident patients managed by EMS. Patients and Methods: We retrospectively analyzed data of traffic accident patients serviced by the Surgico Medical Ambulance and Rescue Team (SMART) at Vajira Hospital, Bangkok, from January 1, 2018, to December 31, 2020. The data were collected from EMS patient care reports recorded using the emergency medical triage protocol as well as the criteria-based dispatch response codes in Thailand. Survival data at 1 month were obtained from electronic medical records. Results: Of the 340 traffic accident patients who fulfilled the study criteria, 314 (92.35%) were alive at 1 month. A multivariable analysis using multiple logistic regression identified prehospital level of consciousness, airway management, and cardiopulmonary resuscitation as factors associated with survival. Unresponsive patients had a lower survival rate than responsive patients (adjusted odds ratio [ORadj] = 0.16, 95% confidence interval [CI]: 0.05– 0.56, p = 0.004). Prehospital airway management and cardiopulmonary resuscitation reduced the survival rate by 0.30 and 0.10 times, respectively (ORadj = 0.30, 95% CI: 0.09–0.97, p = 0.045 and ORadj = 0.10, 95% CI: 0.02–0.47, p = 0.004, respectively). Conclusion: Traffic accident patients had a high survival rate at 1 month. We identified three factors regarding EMS treatment which were related to increased survival: a prehospital responsive level of consciousness, no prehospital airway management, and no prehospital cardiopulmonary resuscitation. Therefore, the development of standard guidelines for the management of traffic accident patients by EMS is crucial to increase the survival rate of traffic accident patients.