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Characteristics and outcomes of patients with dyspnoea as the main symptom, assessed by prehospital emergency nurses- a retrospective observational study
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Prehospen, Högteknologisk vård)ORCID iD: 0000-0002-2729-1923
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
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2020 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 20, no 1, p. 1-11Article in journal (Refereed) Published
Abstract [en]

Background: Dyspnoea (breathing difficulty) is among the most commonly cited reasons for contacting emergency medical services (EMSs). Dyspnoea is caused by several serious underlying medical conditions and, based on patients individual needs and complex illnesses or injuries, ambulance staff are independently responsible for advanced care provision. Few large-scale prehospital studies have reviewed patients with dyspnoea. This study aimed to describe the characteristics and final outcomes of patients whose main symptom was classified as dyspnoea by the prehospital emergency nurse (PEN).

Methods: This retrospective observational study included patients aged >16 years whose main symptom was dyspnoea. All the enrolled patients were assessed in the south-western part of Sweden by PENs during January and December, 2017. Of 7,260 assignments (9% of all primary missions), 6,354 fulfilled the inclusion criteria. Analysis was performed using descriptive statistics, and the tests used were odds ratios and Kaplan-Meier analysis.

Results: The patients mean age was 73 years, and approximately 56% were women. More than 400 different final diagnostic codes (International Statistical Classification of Diseases and Related Health Problems [ICD]-10th edition) were observed, and 11% of the ICD-10 codes denoted time-critical conditions. The three most commonly observed aetiologies were chronic obstructive pulmonary disease (20.4%), pulmonary infection (17.1%), and heart failure (15%). The comorbidity values were high, with 84.4% having previously experienced dyspnoea. The overall 30-day mortality was 11.1%. More than half called EMSs more than 50 hours after symptom onset.

Conclusions:  Among patients assessed by PENs due to dyspnoea as the main symptom there were more than 400 different final diagnoses, of which 11% were regarded as time-critical. These patients had a severe comorbidity and 11% died within the first 30 days.

Place, publisher, year, edition, pages
Springer Nature, 2020. Vol. 20, no 1, p. 1-11
Keywords [en]
Dyspnoea, Epidemiology, Aetiology, Major incidents, Prevention, Emergency Medical Service, Prehospital Emergency Nurse, Ambulance
National Category
General Practice
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-23808DOI: 10.1186/s12873-020-00363-6ISI: 000567505700002Scopus ID: 2-s2.0-85090177607OAI: oai:DiVA.org:hb-23808DiVA, id: diva2:1468404
Available from: 2020-09-17 Created: 2020-09-17 Last updated: 2023-10-20Bibliographically approved

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Kauppi, WivicaHerlitz, JohanPalmér, LinaAxelsson, Christer

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Kauppi, W. (2017). Prehospital dyspnoea.

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