Evidence map›Paper›PMID 39604971›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2024

Predictors of care home resident conveyance to hospital or referral to community pathways by a regional ambulance service attending medical emergencies: a retrospective cross sectional study.

Aloysius Niroshan Siriwardena, Vanessa Botan, Graham Law, Despina Laparidou, Viet-Hai Phung, Ffion Curtis, Gregory Adam Whitley, Joseph Akanuwe, Elise Rowan, Rachael Fothergill and 7 more

Abstract read
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In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2024. 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
–field-weighted citation impact
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.

  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

17 authors.

Aloysius Niroshan SiriwardenaCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK. nsiriwardena@lincoln.ac.uk.
Vanessa BotanSchool of Social Sciences, Nottingham Trent University, Nottingham, NG1 4FQ, UK.
Graham LawCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Despina LaparidouCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Viet-Hai PhungCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Ffion CurtisLiverpool Reviews & Implementation Group (LRiG), University of Liverpool, Liverpool, L69 3GB, UK.
Gregory Adam WhitleyCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Joseph AkanuweCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Elise RowanCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Rachael FothergillLincolnshire Partnership NHS Foundation Trust, Lincoln, LN1 1FS, UK.
Susan BowlerCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Maria KordowiczCommunity and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, LN6 7TS, UK.
Nicoya PalastangaHealthier Aging Patient and Public Involvement Group, University of Lincoln, Lincoln, LN6 7TS, UK.
Lissie WilkinsHealthier Aging Patient and Public Involvement Group, University of Lincoln, Lincoln, LN6 7TS, UK.
Robert SpaightEast Midlands Ambulance Service NHS Trust, Cross O'Cliff Court, Bracebridge Heath, Lincoln, LN4 2HL, UK.
Elizabeth MillerEast Midlands Ambulance Service NHS Trust, Cross O'Cliff Court, Bracebridge Heath, Lincoln, LN4 2HL, UK.
Adam GordonUniversity of Nottingham, Nottingham, NG7 2RD, UK.

Funding

National Institue for Health and Care Research Applied Research Collaboration East Midlands, UK Project 16
6 · The paper itself

Abstract

backgroundCare home residents are at higher risk compared with community dwelling elders for medical emergencies, often resulting in ambulance attendance and conveyance to hospital. We aimed to determine the factors predicting care home resident conveyance to hospital or referral to community pathways by an ambulance service.

methodsWe used a retrospective cross-sectional study design analysing routine data from electronic clinical records from East Midlands Ambulance Service NHS Trust (EMAS). Data comprised all patients including care home residents attended by ambulance from 2018 to 2021. A multivariable logistic regression model was used to identify the main predictors of conveyance to hospital or referral to community services.

resultsData included 170,612 attendances to care homes representing 7.5% of the total number of EMAS attendances between 2018 and 2021. The main predictors of conveyance to hospital were being male (Relative Risk Ratio [RRR] 1.07, 95% Confidence Interval [CI] 1.03-1.10, p < 0.001), aged 70-79 years (RRR 1.09, 95%CI 1.03-1.17, p < 0.001) or 80-89 years (RRR 1.10, 95%CI 1.03-1.17, p < 0.001), situated in an area of higher deprivation (RRR 1.06, 95%CI 1.03-1.09, p < 0.001), or having dispatch categories which included cardiovascular (RRR 11.29, 95%CI 10.43-12.22, p < 0,001), trauma such as falls (RRR 9.50, 95%CI 8.97-10.05, p < 0,001) or neurological conditions (RRR 9.06, 95%CI 8.42-9.75, p < 0,001). Calls made by health care professionals (HCPs) (RRR 15.37, 95%CI 13.41-17.62, p < 0,001) or where patients had a higher National Early Warning Score (NEWS2) (RRR 1.23, 95%CI 1.22-1.24, p < 0,001) resulted in significantly increased conveyance.

conclusionsVarious factors significantly predicted conveyance of care home residents to hospital by ambulance. These included HCP referral and a higher NEWS2 score confirming that severity of clinical condition of the patient significantly increased conveyance. Future interventions to prevent or address certain conditions such as falls or provide enhanced care in care homes may prevent some emergencies or reduce the likelihood of conveyance to hospital.

Indexed as

AmbulancesReferral and ConsultationAgedAged, 80 and overCross-Sectional StudiesEmergenciesEmergency Medical ServicesFemaleHumansMaleNursing HomesRetrospective Studies

Identifiers

PMID39604971
PMCPMC11603973

What OpenQuestion holds

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LicenceCC BY
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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.