Observational studyPloS one2022
Shedding light into the black box of out-of-hospital respiratory distress-A retrospective cohort analysis of discharge diagnoses, prehospital diagnostic accuracy, and predictors of mortality.
Observational study in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 7 citations in OpenAlex.
- RECOVER Guidelines: First Aid in Dogs and Cats. Evidence and Knowledge Gap Analysis With Treatment Recommendations.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2026Article
- RECOVER Guidelines: First Aid for Dogs and Cats. Clinical Guidelines.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2026Article
- Final diagnoses and mortality rates in ambulance patients administered nebulized β2-agonists bronchodilators.Internal and emergency medicine · 2025Observational
- Telemedicine for prehospital respiratory emergencies in a retrospective quality analysis.Scientific reports · 2025Article
- Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service-a subanalysis of the TEMS-trial.Frontiers in digital health · 2025Article
- Machine Learning Models for Differentiating Causes of Dyspnea in Emergency Department Patients: A Retrospective Study.Journal of multidisciplinary healthcare · 2025Article
- Prehospital emergency anesthesia: A single-center retrospective analysis of guideline adherence and unexpected incidents.PloS one · 2024Article
- Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough respiratory distress is one of the most common complaints of patients requiring emergency medical services (EMS), there is a lack of evidence on important aspects.
objectivesOur study aims to determine the accuracy of EMS physician diagnostics in the out-of-hospital setting, identify examination findings that correlate with diagnoses, investigate hospital mortality, and identify mortality-associated predictors.
methodsThis retrospective observational study examined EMS encounters between December 2015 and May 2016 in the city of Aachen, Germany, in which an EMS physician was present at the scene. Adult patients were included if the EMS physician initially detected dyspnea, low oxygen saturation, or pathological auscultation findings at the scene (n = 719). The analyses were performed by linking out-of-hospital data to hospital records and using binary logistic regressions.
resultsThe overall diagnostic accuracy was 69.9% (485/694). The highest diagnostic accuracies were observed in asthma (15/15; 100%), hypertensive crisis (28/33; 84.4%), and COPD exacerbation (114/138; 82.6%), lowest accuracies were observed in pneumonia (70/142; 49.3%), pulmonary embolism (8/18; 44.4%), and urinary tract infection (14/35; 40%). The overall hospital mortality rate was 13.8% (99/719). The highest hospital mortality rates were seen in pneumonia (44/142; 31%) and urinary tract infection (7/35; 20%). Identified risk factors for hospital mortality were metabolic acidosis in the initial blood gas analysis (odds ratio (OR) 11.84), the diagnosis of pneumonia (OR 3.22) reduced vigilance (OR 2.58), low oxygen saturation (OR 2.23), and increasing age (OR 1.03 by 1 year increase).
conclusionsOur data highlight the diagnostic uncertainties and high mortality in out-of-hospital emergency patients presenting with respiratory distress. Pneumonia was the most common and most frequently misdiagnosed cause and showed highest hospital mortality. The identified predictors could contribute to an early detection of patients at risk.
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