ArticleScandinavian journal of trauma, resuscitation and emergency medicine2023
A classification system for identifying patients dead on ambulance arrival: a prehospital medical record review.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Trends in urgency levels and risk of acute critical condition among prehospital patients. A seven-year observational historic register-based cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Does Delayed Response Due to Busy Ambulances Impact Risk of Death and Hospital Service Use?: A Cohort Study of 240,000 Medical Emergencies.Epidemiology (Cambridge, Mass.) · 2025Article
- Existing Data Sources in Clinical Epidemiology: The Danish Prehospital Medical Record System.Clinical epidemiology · 2025Review
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients dead before arrival of the ambulance or before arrival at hospital may be in- or excluded in mortality analyses, making comparison of mortality difficult. Often only physicians are allowed to declare death, thereby impeding uniform registration of prehospital death. Many studies do not report detailed definitions of prehospital mortality. Our aim was to define criteria to identify and categorize prehospital patients' vital status, and to estimate the proportion of these groups, primarily the proportion of patients dead on ambulance arrival.
methodsPrehospital medical records review for patients receiving an ambulance in the North Denmark Region from 2019 to 2021 and registered dead on the same or the following day. We defined three vital status categories: (1) Dead on Ambulance Arrival (DOAA), (2) Out-of-Hospital Cardiac Arrest (OHCA) divided into OHCA Basic Life Support (OHCA BLS) and OHCA Advanced treatment, and 3) Alive on Ambulance Arrival.
resultsAmong 3 174 dead patients, DOAA constituted 28.8%, OHCA BLS 13.4%, OHCA Advanced treatment 31.3%, and Alive on Ambulance Arrival 26.6%.
conclusionWe defined exhaustive and mutually exclusive criteria to define vital status, DOAA, OHCA, and Alive on Ambulance Arrival based on prehospital medical records. More than one out of four patients receiving an ambulance and registered dead on the same or the following day were dead already at ambulance arrival. Adding OHCA BLS where resuscitation was terminated without defibrillation or other treatment, increased the proportion of patients dead on ambulance arrival to 42%. We recommend reporting similar categories of vital status to improve valid comparisons of prehospital mortality rates.
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