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Pre-hospital prediction of death or cardiovascular complications during hospitalisation and death within one year in suspected acute coronary syndrome patients.
Göteborgs Universitet. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
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2015 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 185, 308-312 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To identify pre-hospital predictors of a) death or the development of cardiovascular complications during hospitalisation (primary objective) and b) all-cause death during one year of follow-up (secondary objective), in chest pain patients with suspected acute coronary syndrome (ACS).

METHODS: A prospective study that comprised patients in western Sweden, who were transported to hospital by the emergency medical service (EMS) due to chest pain and suspected ACS. Multiple logistic regression was used to identify independent predictors of adverse outcomes.

RESULTS: Among all 1600 eligible patients, 21% died or had a cardiovascular complication during hospitalisation and 10% died during one year of follow-up. Nine factors were identified pre-hospitalisation as independent predictors of death or cardiovascular complications during hospitalisation. They were increasing age, a history of congestive heart failure, nausea and/or vomiting, rapid breathing rate, low oxygen saturation, high heart rate, together with ST-segment elevation, ST-segment depression and right bundle branch block on the pre-hospital electrocardiogram (ECG). For the secondary objective of death during one year of follow-up, the following five factors were identified as independent predictors: increasing age, a history of congestive heart failure, dyspnea, low oxygen saturation and left bundle branch block on the pre-hospital ECG.

CONCLUSIONS: In the pre-hospital setting of chest pain and suspected ACS, we identified nine predictors of the primary adverse outcome. They were factors representing previous history, symptoms and ECG findings. This information may contribute to the development of a decision support system for the EMS, which then needs to be clinically tested.

Place, publisher, year, edition, pages
2015. Vol. 185, 308-312 p.
Keyword [en]
Ambulanssjukvård
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-8434DOI: 10.1016/j.ijcard.2015.03.143PubMedID: 25828671OAI: oai:DiVA.org:hb-8434DiVA: diva2:893296
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2016-01-12

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