Forecast of the medical evacuation in patients with the cardiovascular dysfunction. A retrospective study

Abstract

Introduction. The prognosis for the patients with the cardiovascular dysfunction and the use vasopressors or cardiotonics is always doubtful. Frequently patientʼs unstability and usage of vasoactive drugs increases the risks of incidents and are contraindication for medical evacuation. The results of published studies indicate that the use of these drugs when transporting patients is accompanied by certain risks, and methods for their prediction are not well described. Objectives. Determine prognostic factors and evaluate the results of medical evacuation in patients requiring vasopressor and cardiotonic support. Materials and methods. The retrospective study included 1210 patients from the database of the Tyumenʼs resuscitative-consultative center and the prospective study included 41 patients who were delivered to the Tyumen level III hospitals in 2019. Patients were distributed into 2 groups - survivors and deceased after evacuation. Results. Our study showed the importance of the integral estimation of severity of patients subjected to medical evacuation and the high predictive value of the National Early Warning Score (NEWS) scale and Full Outline of UnResponsiveness (FOUR) at the stages of evacuation. In the next day after delivery, the Acute Physiology And Chronic Health Evaluation (APACHE II) scale demonstrated high prediction accuracy. Despite the risks associated with the development of undesirable situations during transportation (their frequency according to our data was 12.2 %), the evacuation of patients with cardiovascular dysfunction increases the chance of an favorable outcome 2.8 time. Conclusions. Despite the presence of vascular dysfunction, the evacuation of patients in need of vasopressor and cardiotonic support is a life-saving measure that increases the chances of patients for a favorable outcome by 2.82 times.