Herlitz J, Bång A, Isaksson L, Karlsson T
Division of Cardiology, Sahlgrenska Hospital, University of Göteborg, Sweden.
Eur Heart J. 1995 Dec;16(12):1789-94. doi: 10.1093/oxfordjournals.eurheartj.a060829.
A large number of patients who call for an ambulance because of acute chest pain have an acute ischaemic event, but some do not. AIM. To relate the ambulance despatcher's estimated severity of pain and presence of associated symptoms, in patients who call for an ambulance because of acute chest pain, to whether they develop acute myocardial infarction (AMI) and to the risk of early death.
All those with acute chest pain who contacted the despatch centre in Göteborg over a 2-month period.
In all, 503 patients fulfilled the inclusion criteria. Patients judged as having severe chest pain (68%) developed AMI during the first 3 days in hospital on 26% of occasions as compared with 13% among patients judged as having only vague chest pain (P = 0.0004). The difference was less marked among the elderly and women. The presence of any of the following associated symptoms, dyspnoea, nausea, vertigo, cold sweat or syncope, tended to be associated with a higher infarction rate (24%) than if none of these symptoms was present (17%, P = 0.06). Mortality during the pre-hospital and the hospital phase was not associated with the estimated severity of pain or the presence of associated symptoms.
The despatcher's estimation of the severity of pain and the presence of associated symptoms appears to be associated with the development of AMI but not with early mortality.
大量因急性胸痛呼叫救护车的患者发生了急性缺血性事件，但也有一些患者没有。目的：探讨因急性胸痛呼叫救护车的患者中，救护车调度员对疼痛严重程度及相关症状的评估与急性心肌梗死（AMI）的发生以及早期死亡风险之间的关系。
在两个月内联系哥德堡调度中心的所有急性胸痛患者。
共有503名患者符合纳入标准。被判定为严重胸痛的患者（68%）在入院后的头3天内发生AMI的比例为26%，而被判定为仅有模糊胸痛的患者这一比例为13%（P = 0.0004）。在老年人和女性中，这种差异不太明显。出现以下任何一种相关症状，如呼吸困难、恶心、眩晕、冷汗或晕厥，其梗死发生率（24%）往往高于无这些症状的患者（17%，P = 0.06）。院前和住院期间的死亡率与疼痛严重程度评估或相关症状的存在无关。
调度员对疼痛严重程度和相关症状的评估似乎与AMI的发生有关，但与早期死亡率无关。
