Araz Rawshani1, Anna Larsson2, Carita Gelang2, Jonny Lindqvist3, Martin Gellerstedt4, Angela Bång2, Johan Herlitz5. 1. Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. Electronic address: araz.rawshani@gu.se. 2. The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden. 3. Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. 4. The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden; University West, School of Business, Economics and IT, Trollhättan, Sweden. 5. Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
Abstract
OBJECTIVES: This study aims to describe patients who called for the emergency medical service (EMS) due to chest discomfort, in relation to gender and age. METHODS: All patients who called the emergency dispatch centre of western Sweden due to chest discomfort, between May 2009 and February 2010, were included. Initial evaluation, aetiology and outcome are described as recorded in the databases at the dispatch centre, the EMS systems and hospitals. Patients were divided into the following age groups: ≤50, 51-64 and ≥65 years. RESULTS: In all, 14,454 cases were enrolled. Equal proportions of men (64%) and women (63%) were given dispatch priority 1. The EMS clinicians gave priority 1 more frequently to men (16% versus 12%) and older individuals (10%, 15% and 14%, respective of age group). Men had a significantly higher frequency of central chest pain (83% versus 81%); circulatory compromise (34% versus 31%); ECG signs of ischaemia (17% versus 11%); a preliminary diagnosis of acute coronary syndrome (40% versus 34%); a final diagnosis of acute myocardial infarction (14% versus 9%) and any potentially life-threatening condition (18% versus 12%). Individuals aged ≥65 years were given a lower priority than individuals aged 51-64 years, despite poorer characteristics and outcome. In all, 78% of cases with a potentially life-threatening condition and 67% of cases that died within 30 days of enrolment received dispatch priority 1. Mortality at one year was 1%, 4% and 18% in each individual age group. CONCLUSION: Men and the elderly were given a disproportionately low priority by the EMS.
OBJECTIVES: This study aims to describe patients who called for the emergency medical service (EMS) due to chest discomfort, in relation to gender and age. METHODS: All patients who called the emergency dispatch centre of western Sweden due to chest discomfort, between May 2009 and February 2010, were included. Initial evaluation, aetiology and outcome are described as recorded in the databases at the dispatch centre, the EMS systems and hospitals. Patients were divided into the following age groups: ≤50, 51-64 and ≥65 years. RESULTS: In all, 14,454 cases were enrolled. Equal proportions of men (64%) and women (63%) were given dispatch priority 1. The EMS clinicians gave priority 1 more frequently to men (16% versus 12%) and older individuals (10%, 15% and 14%, respective of age group). Men had a significantly higher frequency of central chest pain (83% versus 81%); circulatory compromise (34% versus 31%); ECG signs of ischaemia (17% versus 11%); a preliminary diagnosis of acute coronary syndrome (40% versus 34%); a final diagnosis of acute myocardial infarction (14% versus 9%) and any potentially life-threatening condition (18% versus 12%). Individuals aged ≥65 years were given a lower priority than individuals aged 51-64 years, despite poorer characteristics and outcome. In all, 78% of cases with a potentially life-threatening condition and 67% of cases that died within 30 days of enrolment received dispatch priority 1. Mortality at one year was 1%, 4% and 18% in each individual age group. CONCLUSION:Men and the elderly were given a disproportionately low priority by the EMS.
Authors: Loes T Wouters; Dorien L Zwart; Daphne C Erkelens; Noël S Cheung; Esther de Groot; Roger A Damoiseaux; Arno W Hoes; Frans H Rutten Journal: Fam Pract Date: 2020-09-05 Impact factor: 2.267
Authors: Daphne Ca Erkelens; Loes Tcm Wouters; Dorien Lm Zwart; Roger Amj Damoiseaux; Esther De Groot; Arno W Hoes; Frans H Rutten Journal: BMJ Open Date: 2019-07-01 Impact factor: 2.692
Authors: Loes Tcm Wouters; Frans H Rutten; Daphne Ca Erkelens; Esther De Groot; Roger Amj Damoiseaux; Dorien Lm Zwart Journal: Open Heart Date: 2020-08