The nationwide survey of patients admitted to Emergency Medical System Centers in Japan

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  • Shimazaki Junya
    Osaka University Graduate School of Medicine Department of Trauma and Acute Critical Medicine
  • Tasaki Osamu
    Osaka University Graduate School of Medicine Department of Trauma and Acute Critical Medicine
  • Shiozaki Tadahiko
    Osaka University Graduate School of Medicine Department of Trauma and Acute Critical Medicine
  • Nakagawa Junichiro
    Osaka University Graduate School of Medicine Department of Trauma and Acute Critical Medicine
  • Ikegawa Hitoshi
    Osaka University Graduate School of Medicine Department of Trauma and Acute Critical Medicine
  • Shimazu Takeshi
    Osaka University Graduate School of Medicine Department of Trauma and Acute Critical Medicine
  • Sugimoto Hisashi
    Hoshigaoka Koseinenkin Hospital

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Other Title
  • 救命救急センターの現況‐全国救命救急センター入室症例予後調査・１０万例の検討‐

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In Japan, the number of patients admitted to tertiary Emergency Medical System Centers (EMSCs) is increasing. However, a nationwide database of these patients has never been compiled before. The aim of this retrospective survey based on review of hospital admissions was to clarify distributions of diseases, lengths of stay in EMSCs, and patient outcome. We investigated patient demographic data, diagnosis, length of stay, and mortality in EMSCs. All patients admitted to EMSCs in Japan (218 institutions) during 2008 were surveyed. Seventy-eight of 218 (35.8%) institutions answered the survey. The total number of patients was 107,237. Average age was 61.6 years old. Peak admissions by 10-year age groups occurred in patients in their seventies. Average EMSC length of stay was 7.7 days, with a mode of 2 days (24.3% of all patients). EMSC long-stay patients (stay >30 days) comprised 4.3% of all patients. Overall mortality rate was 15.3%, and that without cardiopulmonary arrest was 7.8%. Rates of intrinsic and extrinsic disease were 72.9% and 27.1%, respectively. Diseases with large numbers of patients included trauma (18.3% of all patients), cardiovascular diseases (15.5%), cerebrovascular diseases (12.9%), and digestive diseases (11.0%). Diseases with large numbers of deaths included cardiopulmonary arrest (54.1% of all deaths), cerebrovascular diseases (10.3%), cardiovascular diseases (8.0%), and trauma (7.9%). Diseases with large numbers of long EMSC stays were trauma (32.5% of all long stays), cerebrovascular diseases (18.1%), cardiovascular diseases (10.1%), and digestive diseases (6.8%). In this first nationwide survey of patients admitted to EMSCs in Japan, elderly patients and intrinsic diseases were predominant.

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