AI Article Synopsis
- Chest pain accounts for 16.4% of acute ambulance transports, with a 30-day mortality rate of 2.1% for these patients compared to 6.0% for those without chest pain.
- 1034 chest pain patients were diagnosed with acute myocardial infarction, while over half were discharged without a diagnosis but had a very low mortality rate of 0.4%.
- Factors like female gender, younger age, and absence of severe symptoms were linked to being discharged without an acute cardiac diagnosis, suggesting the potential for better risk assessment and resource management in ambulance care.
Article Abstract
Background: Chest pain is common in acute ambulance transports. This study aims to characterize and compare ambulance-transported chest pain patients to non-chest pain patients and evaluate if patient characteristics and accompanying symptoms accessible at the time of emergency call can predict cause and outcome in chest pain patients.
Methods: Retrospective, observational population-based study, including acute ambulance transports. Patient characteristics and symptoms are included in a multivariable risk model to identify characteristics, associated with being discharged without an acute cardiac diagnosis and surviving 30 days after chest pain event.
Results: In total, 10,033 of 61,088 (16.4%) acute ambulance transports were due to chest pain. In chest pain patients, 30-day mortality was 2.1% (95%CI 1.8-2.4) compared to 6.0% (95%CI 5.7-6.2) in non-chest pain patients. Of chest pain patients, 1054 (10.5%) were diagnosed with acute myocardial infarction, and 5068 (50.5%) were discharged without any diagnosis of disease. This no-diagnosis group had very low 30-day mortality, 0.4% (95%CI 0.2-0.9). Female gender, younger age, chronic pulmonary disease, absence of accompanying symptoms of dyspnoea, radiation, severe pain for > 5 min, clammy skin, uncomfortable, and nausea were associated with being discharged without an acute cardiac diagnosis and surviving 30 days after a chest pain event.
Conclusion: Chest pain is a common reason for ambulance transport, but the majority of patients are discharged without a diagnosis and with a high survival rate. Early risk prediction seems to hold a potential for resource downgrading and thus cost-saving in selected chest pain patients.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716930 | PMC |
| http://dx.doi.org/10.1186/s13049-019-0659-6 | DOI Listing |
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