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Could ten questions asked by the dispatch center predict the outcome for patients with chest discomfort?
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Prehospen)
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2016 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 209, 223-225 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIMS: From 2009 to 2010, approximately 14,000 consecutive persons who called for the EMS due to chest discomfort were registered. From the seventh month, dispatchers ask 2285 patient ten pre-specified questions. We evaluate which of these questions was independently able to predict an acute coronary syndrome (ACS), life-threatening condition (LTC) and death.

METHODS: The questions asked mainly dealt with previous history and type of symptoms, each with yes/no answers. The dispatcher took a decision on priority; 1) immediately with sirens/blue light; 2) EMS on the scene within 30min; 3) normal waiting time.We examined the relationship between the answers to these questions and subsequent dispatch priority, as well as outcome, in terms of ACS, LTC and all-cause mortality.

RESULTS: 2285 patients (mean age 67years, 49% women) took part, of which 12% had a final diagnosis of ACS and 15% had a LTC. There was a significant relationship between all the ten questions and the priority given by dispatchers. Localisation of the discomfort to the center of the chest, more intensive pain, history of angina or myocardial infarction as well as experience of cold sweat were the most important predictors when evaluating the probability of ACS and LTC. Not breathing normally and having diabetes were related to 30-day mortality.

CONCLUSIONS: Among individuals, who call for the EMS due to chest discomfort, the intensity and the localisation of the pain, as well as a history of ischemic heart disease, appeared to be the most strongly associated with outcome.

Place, publisher, year, edition, pages
2016. Vol. 209, 223-225 p.
Keyword [en]
acute coronary syndrome, aged, angina pectoris, apparent life threatening event, Article, breathing disorder, clinical decision making, cold sweat, diabetes mellitus, disease association, emergency health service, female, health care availability, health care need, heart infarction, human, ischemic heart disease, major clinical study, male, medical history, mortality, outcome assessment, pain assessment, priority journal, symptomatology, telephone interview, thorax pain
National Category
Clinical Medicine
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-11510DOI: 10.1016/j.ijcard.2016.02.011ISI: 000372530700061PubMedID: 26897074Scopus ID: 84961743190OAI: oai:DiVA.org:hb-11510DiVA: diva2:1059457
Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2016-12-28Bibliographically approved

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Herlitz, JohanBång, Angela
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