![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Objective. To evaluate both factors predicting nontransport andmortality rates in an emergency medical services system with a nontransport policy. Methods. We reviewed data from 1,581 transported andnontransported patients from October 2001 to July 2003. Patients who refused transport against medical advice were excluded. Extracted data included demographics, run characteristics, chief complaint, andclinical impression. Transported andnontransported patients were compared using Mann–Whitney U or chi-square tests. Logistic regression identified factors predictive of nontransport. A Social Security Death Index search determined 30-day mortality. Results. A total of 1,501 runs involving 1,059 patients were included. Median age was 60 years (range, 0–97 years). A total of 427 (40.4%) were male; 107 (10.2%) were nonwhite. Older patients were more likely to be transported (odds ratio, 1.03; confidence interval, 1.02–1.03). Race, frequency of calls, mutual aid, or time of day did not significantly influence probability of transport. Patients with cardiovascular, respiratory, andgastrointestinal complaints were more likely to be transported than those with other conditions (P < 0.005); patients with endocrine, trauma, andmiscellaneous complaints were less likely to be transported (P < 0.003). Patients with renal, obstetrics/gynecology, andhema matology/oncology were complaints all transported. Mortality was 4.9% (confidence interval, 3.9%–6.2%) for transported patients and1.0% for those not transported (confidence interval, 0.2%–3.7%). Conclusions. Age is a determinant when deciding on transporting patients. Patients with complaints with potentially higher acuity were transported most often. Only two nontransported patients died within 30 days, although it is unknown whether initial transport would have changed their mortality. Our data suggest that emergency medical services–initiated nontransport is influenced only by age andchief complaint andmay not result in significant mortality.