Abstract：
How prehospital medication predicts patient outcomes is unclear. The aim of this work was to unveil the association between medication burden administration in prehospital care and short, mid, and long-term mortality (2, 30, and 365 day) in unselected acute diseases and to assess the potential of the number of medications administered for short, mid, and long-term mortality prediction. A prospective, multicenter, ambulance-based, cohort study was carried out in adults with unselected acute diseases managed by emergency medical services (EMS). The study was carried out in Spain with 44 ambulances and four hospitals. The principal outcome was cumulative mortality at 2, 30, and 365 days. Epidemiological variables, vital signs, and prehospital medications were collected. Patients were classified into four categories: no medication dispensed in prehospital care, one to two medications, three to four medications, and five or more medications. A total of 6401 patients were selected. The 2-day mortality associated with each group was 0.5%, 1.8%, 6.5%, and 18.8%. The 30-day mortality associated with each group was 3.8%, 6.2%, 13.5%, and 31.9%. The 365-day mortality associated with each group was 11%, 15.3%, 25.2%, and 45.7%. The predictive validity of the number of drugs administered, measured by the area under the curve, was 0.808, 0.720, and 0.660 for 2-, 30-, and 365-day mortality, respectively. Our results showed that prehospital drugs could provide relevant information regarding the mortality prediction of patients. The incorporation of this score could improve the management of high-risk patients by the EMS.
摘要：
院前用药如何预测患者预后尚不清楚。这项工作的目的是揭示院前护理中的药物负担管理与短期，mid,和长期死亡率（2日，30日和365日）在未选择的急性疾病，并评估潜在的数量的药物短期使用，mid,和长期死亡率预测。一个潜在的，多中心，以救护车为基础，队列研究是在由急诊医疗服务(EMS)管理的未选择急性疾病的成人中进行的.这项研究是在西班牙进行的，有44辆救护车和4家医院。主要结果是2、30和365天的累积死亡率。流行病学变量，生命体征,并收集院前用药。患者分为四类：院前护理中未分配药物，一到两种药物，三到四种药物，五种或更多的药物。共选择6401名患者。与每组相关的2天死亡率为0.5％，1.8%,6.5%,18.8%。与每组相关的30天死亡率为3.8％，6.2%,13.5%,和31.9%。与每组相关的365天死亡率为11％，15.3%,25.2%,和45.7%。给药数量的预测效度，用曲线下的面积来衡量，对于2-，分别为0.808、0.720和0.660，30-,和365天死亡率，分别。我们的结果表明，院前药物可以提供有关患者死亡率预测的相关信息。合并该评分可以改善EMS对高危患者的管理。
