Effect of the Colombian Emergency Department Triage Policy on the timeliness of ED care and the mortality in patients with cerebrovascular attack: A controlled interrupted time series analysis
Research Square (Research Square)(2020)
摘要
Abstract Background: Ischemic Cerebrovascular Accident (CVA) is the second cause of death and one of the leading causes of disability in the world. In Colombia, there is a prevalence of 0.16% and a mortality rate of 16.82 deaths per 100,000 inhabitants. This study assessed the Colombian Ministry of Health’s Emergency Department Triage Policy (TP) on the timeliness of hospital care, the mortality, and change in reperfusion therapy of patients with the first episode of an CVA in the Emergency Department (ED) of a hospital in the city of Medellín.Methods: A controlled interrupted time series analysis between January 2011 and November 2017 was performed in one emergency department using segmented regression analysis. The emergency department of other hospital was used as a control. Data were aggregated by month for both ED, including 60 pre-intervention and 23 intervention points.Results: No decrease in the timeliness of care in the ED was found in patients with a stroke after implementing the Colombian Ministry of Health’s TP (12.55 minutes, IC -17.07, 42.17; p: 0.4). The TP intervention produced a level change in the timeliness of care in Triage I and II subgroups, of 28.34 minutes (IC 95% 16.9, 39.79; p valor 0.00), there was no change in the trend. The classification of Triage I and II was more frequent in the post-intervention period. There was evidence of the increase in reperfusion therapy with tissue plasminogen activator (rTPA) in 4% (95% CI – 0.08, - 0.01; p value 0.01). Mortality increased 4% in the post-intervention period without being statistically significant (0.04, IC 95% - 0.08 – 0; p valor 0.06). There were no significant changes in the same outcomes in the control group.Conclusions: The implementation of the triage policy allowed improving the timeliness of ED care only in patients with ischemic CVA classified as Triage I and II, in an Emergency Department in the city of Medellín, Colombia.
更多查看译文
关键词
cerebrovascular attack,ed care,emergency department
AI 理解论文
溯源树
样例
![](https://originalfileserver.aminer.cn/sys/aminer/pubs/mrt_preview.jpeg)
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要