Short hospital contacts without documented in-hospital intervention following emergency medical services transport in the Central Denmark Region: a population-based cohort study.

OBJECTIVES

To identify and characterise emergency medical services (EMS)-conveyed patients with short hospital stays without documented in-hospital intervention, and compare mortality across groups.

DESIGN

Population-based cohort study.

SETTING

Tax-funded EMS system in the Central Denmark Region, covering emergency calls from January 2022 to December 2023.

PARTICIPANTS

EMS-attended patient contacts with a completed prehospital record and linkage to hospital data. Interfacility transfers and missions cancelled before patient contact were excluded. Patients were classified as non-conveyed or, if transported, by hospital-contact duration and documented procedures, medication or diagnostic imaging.

MAIN OUTCOME MEASURES: Prehospital characteristics, hospital diagnoses and resource use and short-term mortality across the four study groups.

RESULTS

Among 89 560 emergency calls resulting in EMS dispatch, 13 539 (15.1%) patients were non-conveyed after on-scene assessment and 76 021 (84.9%) were transported. Among transported patients, 14 551 (19.1%) had a hospital contact ≤6 hours without documented in-hospital procedures, medication or diagnostic imaging. This group was younger, had lower comorbidity, fewer markers of pronounced physiological compromise and was frequently discharged with non-specific diagnoses. Short-term mortality, defined as death on the index date or during the following two calendar days, was 0.4% among short stays without intervention, <0.1% among non-conveyed patients, 1.7% among short stays with intervention and 1.3% among stays >6 hours. Compared with stays >6 hours, absolute risk differences were −0.95 percentage points (95% CI −1.09 to −0.81), −1.27 (95% CI −1.38 to −1.16) and 0.40 (0.16 to 0.63), respectively. Among transported patients, index-day mortality was 0.2%, 1.4% and 0.2% in short stays without intervention, short stays with intervention and stays >6 hours, respectively. Among index-day survivors, corresponding mortality during days 1–7 was 0.2%, 0.6% and 2.5%.

CONCLUSION

Nearly one-fifth of hospital contacts following EMS transport were short stays without documented intervention. Low short-term mortality supports prospective evaluation of prehospital risk stratification and alternative care pathways.