Prehospital factors associated with an acute life-threatening condition in non-traumatic chest pain patients — A systematic review

Wibring, Kristoffer; Herlitz, Johan; Christensson, Lennart; Lingman, Markus; Bång, Angela

doi:10.1016/j.ijcard.2016.06.066

Cited by 17 publications

(17 citation statements)

References 38 publications

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“…In this multicenter study that included fourteen regional and university hospitals, we enrolled 1173 patients consulting the ED for ACP. ACS prevalence, management and relation with CVRFs have rarely been described in our country [ 11 – 13 ]; it was considered necessary to conduct this study to provide the basis for adapted public health strategies and decisions.…”

Section: Discussionmentioning

confidence: 99%

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

et al. 2018

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BackgroundWe aimed to describe diagnosed acute coronary syndrome (ACS) and its care management and outcomes in emergency departments (EDs) and to determine related cardiovascular risk factors (CVRFs).MethodsWe conducted a cross sectional multicenter study that included 1173 adults admitted to EDs for acute chest pain (ACP) in 2015 at 14 sites in Tunisia. Data included patients’ baseline characteristics, diagnosis, treatment and output.ResultsACS represented 49.7% of non-traumatic chest pain [95% CI: 46.7–52.6]; 74.2% of ACS cases were unstable angina/non-ST-segment-elevation myocardial infarction (UA/NSTEMI). Males represented 67.4% of patients with ACS (p < 0.001). The median age was 60 years (IQR 52–70). Emergency medical service transportation was used in 11.9% of cases. The median duration between chest pain onset and ED arrival was two hours (Inter quartile ranges (IQR) 2–4 h). The age-standardized prevalence rate was 69.9/100,000 PY; the rate was 96.24 in men and 43.7 in women. In the multivariable analysis, CVRFs related to ST segment elevation myocardial infarction were age correlated to sex and active smoking. CVRFs related to UA/NSTEMI were age correlated to sex, familial and personal vascular history and type 2 diabetes. We reported 27 cases of major adverse cardiovascular events (20.0%) in patients with STEMI and 36 in patients with UA/NSTEMI (9.1%).ConclusionHalf of the patients consulting EDs with ACP had ACS. Emergency medical service transportation calls were rare. Management delays were acceptable. The risk of developing an UA/NSTEMI was equal to the number of CVRFs + 1. To improve patient outcomes, it is necessary to increase adherence to international management guidelines.

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Section: Discussionmentioning

confidence: 99%

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

et al. 2018

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“…5 In the 1980s, 28.0% of all prehospital patients had acute myocardial infarction (AMI), but this number decreased to 12.0% in 2010, indicating greater use of EMS by low-risk patients. 6 Conflicts of interest/funding: This study was funded by the American Heart Association (Dallas, Texas USA; 12CRP12000001). Dr. Mahler As prehospital health care evolves, paramedics continue to expand their scope of practice and make more complex medical decisions.…”

Section: Introductionmentioning

confidence: 99%

“…3,7 A systematic review identified increasing age, male gender, elevated heart rate, low systolic blood pressure, and ST-elevation myocardial infarction (STEMI) or depression on 12-lead electrocardiogram (ECG) as prehospital factors associated with acute life-threatening conditions in non-traumatic chest pain patients. 6 However, to date, decision aids haven't been deployed to help paramedics risk stratify patients with acute chest pain who are without evidence of STEMI on ECG.…”

Section: Introductionmentioning

confidence: 99%

Prehospital Modified HEART Score Predictive of 30-Day Adverse Cardiac Events

Stopyra

Harper

Higgins

et al. 2018

Prehosp. Disaster med.

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Prehospital modified HEART scores have a high NPV for MACE at 30 days. A study in which prehospital providers prospectively apply this decision aid is warranted. Stopyra JP , Harper WS , Higgins TJ , Prokesova JV , Winslow JE , Nelson RD , Alson RL , Davis CA , Russell GB , Miller CD , Mahler SA . Prehospital modified HEART score predictive of 30-day adverse cardiac events. Prehosp Disaster Med. 2018;33(1):58-62.

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“…Ово наглашава значај благовременог постављања радне дијагнозе и ургентне активације одговарајућих протокола (11,12). Као симптом, бол -тегоба у грудима има широку диференцијалну дијагнозу, која обухвата и многа ургентна стањa, нa пример: акутни коронарни синдром као најчешће, дисекције аорте и руптуру анеуризме, плућну емболију, пнеумоторакс, перикардитис са тампонадом и езофагеалну руптуру (13). Исхемијскa болест срца је један од водећих узрока смртности у свету (14).…”

Section: Introductionunclassified

Influence of patient gender on response time intervention at the Emergency Dispatch Centre

Šarenac¹,

Živanović²

2019

Medicinski časopis

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Prehospital factors associated with an acute life-threatening condition in non-traumatic chest pain patients — A systematic review

Cited by 17 publications

References 38 publications

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

Prehospital Modified HEART Score Predictive of 30-Day Adverse Cardiac Events

Influence of patient gender on response time intervention at the Emergency Dispatch Centre

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