More emergency patients presenting with chest pain.

<h4>Introduction</h4>Throughout recent years the demand for prehospital emergency care has increased significantly. Non-traumatic chest pain is one of the most frequent complaints. Our aim was to investigate the trend in frequency of the most urgent ambulance patients with chest pain, su...

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Main Authors: Tim Alex Lindskou, Patricia Jessen Andersen, Erika Frischknecht Christensen, Morten Breinholt Søvsø
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0283454
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author Tim Alex Lindskou
Patricia Jessen Andersen
Erika Frischknecht Christensen
Morten Breinholt Søvsø
author_facet Tim Alex Lindskou
Patricia Jessen Andersen
Erika Frischknecht Christensen
Morten Breinholt Søvsø
author_sort Tim Alex Lindskou
collection DOAJ
description <h4>Introduction</h4>Throughout recent years the demand for prehospital emergency care has increased significantly. Non-traumatic chest pain is one of the most frequent complaints. Our aim was to investigate the trend in frequency of the most urgent ambulance patients with chest pain, subsequent acute myocardial infarction (AMI) diagnoses, and 48-hour and 30-day mortality of both groups.<h4>Methods</h4>Population-based historic cohort study in the North Denmark Region during 2012-2018 including chest pain patients transported to hospital by highest urgency level ambulance following a 1-1-2 emergency call. Primary diagnoses (ICD-10) were retrieved from the regional Patient Administrative System, and descriptive statistics (distribution, frequency) performed. We evaluated time trends using linear regression, and mortality (48 hours and 30 days) was assessed by the Kaplan Meier estimator.<h4>Results</h4>We included 18,971 chest pain patients, 33.9% (n = 6,430) were diagnosed with"Diseases of the circulatory system" followed by the non-specific R- (n = 5,288, 27.8%) and Z-diagnoses (n = 3,634; 19.2%). AMI was diagnosed in 1,967 patients (10.4%), most were non-ST-elevation AMI (39.7%). Frequency of chest pain patients and AMI increased 255 and 22 patients per year respectively, whereas the AMI proportion remained statistically stable, with a tendency towards a decrease in the last years. Mortality at 48 hours and day 30 in chest pain patients was 0.7% (95% CI 0.5% to 0.8%) and 2.4% (95% CI 2.1% to 2.6%).<h4>Conclusions</h4>The frequency of chest pain patients brought to hospital during 2012-2018 increased. One-tenth were diagnosed with AMI, and the proportion of AMI patients was stable. Almost 1 in of 4 high urgency level ambulances was sent to chest pain patients. Only 1 of 10 patients with chest pain had AMI, and overall mortality was low. Thus, monitoring the number of chest pain patients and AMI diagnoses should be considered to evaluate ambulance utilisation and triage.
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spelling doaj.art-1702234c7cb24548a35b22304a2ecac32023-04-21T05:34:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183e028345410.1371/journal.pone.0283454More emergency patients presenting with chest pain.Tim Alex LindskouPatricia Jessen AndersenErika Frischknecht ChristensenMorten Breinholt Søvsø<h4>Introduction</h4>Throughout recent years the demand for prehospital emergency care has increased significantly. Non-traumatic chest pain is one of the most frequent complaints. Our aim was to investigate the trend in frequency of the most urgent ambulance patients with chest pain, subsequent acute myocardial infarction (AMI) diagnoses, and 48-hour and 30-day mortality of both groups.<h4>Methods</h4>Population-based historic cohort study in the North Denmark Region during 2012-2018 including chest pain patients transported to hospital by highest urgency level ambulance following a 1-1-2 emergency call. Primary diagnoses (ICD-10) were retrieved from the regional Patient Administrative System, and descriptive statistics (distribution, frequency) performed. We evaluated time trends using linear regression, and mortality (48 hours and 30 days) was assessed by the Kaplan Meier estimator.<h4>Results</h4>We included 18,971 chest pain patients, 33.9% (n = 6,430) were diagnosed with"Diseases of the circulatory system" followed by the non-specific R- (n = 5,288, 27.8%) and Z-diagnoses (n = 3,634; 19.2%). AMI was diagnosed in 1,967 patients (10.4%), most were non-ST-elevation AMI (39.7%). Frequency of chest pain patients and AMI increased 255 and 22 patients per year respectively, whereas the AMI proportion remained statistically stable, with a tendency towards a decrease in the last years. Mortality at 48 hours and day 30 in chest pain patients was 0.7% (95% CI 0.5% to 0.8%) and 2.4% (95% CI 2.1% to 2.6%).<h4>Conclusions</h4>The frequency of chest pain patients brought to hospital during 2012-2018 increased. One-tenth were diagnosed with AMI, and the proportion of AMI patients was stable. Almost 1 in of 4 high urgency level ambulances was sent to chest pain patients. Only 1 of 10 patients with chest pain had AMI, and overall mortality was low. Thus, monitoring the number of chest pain patients and AMI diagnoses should be considered to evaluate ambulance utilisation and triage.https://doi.org/10.1371/journal.pone.0283454
spellingShingle Tim Alex Lindskou
Patricia Jessen Andersen
Erika Frischknecht Christensen
Morten Breinholt Søvsø
More emergency patients presenting with chest pain.
PLoS ONE
title More emergency patients presenting with chest pain.
title_full More emergency patients presenting with chest pain.
title_fullStr More emergency patients presenting with chest pain.
title_full_unstemmed More emergency patients presenting with chest pain.
title_short More emergency patients presenting with chest pain.
title_sort more emergency patients presenting with chest pain
url https://doi.org/10.1371/journal.pone.0283454
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