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Clínica médica/Intensiva/Enfermagem

Aumento do intervalo QT corrigido é importante fator prognóstico para Hemorragia Intracraniana em pacientes admitidos em Departamento de Emergência

01/07/2004

Pesquisadores ligados ao National Taiwan University Hospital publicaram, recentemente, no The American Journal of Emergency Medicine, um estudo em que investigaram a significância prognóstica do aumento do intervalo QT corrigido (QTc) em pacientes admitidos ao Departamento de Emergência com quadro de hemorragia intracraniana aguda.

Foram estudadas as diferenças do aumento do intervalo QTc, medido em eletrocardiograma realizado à admissão no Departamento de Emergência, de pacientes que sobreviveram à hemorragia intracraniana e foram submetidos a novo eletrocardiograma imediatamente antes da alta hospitalar, e de pacientes que não sobreviveram à hemorragia.

Os resultados mostraram que os pacientes com menor chance de sobreviver e ter alta hospitalar apresentavam aumento significativo do intervalo QTc, maior intervalo QTc em medida absoluta, menor escore à Escala de Coma de Glasgow e acometimento de tronco cerebral. O aumento do intervalo QTc e o escore à Escala de Coma de Glasgow foram os fatores preditores independentes que apresentaram relação estatisticamente significante à análise multivariada.

Portanto, os pesquisadores concluíram que o aumento do intervalo QT corrigido é importante fator prognóstico para hemorragia intracraniana em pacientes admitidos em Departamento de Emergência.

QTc dispersion as a prognostic factor in intracerebral hemorrhage - The American Journal of Emergency Medicine 2004; 22(3): 141-144.

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The American Journal of Emergency Medicine
Volume 22, Issue 3 , May 2004, Pages 164-170

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doi:10.1016/j.ajem.2004.02.003    How to Cite or Link Using DOI (Opens New Window)  
Copyright © 2004 Elsevier Inc. All rights reserved.

Original contribution

A geographic information system simulation model of EMS: reducing ambulance response time*1

Kobi Peleg PHDCorresponding Author Contact Information, E-mail The Corresponding Author, *, and Joseph S. Pliskin PHD,

* Trauma and Emergency Medicine Research Unit, The Gertner Institute for Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
Department of Industrial Engineering and Management and Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA

Received 15 December 2002;  accepted 23 April 2003.  Available online 6 May 2004.


Abstract

Response time is a very important factor in determining the quality of prehospital EMS. Our objective was to model the response by Israeli ambulances and to offer model-derived strategies for improved deployment of ambulances to reduce response time. Using a geographic information system (GIS), a retrospective review of computerized ambulance call and dispatch logs was performed in two different regional districts, one large and urban and the other rural. All calls that were pinpointed geographically by the GIS were included, and their data were stratified by weekday and by daily shifts. Geographic areas (polygons) of, at most, 8 minutes response time were simulated for each of these subgroups to maximize the timely response of calls. Before using the GIS model, mean response times in the Carmel and Lachish districts were 12.3 and 9.2 minutes, respectively, with 34% and 62% of calls responded within 8 minutes. When ambulances were positioned within the modeled polygons, more than 94% of calls met the 8-minute criterion. The GIS simulation model presented in this study suggests that EMS could be more effective if a dynamic load-responsive ambulance deployment is adopted, potentially resulting in increased survival and cost-effectiveness.

Author Keywords: Emergency medical service; ambulance; response time; geographic information system


Corresponding Author Contact InformationCorresponding author. Address reprint requests to Kobi Peleg, PhD, Gertner Institute, Sheba Medical Center, , Tel-Hashomer 52621, , Israel

*1 Supported in part by grant 15/97 from the Israeli National Institute for Health Policy and Health Services Research.



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