Herlitz J, Bång A, Isaksson L, Karlsson T
Division of Cardiology, Sahlgrenska Hospital, University of Göteborg, Sweden.
Eur J Emerg Med. 1995 Jun;2(2):75-82. doi: 10.1097/00063110-199506000-00004.
The very early handling of patients with suspected acute myocardial infarction (AMI) is of critical importance to the outcome. The aim of this study was to relate the dispatcher's initial suspicion of AMI, among patients who call for an ambulance due to chest pain, to the subsequent diagnosis and outcome. All patients who called for an ambulance in Gothenburg due to acute chest pain during a 2-month period were included in the study. In all, 503 patients fulfilled the inclusion criteria, and information on the dispatcher's initial suspicion of AMI was available in 484 patients. There was at least a strong suspicion of AMI in 36%, a moderate suspicion of AMI in 34% and only a vague or no suspicion in 30%. Among patients with at least a strong suspicion of AMI, 29% subsequently developed infarcation, compared with 18% among patients with a moderate suspicion of AMI and 15% among patients with only a vague or no suspicion (p < 0.001). However, the priority level was similar in patients with and without a life-threatening condition, and the mortality rate remained similar in patients with a strong suspicion and those without a strong suspicion of AMI. Thus, among patients who called for an ambulance due to acute chest pain there was a direct relationship between the dispatcher's suspicion of AMI and the subsequent diagnosis, but the mortality rate was similar in the different groups.
对疑似急性心肌梗死（AMI）患者的早期处理对其预后至关重要。本研究的目的是探讨胸痛呼叫救护车患者中调度员对AMI的初步怀疑与后续诊断及预后之间的关系。研究纳入了哥德堡在2个月内因急性胸痛呼叫救护车的所有患者。共有503例患者符合纳入标准，其中484例患者有调度员对AMI初步怀疑的相关信息。至少高度怀疑AMI的患者占36%，中度怀疑AMI的患者占34%，仅有模糊怀疑或无怀疑的患者占30%。在至少高度怀疑AMI的患者中，29%随后发生梗死，中度怀疑AMI的患者中这一比例为18%，仅有模糊怀疑或无怀疑的患者中为15%（p<0.001）。然而，有或无危及生命情况患者的优先级别相似，高度怀疑AMI和未高度怀疑AMI患者的死亡率也相似。因此，在因急性胸痛呼叫救护车的患者中，调度员对AMI的怀疑与后续诊断之间存在直接关系，但不同组的死亡率相似。
