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{
    "pk": 10911,
    "title": "Outcomes of Emergency Medical Service Usage in Severe Road Traffic Injury during Thai Holidays",
    "subtitle": null,
    "abstract": "Introduction:\n Thailand has the highest mortality from road traffic injury (RTI) in the world. There are usually higher incident rates of RTI in Thailand over long holidays such as New Year and Songkran. To our knowledge, there have been no studies that describe the impact of emergency medical service (EMS) utilization by RTI patients in Thailand. We sought to determine the outcomes of EMS utilization in severe RTIs during the holidays.\nMethods:\n We conducted a retrospective review study by using a nationwide registry that collected RTI data from all hospitals in Thailand during the New Year holidays in 2008–2015 and Songkran holidays in 2008–2014. A severe RTI patient was defined as one who was admitted, transferred to another hospital, or who died at the emergency department (ED) or during referral. We excluded patients who died at the scene, those who were not transported to the ED, and those who were discharged from the ED. Outcomes associated with EMS utilization were identified by using multiple logistic regression and adjusted by using factors related to injury severity.\nResults: \nOverall we included 100,905 patients in the final analysis; 39,761 severe RTI patients (39.40%; 95% confidence interval [CI] 95% CI [39.10%–39.71%]) used EMS transportation to hospitals. Severe RTI patients transported by EMS had a significantly higher mortality rate in the ED and during referral than that those who were not (2.00% vs. 0.78%, p < 0.001). Moreover, EMSuse was significantly associated with increased mortality rate in the first 24 hours of admission to hospitals (1.38% for EMS use vs. 0.57% for no EMS use, p < 0.001). EMS utilization was a significant predictor of mortality in EDs and during referral (adjusted odds ratio [OR] 2.19; 95% CI [1.88–2.55]), and mortality in the first 24 hours of admission (adjusted OR 2.31; 95% CI [1.95–2.73]).\nConclusion:\n In this cohort, severe RTI patients transported by EMS had a significantly higher mortality rate than those who went to hospitals using private vehicles during these holidays.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Emergency Medical Service, EMS Utilization, Road Traffic Injury"
        }
    ],
    "section": "Emergency Medical Services",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4sk726vm",
    "frozenauthors": [
        {
            "first_name": "Sattha",
            "middle_name": "",
            "last_name": "Riyapan",
            "name_suffix": "",
            "institution": "Faculty of Medicine Siriraj Hospital, Mahidol University, Department of Emergency Medicine, Bangkok, Thailand",
            "department": "None"
        },
        {
            "first_name": "Phanthanee",
            "middle_name": "",
            "last_name": "Thitichai",
            "name_suffix": "",
            "institution": "Bureau of Epidemiology, Ministry of Public Health, Mueang Nonthaburi, Nonthaburi, Thailand",
            "department": "None"
        },
        {
            "first_name": "Wansiri",
            "middle_name": "",
            "last_name": "Chaisirin",
            "name_suffix": "",
            "institution": "Faculty of Medicine Siriraj Hospital, Mahidol University, Department of Emergency Medicine, Bangkok, Thailand",
            "department": "None"
        },
        {
            "first_name": "Tanyaporn",
            "middle_name": "",
            "last_name": "Nakornchai",
            "name_suffix": "",
            "institution": "Faculty of Medicine Siriraj Hospital, Mahidol University, Department of Emergency Medicine, Bangkok, Thailand",
            "department": "None"
        },
        {
            "first_name": "Tipa",
            "middle_name": "",
            "last_name": "Chakorn",
            "name_suffix": "",
            "institution": "Faculty of Medicine Siriraj Hospital, Mahidol University, Department of Emergency Medicine, Bangkok, Thailand",
            "department": "None"
        }
    ],
    "date_submitted": "2017-06-12T04:58:51Z",
    "date_accepted": "2017-06-12T04:58:51Z",
    "date_published": "2018-02-20T18:55:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/10911/galley/5914/download/"
        }
    ]
}