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A description of the prehospital phase of aortic dissection in terms of early suspicion and treatment.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
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2015 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 30, no 2Article in journal, Editorial material (Refereed) 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.

Place, publisher, year, edition, pages
2015. Vol. 30, no 2
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-8427DOI: 10.1017/S1049023X15000060PubMedID: 25668482OAI: oai:DiVA.org:hb-8427DiVA: diva2:893227
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2017-05-02Bibliographically approved

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Axelsson, ChristerHerlitz, Johan
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CiteExportLink to record
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Citation style
  • apa
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