ArticleScandinavian journal of trauma, resuscitation and emergency medicine2016
Dyspnea, a high-risk symptom in patients suspected of myocardial infarction in the ambulance? A population-based follow-up study.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Dyspnea is severe and associated with a higher intubation rate in de novo acute hypoxemic respiratory failure.Critical care (London, England) · 2024Trial
- Patient-reported dyspnoea predicts six-fold increased hospital mortality.ERJ open research · 2026Article
- Dyspnea as a marker of prognosis in immunocompromised patients with acute respiratory failure.Annals of intensive care · 2026Article
- Frequencies and Trends of Myocardial Infarction Symptoms From the Years 1985-2019: A Register-based, Real-world Analysis.CJC open · 2025Article
- The predictive role of dyspnea in left main and/or three-vessel coronary artery involvement in patients with myocardial infarction: an analytical cross-sectional study.BMC cardiovascular disorders · 2025Article
- Severity of Airflow Obstruction Based on FEVAmerican journal of respiratory and critical care medicine · 2024Article
- Association of accompanying dyspnoea with diagnosis and outcome of patients presenting with acute chest discomfort.European heart journal. Acute cardiovascular care · 2023Article
- PrehospitaL Ultrasound in Undifferentiated DyspnEa (PreLUDE): a prospective, clinical, observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Observational
- Characteristics and outcomes of patients with dyspnoea as the main symptom, assessed by prehospital emergency nurses- a retrospective observational study.BMC emergency medicine · 2020Observational
- Point-of-care ultrasound induced changes in management of unselected patients in the emergency department - a prospective single-blinded observational trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Observational
- Article
- Acute pain in the prehospital setting: a register-based study of 41.241 patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Observational
- Prehospital triage of patients diagnosed with perforated peptic ulcer or peptic ulcer bleeding: an observational study of patients calling 1-1-2.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Observational
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9 authors.
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Abstract
backgroundSystematic management of patients suffering high-risk symptoms is essential in emergency medical services. Patients with chest pain receive algorithm-based work-up and treatment. Though dyspnea is recognized as an independent predictor of mortality, no generally accepted prehospital treatment algorithm exists and this may affect outcome. The objective of this study was to compare mortality in patients suspected of myocardial infarction (MI) presenting with dyspnea versus chest pain in the ambulance.
methodsFollow-up study in patients undergoing electrocardiogram-based telemedical triage because of suspected MI in an ambulance in the Central Denmark Region from 1 June 2008 to 1 January 2013. Primary outcome was 30-day mortality. Secondary outcomes were 4-year mortality and mortality rates in subgroups of patients with and without a confirmed MI. Absolute risk differences adjusted for comorbidity, age, systolic blood pressure and heart rate were calculated by a generalized linear regression model.
resultsOf 17,398 patients, 12,230 (70%) suffered from chest pain, 1464 (8%) from dyspnea, 3540 (20%) from other symptoms and 164 (1%) from cardiac arrest. Among patients with dyspnea, 30-day mortality was 13% (CI 12-15) and 4-year mortality was 50% (CI 47-54) compared to 2.9% (CI 2.6-3.2) and 20% (CI 19-21) in patients with chest pain. MI was confirmed in 121 (8.3%) patients with dyspnea and in 2319 (19%) with chest pain. Patients with dyspnea and confirmed MI had a 30-day and 4-year mortality of 21 % (CI 15-30) and 60% (CI 50-70) compared to 5.0% (CI 4.2-5.8) and 23% (CI 21-25) in patients with chest pain and confirmed MI. Adjusting for age, comorbidity, systolic blood pressure and heart rate did not change these patterns.
conclusionPatients suspected of MI presenting with dyspnea have significantly higher short- and long-term mortality than patients with chest pain irrespective of a confirmed MI diagnosis. Future studies should examine if supplementary prehospital diagnostics can improve triage, facilitate early therapy and improve outcome in patients presenting with dyspnea.
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