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Association between use of pre-hospital ECG and 30-day mortality: A large cohort study of patients experiencing chest pain
Sahlgrenska University Hospital, Östra Sjukhuset, Department of Emergency Medicine, Göteborg, Sweden.
University of Gothenburg, Department of Medicine, Göteborg, Sweden.
University of Borås, The Pre-hospital Research Centre of Western Sweden, Prehospen, Borås, Sweden.
University of Borås, The Pre-hospital Research Centre of Western Sweden, Prehospen, Borås, Sweden.
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2017 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 248, no December, 77-81 p.Article in journal (Refereed) Published
Abstract [en]

Background

In the assessment of patients with chest pain, there is support for the use of pre-hospital ECG in the literature and in the care guidelines. Using propensity score methods, we aim to examine whether the mere acquisition of a pre-hospital ECG among patients with chest pain affects the outcome (30-day mortality).

Methods

The association between pre-hospital ECG and 30-day mortality was studied in the overall cohort (n = 13151), as well as in the one-to-one matched cohort with 2524 patients not examined with pre-hospital ECG and 2524 patients examined with pre-hospital ECG.

Results

In the overall cohort, 21% (n = 2809) did not undergo an ECG tracing in the pre-hospital setting. Among those who had pain during transport, 14% (n = 1159) did not undergo a pre-hospital ECG while 32% (n = 1135) of those who did not have pain underwent an ECG tracing. In the overall cohort, the OR for 30-day mortality in patients who had a pre-hospital ECG, as compared with those who did not, was 0.63 (95% CI 0.05-0.79; p < 0.001). In the matched cohort, the OR was 0.65 (95% CI 0.49-0.85; p < 0.001). Using the propensity score, in the overall cohort, the corresponding HR was 0.65 (95% CI 0.58-0.74).

Conclusion

Using propensity score methods, we provide real-world data demonstrating that the adjusted risk of death was considerably lower among the cases in whoma pre-hospital ECG was used. The PH-ECG is underused among patients with chest discomfort and the mere acquisition of a pre-hospital ECG may reduce mortality.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 248, no December, 77-81 p.
Keyword [en]
Pre-hospital, Chest pain, Electrocardiography (ECG), Mortality
National Category
Cardiac and Cardiovascular Systems
Research subject
SOCIAL SCIENCE, Informatics; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-11590DOI: 10.1016/j.ijcard.2017.06.032ISI: 000411439900014OAI: oai:DiVA.org:hv-11590DiVA: diva2:1143110
Available from: 2017-09-20 Created: 2017-09-20 Last updated: 2017-12-05

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Gellerstedt, Martin

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