Background
Methods
Study design and population
Description of the state PEMS
Databases and variables
Statistical analysis
Ethical aspects
Results
Description of PEMS interventions
Variables | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
---|---|---|---|---|---|---|---|---|---|---|
Primary interventions
| 21722 | 21753 | 23225 | 23510 | 24630 | 25048 | 26170 | 27376 | 27603 | 28697 |
Nb/1000 inhabitants | 34 | 34 | 36 | 35 | 37 | 37 | 38 | 39 | 38 | 39 |
SMUR interventions
| 5865 | 6431 | 7230 | 6634 | 6724 | 6611 | 6452 | 6024 | 6090 | 6453 |
Nb/1000 inhabitants | 9 | 10 | 11 | 10 | 10 | 10 | 9 | 8 | 8 | 9 |
Age (years)
| ||||||||||
<16 | 1394 (6.6) | 1383 (6.5) | 1322 (5.9) | 1218 (5.4) | 1274 (5.4) | 1308 (5.4) | 1353 (5.3) | 1340 (5.1) | 1635 (6.1) | 1565 (5.6) |
17-49 | 7108 (33.5) | 7162 (33.8) | 7591 (33.6) | 7625 (33.5) | 7828 (32.9) | 7877 (32.5) | 8293 (32.7) | 8357 (31.5) | 8475 (31.7) | 8547 (30.9) |
50-79 | 7635 (36.0) | 7474 (35.2) | 7650 (33.8) | 7636 (33.9) | 7994 (33.6) | 8139 (33.4) | 8571 (33.6) | 9032 (34.0) | 9303 (34.7) | 9653 (34.6) |
> = 80 | 5076 (23.9) | 5179 (24.4) | 6047 (26.7) | 6281 (27.6) | 6706 (28.2) | 6972 (28.7) | 7202 (28.3) | 7807 (29.4) | 7359 (27.5) | 8039 (28.9) |
Male gender
| 10460 (49.4) | 10603 (50.0) | 11344 (50.2) | 11331 (49.8) | 11540 (48.5) | 12053 (49.6) | 12522 (49.3) | 13015 (49.1) | 13317 (49.8) | 13742 (49.4) |
NACA Score**
| ||||||||||
<4 | 18735 (82.8) | 19220 (84.5) | 19851 (83.4) | 20344 (83.8) | 21118 (83.1) | 22229 (83.8) | 22490 (84.0) | 23469 (84.4) | ||
4-6 | 3429 (15.2) | 3108 (13.7) | 3485 (14.6) | 3487 (14.4) | 3853 (15.2) | 3853 (14.5) | 3786 (14.1) | 3877 (13.9) | ||
7 | 470 (2.1) | 437 (1.9) | 468 (2.0) | 465 (1.9) | 451 (1.8) | 457 (1.7) | 498 (1.9) | 460 (1.7) |
Medical aspects
Variables | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
---|---|---|---|---|---|---|---|---|---|---|
Primary interventions
| 21722 | 21753 | 23225 | 23510 | 24630 | 25048 | 26170 | 27376 | 27603 | 28697 |
Medical problem*
| ||||||||||
Trauma | 5962 (28.1) | 6138 (28.9) | 6599 (29.2) | 6634 (29.1) | 6806 (28.6) | 6721 (27.7) | 7261 (28.6) | 7399 (27.9) | 7661 (28.6) | 7965 (28.6) |
Medical problem | ||||||||||
Coma
| 1804 (8.5) | 1902 (9.0) | 1991 (8.8) | 2028 (8.9) | 2024 (8.5) | 2169 (8.9) | 2419 (9.5) | 2437 (9.2) | 2505 (9.4) | 2548 (9.2) |
Chest pain
| 1594 (7.5) | 1610 (7.6) | 1586 (7.0) | 1659 (7.3) | 1697 (7.1) | 1847 (7.6) | 1967 (7.7) | 1865 (7.0) | 1565 (5.9) | 1715 (6.2) |
Dyspnoea
| 1233 (5.8) | 1300 (6.1) | 1442 (6.4) | 1314 (5.8) | 1544 (6.5) | 1633 (6.7) | 1710 (6.7) | 1699 (6.4) | 1693 (6.3) | 1613 (5.8) |
Cardiac arrest
| 506 (2.4) | 495 (2.3) | 500 (2.2) | 466 (2.1) | 533 (2.2) | 544 (2.2) | 525 (2.1) | 543 (2.1) | 574 (2.1) | 559 (2.0) |
Place of intervention
| ||||||||||
Home | 13436 (59.4) | 13719 (60.3) | 14575 (61.2) | 15207 (62.6) | 15488 (60.9) | 15949 (60.1) | 15999 (59.6) | 16904 (60.6) | ||
Public place | 6229 (27.5) | 6106 (26.8) | 6021 (25.3) | 5786 (23.8) | 6073 (23.9) | 6156 (23.2) | 6231 (23.2) | 6277 (22.5) | ||
School or workplace | 859 (3.8) | 815 (3.6) | 882 (3.7) | 978 (4.0) | 1082 (4.3) | 1021 (3.9) | 1117 (4.2) | 1178 (4.2) | ||
Hospital/private practice | 690 (3.0) | 693 (3.0) | 767 (3.2) | 840 (3.5) | 1354 (5.3) | 1816 (6.8) | 1917 (7.1) | 2105 (7.5) | ||
Sport area | 923 (4.1) | 882 (3.9) | 921 (3.9) | 990 (4.1) | 982 (3.9) | 1105 (4.2) | 1153 (4.3) | 976 (3.5) | ||
Other | 497 (2.2) | 550 (2.4) | 638 (2.7) | 495 (2.0) | 443 (1.7) | 491 (1.9) | 419 (1.6) | 450 (1.6) |
Evolution of process indicators over time
Indicators | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
---|---|---|---|---|---|---|---|---|---|---|
Time to start (min)
$
| ||||||||||
Ambulance/SMUR | -/4(2) | -/4(3) | 4(2)/4(3) | 3(2)/4(3) | 4(2)/4(3) | 4(2)/4(3) | 3(2)/4(3) | 4(2)/4(3) | 6(2)/4(3) | 5(2)/4(3) |
% of departures > 5 min
| ||||||||||
Ambulance/SMUR | -/14.5 | -/14.1 | 18.8/12.6 | 17.6/16.7 | 16.6/15.7 | 17.4/13.1 | 17.4/11.7 | 21.1/13.7 | 19.9/15.0 | 15.3/15.3 |
Time to response (min)
#
| ||||||||||
Ambulance/SMUR | -/11(7) | -/11(7) | 11(6)/11(7) | 11(6)/11(7) | 12(6)/11.5(7) | 11(6)/11(7) | 11(6)/11(7) | 13(7)/12(8) | 17(8)/12(8) | 16(7)/12(8) |
Time on scene (min)
£
| ||||||||||
Ambulance | ||||||||||
Age <16
| 17(15) | 18(16) | 18(16) | 18.5(16) | 18(16) | 17(15) | 17(15) | 17(15.5) | ||
Age 17-79
| 20(19) | 21(19) | 21(19) | 20(19) | 20(19) | 20(19) | 20(19) | 20(18) | ||
Age > =80
| 22(20) | 22(21) | 22(21) | 22(21) | 23(21) | 23(22) | 23(22) | 23(22) | ||
SMUR | ||||||||||
Age <16
| 17(14) | 15(13) | 17(14) | 19(16) | 19(17) | 17.5(16) | 16.5(15) | 17.5(15) | 17(15) | 18(15) |
Age 17-79
| 20(19) | 21(19) | 21(19) | 22(20) | 22(20) | 20(20) | 20(19) | 23(20) | 23(21) | 23(21) |
Age > =80
| 20(19) | 21(20) | 20(19) | 21.5(21) | 21(21) | 20(20) | 20.5(21) | 22(21) | 22(21) | 22(21) |
% of time on scene > 20 min
| ||||||||||
Ambulance/SMUR | -/42.3 | -/45.0 | 51.5/43.7 | 53.0/50.5 | 53.5/47.7 | 52.4/59.3 | 51.4/58.3 | 52.1/48.9 | 51.8/51.2 | 51.9/50.3 |
48-hours patients’ outcome for PEMS interventions
Indicators | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
---|---|---|---|---|---|---|---|---|---|---|
All interventions
| 4879 | 5361 | 5652 | 5436 | 5581 | 5413 | 5303 | 4782 | 4991 | 5158 |
Alive, not brought to hospital
| 182(3.7) | 164(3.1) | 188(3.3) | 171(3.1) | 192(3.4) | 183(3.4) | 142(2.7) | 143(3.0) | 180(3.6) | 165(3.2) |
Dead on the scene
| 375(7.7) | 405(7.8) | 387(6.9) | 385(7.1) | 401(7.2) | 395(7.3) | 362(6.8) | 361(7.6) | 408(8.2) | 391(7.6) |
Alive or Out of hospital at 48 h
| 1844(37.8) | 1932(36.0) | 2069(36.6) | 2108(38.8) | 2016(36.1) | 2059(38.0) | 1928(36.3) | 1710(35.7) | 1962(39.3) | 1958(37.9) |
Survival at 48 h
| ||||||||||
All interventions | 4274(87.6) | 4761(88.8) | 5030(88.9) | 4851(89.2) | 4962(88.9) | 4790(88.5) | 4734(89.2) | 4208(88.0) | 4393(87.9) | 4587(88.7) |
Cardiac arrest | 22(7.4) | 31(9.7) | 34(11.5) | 29(10.2) | 32(9.8) | 28(8.5) | 42(13.2) | 56(16.1) | 56(14.4) | 77(18.0) |
Myocardial infarction | 199(88.4) | 251(94.0) | 218(91.2) | 213(92.2) | 245(88.5) | 264(90.4) | 298(92.8) | 268(93.4) | 308(93.1) | 348(95.3) |
Stroke | 96(89.7) | 111(89.5) | 117(89.3) | 99(90.8) | 86(89.6) | 97(89.0) | 89(85.6) | 76(82.6) | 74(83.1) | 182(92.4) |
Sepsis | 12(66.7) | 20(71.4) | 28(77.8) | 22(73.3) | 31(81.6) | 24(72.7) | 41(87.2) | 41(83.7) | 42(67.7) | 48(84.2) |