{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:36:47Z","timestamp":1791387407668,"version":"4.3.3"},"reference-count":30,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NHMRC Post Graduate Sholarship"},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,8,26]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with shock treated by emergency medical services (EMS) have high morbidity and mortality. Knowledge of prehospital factors predicting outcomes in patients with shock remains limited. We aimed to describe the prehospital predictors of mortality in patients with non-traumatic shock transported to hospital by EMS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>This is a retrospective cohort study of consecutive ambulance attendances for non-traumatic shock in Victoria, Australia (January 2015\u2013June 2019) linked with government-held administrative data (emergency, admissions and mortality records). Predictors of 30-day mortality were assessed using Cox proportional regressions. The primary outcome was 30-day all-cause mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 21\u2009334 patients with non-traumatic shock (median age 69 years, 54.8% female) were successfully linked with state administrative records. Among this cohort, 9 149 (43%) patients died within 30-days. Compared with survivors, non-survivors had a longer median on-scene time: 60 (35\u201398) versus 30 (19\u201350), p &lt;0.001. Non-survivors were more likely to be older (median age in years: 74 (61\u201384) vs 65 (47\u201378), p&lt;0.001), had prehospital cardiac arrest requiring cardiopulmonary resuscitation (adjusted HR (aHR)=6.26, 95% CI 5.87, 6.69) and had prehospital intubation (aHR=1.07, CI 1.00, 1.14). Reduced 30-day mortality was associated with administration of epinephrine (aHR=0.66, CI 0.62, 0.71) and systolic blood pressures above 80\u2009mm Hg in the prehospital setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The 30-day mortality from non-traumatic shock is high at 43%. Independent predictors of mortality included age, prehospital cardiac arrest and endotracheal intubation. Interventions that target reversible causes of short-term mortality in patients with non-traumatic shock are a high priority.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002799","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T13:20:34Z","timestamp":1727702434000},"page":"e002799","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Prehospital factors predicting mortality in patients with shock: state-wide linkage study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9160-9422","authenticated-orcid":false,"given":"Amminadab L","family":"Eliakundu","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Department of Cardiology, The Alfred Hospital, Prahran, Victoria, Australia"},{"name":"Centre for Research and Evaluation, 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Ambulance Victoria, Blackburn, Victoria, Australia"},{"name":"Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Nehme","sequence":"additional","affiliation":[{"name":"Centre for Research and Evaluation, Ambulance Victoria, Blackburn, Victoria, Australia"},{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Okyere","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Centre for Research and Evaluation, Ambulance Victoria, Blackburn, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Heritier","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandr","family":"Voskoboinik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Alfred Hospital, Prahran, Victoria, Australia"},{"name":"Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3789-5808","authenticated-orcid":false,"given":"Luke","family":"Dawson","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Centre for Research and Evaluation, Ambulance Victoria, Blackburn, Victoria, Australia"},{"name":"Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Cox","sequence":"additional","affiliation":[{"name":"Centre for Research and Evaluation, Ambulance Victoria, Blackburn, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Alfred Hospital, Prahran, Victoria, Australia"},{"name":"Department of Intensive Care & Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia"},{"name":"Department of Paramedicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Burrell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"ANZ Intensive Care Research Centre, The Alfred Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pilcher","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"ANZ Intensive Care Research Centre, The Alfred Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek P","family":"Chew","sequence":"additional","affiliation":[{"name":"Victorian Heart Institute, Monash University, Blackburn, Victoria, Australia"},{"name":"Victorian Heart Hospital, Blackburn, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Alfred Hospital, Prahran, Victoria, Australia"},{"name":"Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2432-1645","authenticated-orcid":false,"given":"Ziad","family":"Nehme","sequence":"additional","affiliation":[{"name":"Centre for Research and 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