Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
Scand J Trauma Resusc Emerg Med. 2019 Aug 29;27(1):84. doi: 10.1186/s13049-019-0659-6.
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.
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.
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.
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.
胸痛在急性救护车转运中很常见。本研究旨在对胸痛患者和非胸痛患者进行特征描述和比较，并评估急救电话时可获得的患者特征和伴随症状是否可预测胸痛患者的病因和结局。
这是一项回顾性、基于人群的观察性研究，包括急性救护车转运。患者特征和症状纳入多变量风险模型，以确定与无急性心脏诊断出院和胸痛事件后 30 天存活相关的特征。
在 61088 例急性救护车转运中，共有 10033 例（16.4%）是由于胸痛。胸痛患者的 30 天死亡率为 2.1%（95%CI 1.8-2.4），而非胸痛患者为 6.0%（95%CI 5.7-6.2）。在胸痛患者中，1054 例（10.5%）诊断为急性心肌梗死，5068 例（50.5%）无任何疾病诊断出院。该无诊断组的 30 天死亡率非常低，为 0.4%（95%CI 0.2-0.9）。女性、年龄较小、慢性肺部疾病、无呼吸困难等伴随症状、无辐射、疼痛持续>5 分钟、皮肤湿冷、不适和恶心与无急性心脏诊断出院和胸痛事件后 30 天存活相关。
胸痛是救护车转运的常见原因，但大多数患者无诊断且存活率高。早期风险预测似乎为资源降级和成本节约提供了潜力，可应用于某些胸痛患者。
