Table Table11 also describes the patients’ severity of illness, represented by NACA-score stratified
by whether the doctor was alerted by radio, doctor’s response to the alarm, Ipatasertib prehospital response time and involvement of air ambulance services. Severity of illness did not seem to affect whether or not the doctor was alerted by radio alarm, but the doctors’ call out rate generally increased with the patients’ severity of illness, with a call out in one of five patients with NACA 0-1, compared to 43% of the patients with NACA 4-6. Increasing NACA-score showed a tendency towards shorter prehospital response time, but the association between increasing NACA-score and shorter Inhibitors,research,lifescience,medical prehospital Inhibitors,research,lifescience,medical response time was not significant (p = 0,07). Air ambulance was alerted in 56 (6%) of the cases, and a helicopter with an anaesthetist was sent to assist in 34 (3%) of the patients. Air ambulance service was not requested in any patients with NACA 0-1. In the group with potentially or definitely critically
ill patients (NACA 4-6), a helicopter was requested in 16% of the cases, and actually sent to assist in 10%. Analyses of the patients’ whereabouts revealed that the large majority of the patients with acute chest pain categorised as “red response” were residing at home or at private facilities, 9% were Inhibitors,research,lifescience,medical in public areas and 6% at their general practitioner’s surgery when the red response was triggered (table (table1).1). The vast majority of the patients were admitted to a hospital
for further investigation and/or treatment (N = 825, 76%), either Inhibitors,research,lifescience,medical via the casualty clinic (12%) or directly with (39%) or without (25%) being examined by a doctor. Of the 267 patients who were not admitted, 155 (58%) received final treatment at the casualty clinic, while 100 (37%) patients were not brought to a doctor for further investigation or treatment. The cases were also classified with an ICPC-2 code, with the codes A11 “Chest pain” (56%) and K01 “Heart pain” (32%) constituting the vast majority. The remainder 12% were spread over 35 different Inhibitors,research,lifescience,medical ICPC-2 codes, with A06 “Fainting/syncope” accounting for 3% of the cases, and R02/R04 “Dyspnoea/Breathing problem” 2%. An ICPC-2 code from the psychiatry-chapter (P01-P29) was used in 1%. Discussion Summary of main findings This prospective population based study showed many an estimated rate of 5.4 acute chest pain cases involved in a red response per 1000 inhabitants per year. This corresponds to approximately 10 patients with acute chest pain in need of immediate medical help each week in an out-of-hours district covering 100.000 inhabitants. Over 20% of all contacts to the EMCCs ending in a red response involved chest pain as the main symptom. Males constituted a majority of the patients, and were significantly younger than the females.