Rawshani Araz, Larsson Anna, Gelang Carita, Lindqvist Jonny, Gellerstedt Martin, Bång Angela, Herlitz Johan
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.
Int J Cardiol. 2014 Oct 20;176(3):859-65. doi: 10.1016/j.ijcard.2014.08.004. Epub 2014 Aug 8.
This study aims to describe patients who called for the emergency medical service (EMS) due to chest discomfort, in relation to gender and age.
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.
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.
Men and the elderly were given a disproportionately low priority by the EMS.
本研究旨在描述因胸部不适呼叫紧急医疗服务（EMS）的患者的性别和年龄情况。
纳入2009年5月至2010年2月期间因胸部不适呼叫瑞典西部紧急调度中心的所有患者。根据调度中心、EMS系统和医院数据库中记录的情况，描述初始评估、病因及结果。患者分为以下年龄组：≤50岁、51 - 64岁和≥65岁。
共纳入14454例病例。男性（64%）和女性（63%）获得调度优先1级的比例相当。EMS临床医生将优先1级更频繁地给予男性（16%对12%）和年龄较大者（各年龄组分别为10%、15%和14%）。男性中心胸痛的发生率显著更高（83%对81%）；循环功能障碍（34%对31%）；心电图缺血迹象（17%对11%）；急性冠状动脉综合征的初步诊断（40%对34%）；急性心肌梗死的最终诊断（14%对9%）以及任何潜在危及生命的情况（18%对12%）。≥65岁的个体获得的优先级低于51 - 64岁的个体，尽管其特征和预后较差。在所有病例中，78%有潜在危及生命情况的病例和67%在入组后30天内死亡的病例获得调度优先1级。各年龄组一年的死亡率分别为1%、4%和18%。
EMS给予男性和老年人的优先级低得不成比例。
