TY - JOUR
T1 - Dead on arrival in a low-income country
T2 - Results from a multicenter study in Pakistan
AU - Khursheed, Munawar
AU - Bhatti, Junaid Ahmad
AU - Parukh, Fatima
AU - Feroze, Asher
AU - Naeem, Syed Saad
AU - Khawaja, Haseeb
AU - Razzak, Junaid Abdul
N1 - Funding Information:
The Pak-NEDS study was supported through the “Johns Hopkins International Collaborative Trauma and Injury Research Training Program” [Grant No. D43TW007292] by Fogarty International Center of the United States National Institutes of Health. The content is solely the responsibility of the authors and does not represent the views of Fogarty or NIH. We are grateful to the research assistants as well as the administrators of the emergency departments of participating hospitals who facilitated this study. We also thank Ms. Leann Rosenberg for providing language edits of the paper. This article has been published as part of BMC Emergency Medicine Volume 15 Supplement 2, 2015: Articles from the Pakistan National Emergency Departments Surveillance Study (Pak-NEDS). The full contents of the supplement are available online at http://www.biomedcentral.com/ bmcemergmed/supplements/15/S2. Publication of this supplement was funded by the Johns Hopkins School of Public Health.
Publisher Copyright:
© 2015 Khursheed et al.
PY - 2015/12/11
Y1 - 2015/12/11
N2 - Background: This study assessed the characteristics of dead on arrival (DOA) patients in Pakistan. Methods: Data about the DOA patients were extracted from Pakistan National Emergency Department Surveillance study (Pak-NEDS). This study recruited all ED patients presenting to seven tertiary care hospitals during a four-month period between November 2010 and March 2011. This study included patients who were declared dead-on-arrival by the ED physician. Results: A total of 1,557 DOA patients (7 per 1,000 visits) were included in the Pak-NEDS. Men accounted for two-thirds (64%) of DOA patients. Those aged 20-49 years accounted for about 46% of DOA patients. Nine percent (n = 72) of patients were brought by ambulance, and most patients presented at a public hospital (80%). About 11% of DOA patients had an injury. Factors significantly associated (p < 0.05) with ambulance use were men (adjusted odds ratio [aOR] = 2.72), brought to a private hospital (OR = 2.74), and being injured (aOR = 1.89). Cardiopulmonary resuscitation (CPR) was performed on 6% (n = 42) of patients who received treatment. Those brought to a private hospital were more likely to receive CPR (aOR = 2.81). Conclusion: This study noted a higher burden of DOA patients in Pakistan compared to other resourceful settings (about 1 to 2 per 1,000 visits). A large proportion of patients belonging to productive age groups, and the low prevalence of ambulance and CPR use, indicate a need for improving the prehospital care and basic life support training in Pakistan.
AB - Background: This study assessed the characteristics of dead on arrival (DOA) patients in Pakistan. Methods: Data about the DOA patients were extracted from Pakistan National Emergency Department Surveillance study (Pak-NEDS). This study recruited all ED patients presenting to seven tertiary care hospitals during a four-month period between November 2010 and March 2011. This study included patients who were declared dead-on-arrival by the ED physician. Results: A total of 1,557 DOA patients (7 per 1,000 visits) were included in the Pak-NEDS. Men accounted for two-thirds (64%) of DOA patients. Those aged 20-49 years accounted for about 46% of DOA patients. Nine percent (n = 72) of patients were brought by ambulance, and most patients presented at a public hospital (80%). About 11% of DOA patients had an injury. Factors significantly associated (p < 0.05) with ambulance use were men (adjusted odds ratio [aOR] = 2.72), brought to a private hospital (OR = 2.74), and being injured (aOR = 1.89). Cardiopulmonary resuscitation (CPR) was performed on 6% (n = 42) of patients who received treatment. Those brought to a private hospital were more likely to receive CPR (aOR = 2.81). Conclusion: This study noted a higher burden of DOA patients in Pakistan compared to other resourceful settings (about 1 to 2 per 1,000 visits). A large proportion of patients belonging to productive age groups, and the low prevalence of ambulance and CPR use, indicate a need for improving the prehospital care and basic life support training in Pakistan.
KW - Cardiopulmonary resuscitation
KW - Critical illness
KW - Prehospital care
KW - Surveillance
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U2 - 10.1186/1471-227X-15-S2-S8
DO - 10.1186/1471-227X-15-S2-S8
M3 - Article
C2 - 26689125
AN - SCOPUS:84977656411
SN - 1471-227X
VL - 15
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
IS - 2
M1 - S8
ER -