The Korean Journal of Emergency Medical Services (한국응급구조학회지)

The Korea Society of Emergency Medical Services (한국응급구조학회)
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Analysis of pre-hospital records of patients with non-traumatic subarachnoid hemorrhage using prediction tools

예측 도구를 활용한 비외상성 거미막밑출혈 환자의 병원 전 기록 분석

  • Kim, Yong-Joon (Department of Emergency Medicine, SMG-SNU Boramae Medical Center) ;
  • Sim, Kyoung-Yul (Department of Emergency Medical center, Gyeongsang National University Changwon Hospital) ;
  • Lee, Kyoung-Youl (Department of Emergency Medical Service, Kongju National University)
  • Received : 2022.06.24
  • Accepted : 2022.08.24
  • Published : 2022.08.31
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Abstract

Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

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References

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