Morbidity and Mortality Associated with Prehospital “Lift-assist” Calls

Abstract

Introduction: When an individual requires assistance with mobilization, emergency medical services (EMS) may be called. If a patient does not receive treatment on scene and is not transported to hospital, these are referred to as “Lift Assist” (LA) calls. It is possible this need for assistance represents a subtle onset of a disease process or decline in function. Without recognition or treatment, the patient may be at risk for recurrent falls, repeat EMS visits or worsening illness. Objective: To examine the 14-day morbidity and mortality associated with LA calls and determine factors that are associated with increased risk of these outcomes. Methods: All LA calls from a single EMS agency were collected over a one year study period (January–December 2013). Calls were linked with hospital records to determine if LA patients had a subsequent visit to the emergency department (ED), admission, or death within 14 days of the LA call. Logistic regression analyses were completed to determine factors predicting ED visit or hospital admission within 14 days of the LA call. Results: Of 42,055 EMS calls, 804 (1.9%) were LAs. These calls were for 414 individuals; 298 (72%) patients had 1 LA, and 116 (28%) patients had >1 LA call. There were 169 (21%) ED visits, 93 (11.6%) hospital admissions and 9 (1.1%) deaths within 14 days of a LA call. Patient age (p = 0.025) significantly predicted ED visit. Patient age (p = 0.006) and an Ambulance Call Record missing at least 1 vital sign (p = 0.038) significantly predicted hospital admission. Conclusions: LA calls are associated with short-term morbidity and mortality. Patient age was found to be associated with these outcomes. These calls may be early indicators of problems requiring comprehensive medical evaluation and thus further factors associated with poor outcomes should be determined.

Key words::

• emergency medical services
• prehospital emergency care
• falls
• lift assist