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A description of the prehospital phase of aortic dissection in terms of early suspicion and treatment.
Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
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2015 (Engelska)Ingår i: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 30, nr 2Artikel i tidskrift, Editorial material (Refereegranskat) Published
Abstract [en]

PURPOSE: Aortic dissection is difficult to detect in the early phase due to a variety of symptoms. This report describes the prehospital setting of aortic dissection in terms of symptoms, treatment, and suspicion by the Emergency Medical Service (EMS) staff.

BASIC PROCEDURES: All patients in the Municipality of Gothenburg, Sweden, who, in 2010 and 2011, had a hospital discharge diagnosis of aortic dissection (international classification of disease (ICD) I 71,0) were included. The exclusion criteria were: age<18 years of age and having a planned operation. This was a retrospective, descriptive study based on patient records. In the statistical analyses, Fisher's exact test and the Mann-Whitney U test were used for analyses of dichotomous and continuous/ordered variables.

MAIN FINDINGS: Of 92 patients, 78% were transported to the hospital by the EMS. The most common symptom was pain (94%). Pain was intensive or very intensive in 89% of patients, with no significant difference in relation to the use of the EMS. Only 47% of those using the EMS were given pain relief with narcotic analgesics. Only 12% were free from pain on admission to the hospital. A suspicion of aortic dissection was reported by the EMS staff in only 17% of cases. The most common preliminary diagnosis at the dispatch center (31%) and by EMS clinicians (52%) was chest pain or angina pectoris. In all, 79% of patients were discharged alive from the hospital (75% of those that used the EMS and 95% of those that did not).

CONCLUSION: Among patients who were hospitalized due to aortic dissection in Gothenburg, 78% used the EMS. Despite severe pain in the majority of patients, fewer than half received narcotic analgesics, and only 12% were free from pain on admission to the hospital. In fewer than one-in-five patients was a suspicion of aortic dissection reported by the EMS staff.

Ort, förlag, år, upplaga, sidor
2015. Vol. 30, nr 2
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Människan i vården
Identifikatorer
URN: urn:nbn:se:hb:diva-8427DOI: 10.1017/S1049023X15000060ISI: 000358409100008PubMedID: 25668482Scopus ID: 2-s2.0-84925444744OAI: oai:DiVA.org:hb-8427DiVA, id: diva2:893227
Tillgänglig från: 2016-01-12 Skapad: 2016-01-12 Senast uppdaterad: 2018-12-07Bibliografiskt granskad

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Axelsson, ChristerHerlitz, Johan

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