Evidence map›Paper›PMID 35580968›Full record

ArticleBMJ open2022

Accuracy of prehospital clinicians' perceived prognostication of long-term survival in critically ill patients: a nationwide retrospective cohort study on helicopter emergency service patients.

Anssi Heino, Johannes Björkman, Miretta Tommila, Timo Iirola, Helena Jäntti, Jouni Nurmi

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Anssi HeinoDepartment of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland anssi.heino@tyks.fi.ORCID 0000-0002-5230-0166
Johannes BjörkmanResearch and Development Unit, FinnHEMS Ltd, Vantaa, Finland.
Miretta TommilaDepartment of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland.
Timo IirolaEmergency Medical Services, Turku University Hospital, Turku, Finland.
Helena JänttiCenter for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland.
Jouni NurmiResearch and Development Unit, FinnHEMS Ltd, Vantaa, Finland.
Turku University Hospital · FIUniversity of Helsinki · FIKuopio University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPrehospital critical care physicians regularly attend to patients with poor prognosis and may limit the advanced therapies. The aim of this study was to evaluate the accuracy of poor prognosis given by prehospital critical care clinicians.

designCohort study.

settingWe performed a retrospective cohort study using the national helicopter emergency medical services (HEMS) quality database.

participantsPatients classified by the HEMS clinician to have survived until hospital admission solely because of prehospital interventions but evaluated as having no long-term survival by prehospital clinician, were included. PRIMARY AND SECONDARY OUTCOME: The survival of the study patients was examined at 30 days, 1 year and 3 years.

resultsOf 36 715 patients encountered by the HEMS during the study period, 2053 patients were classified as having no long-term survival and included. At 30 days, 713 (35%, 95% CI 33% to 37%) were still alive and 69 were lost to follow-up. Furthermore, at 1 year 524 (26%) and at 3 years 267 (13%) of the patients were still alive. The deceased patients received more often prehospital rapid sequence intubation and vasoactives, compared with patients alive at 30 days. Patients deceased at 30 days were older and had lower initial Glasgow Coma Scores. Otherwise, no clinically relevant difference was found in the prehospital vital parameters between the survivors and non-survivors.

conclusionsThe prognostication of long-term survival for critically ill patients by a prehospital critical care clinician seems to fulfil only moderately. A prognosis based on clinical judgement must be handled with a great degree of caution and decision on limitation of advanced care should be made cautiously.

Indexed as

Critical IllnessEmergency Medical ServicesAircraftCohort StudiesHumansRetrospective Studiesaccident & emergency medicineadult intensive & critical care

Identifiers

PMID35580968
PMCPMC9115026
OpenAlexW4280603391

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.