• Hu Hai, He Ya-rong, Du Xin-miao, Zhang Shu, Ye Lei, Wan Zhi, Nie Hu, Yu Hai-fang, Lau Wayne Bond, and Cao Yu.
• aEmergency Medicine Department of West China Hospital, Sichuan University bDepartment of Respiratory and Critical Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China cDepartment of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
• Eur J Emerg Med. 2014 Oct 1;21(5):364-7.

ObjectivesPrevious studies have reported that civilian transport is a mortality risk factor in low-resource communities. Few studies have analyzed the chief complaints associated with mortality involving civilian transport after an earthquake.Therefore, the present study was conducted to determine whether mortality resulting from medical professional transport differs from that involving civilian transport, and if so, the chief complaints associated with mortality involving civilian transport after the Wen-chuan earthquake.MethodsA hospital-based case-control study was conducted. Cases included all victims transported by civilians to West China Hospital from the disaster area (n=473). Controls included all victims transported by medical professionals to West China Hospital (n=1452). We further analyze six potential chief complaints of death to clarify the specific contributing chief complaints associated with mortality involving civilian transport.ResultsCivilian transport is associated with significantly greater mortality compared with medical professional transport (Pearson's χ-test: P<0.05). Patients with altered mental status had the greatest risk of death [odds ratio (OR)=4.552, 95% confidence interval (CI)=2.165-9.572], followed by patients with trunk injury (OR=2.517, 95% CI=1.251-5.066), and finally patients with shortness of breath (OR=2.345, 95% CI=1.040-5.288).ConclusionAltered mental status, trunk injury, and shortness of breath were the significant chief complaints associated with mortality involving civilian transport to the hospital after the Wen-chuan earthquake. Our data suggest that patients with any of these complaints should be transported by medical professionals, not civilians, to the nearest hospital for treatment.

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