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Association between the reported intensity of an acute symptom at first prehospital assessment and the subsequent outcome: a study on patients with acute chest pain and presumed acute coronary syndrome
Sörmland County Council, Sweden;Mälardalen University, Sweden;University of Borås, Sweden.ORCID iD: 0000-0003-1878-0992
University of Borås, Sweden.
South Älvsborgs Hospital, Sweden.
South Älvsborgs Hospital, Sweden.
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2018 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 18, p. 1-10, article id 216Article in journal (Refereed) Published
Abstract [en]

Background: To decrease the morbidity burden of cardiovascular disease and to avoid the development of potentially preventable complications, early assessment and treatment of acute coronary syndrome (ACS) are important. The aim of this study has therefore been to explore the possible association between patients' estimated intensity of chest pain when first seen by the ambulance crew in suspected ACS, and the subsequent outcome before and after arrival in hospital. 

Methods: Data was collected both prospectively and retrospectively. The inclusion criteria were chest pain raising suspicion of ACS and a reported intensity of pain 4 on the visual analogue scale. 

Results: All in all, 1603 patients were included in the study. Increased intensity of chest pain was related to: 1) more heart-related complications before hospital admission; 2) a higher proportion of heart failure, anxiety and chest pain after hospital admission; 3) a higher proportion of acute myocardial infarction and 4) a prolonged hospitalisation. However, there was no significant association with mortality neither in 30 days nor in three years. Adjustment for possible confounders including age, a history of smoking and heart failure showed similar results. 

Conclusion: The estimated intensity of chest pain reported by the patients on admission by the ambulance team was associated with the risk of complications prior to hospital admission, heart failure, anxiety and chest pain after hospital admission, the final diagnosis and the number of days in hospital.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 18, p. 1-10, article id 216
Keywords [en]
Acute coronary syndrome, Ambulance care, Ambulance nurse, Assessment, Chest pain, Patients ́ experiences
National Category
Cardiac and Cardiovascular Systems
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-79554DOI: 10.1186/s12872-018-0957-3ISI: 000451531300001PubMedID: 30486789Scopus ID: 2-s2.0-85057532229OAI: oai:DiVA.org:lnu-79554DiVA, id: diva2:1279336
Available from: 2019-01-16 Created: 2019-01-16 Last updated: 2019-08-28Bibliographically approved

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Holmberg, Mats

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