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  • 1.
    Andersson, Henrik
    et al.
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Axelsson, Christer
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Larsson, Anna
    Ambulance Department, South Älvsborg's Hospital, Borås, Sweden.
    Bremer, Anders
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; Linnaeus University, Faculty of Health and Life Sciences, Växjö, Sweden.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics.
    Bång, Angela
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Herlitz, Johan
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Ljungström, Lars
    Skaraborg Hospital, Infection Disease Department, Skövde, Sweden.
    The early chain of care in bacteraemia patients: Early suspicion, treatment and survival in prehospital emergency care.2018In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 36, no 12, p. 2211-2218, article id S0735-6757(18)30279-1Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28days after admission to hospital. Furthermore, the long-term outcome was assessed.

    METHODS: This study has a quantitative design based on data from Emergency Medical Services (EMS) and hospital records.

    RESULTS: In all, 961 patients were included in the study. Of these patients, 13.5% died during the first 28days. The EMS was more frequently used by non-survivors. Among patients who used the EMS, the suspicion of sepsis already on scene was more frequent in survivors. Similarly, EMS personnel noted the ESS code "fever, infection" more frequently for survivors upon arriving on scene. The delay time from call to the EMS and admission to hospital until start of antibiotics was similar in survivors and non-survivors. The five-year mortality rate was 50.8%. Five-year mortality was 62.6% among those who used the EMS and 29.5% among those who did not (p<0.0001).

    CONCLUSION: This study shows that among patients with bacteraemia who used the EMS, an early suspicion of sepsis or fever/infection was associated with improved early survival whereas the delay time from call to the EMS and admission to hospital until start of treatment with antibiotics was not. 50.8% of all patients were dead after five years.

  • 2.
    Gellerstedt, Martin
    et al.
    University West, School of Business, Economics and IT, Division of Computer Science and Informatics.
    Bång, Angela
    University College of Borås, Prehospital Research Centre of Western Sweden.
    Andréasson, Emma
    University West.
    Johansson, Anna
    University West.
    Herlitz, Johan
    Sahlgrenska University Hospital,, The Prehospital Research Centre of Western Sweden, Institute of Medicine, Department of Molecular and Clinical Medicine,.
    Does sex influence the allocation of life support level by dispatchers in acute chest pain?2010In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 28, no 8, p. 922-7Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to evaluate (a) the differences between men and women in symptom profile, allocated life support level (LSL), and presence of acute myocardial infarction (AMI), life-threatening condition (LTC), or death and (b) whether a computer-based decision support system could improve the allocation of LSL. PATIENTS: All patients in Göteborg, Sweden, who called the dispatch center because of chest pain during 3 months (n = 503) were included in this study. METHODS: Age, sex, and symptom profile were background variables. Based on these, we studied allocation of LSL by the dispatchers and its relationship to AMI, LTC, and death. All evaluations were made from a sex perspective. Finally, we studied the potential benefit of using a statistical model for allocating LSL. RESULTS: The advanced life support level (ALSL) was used equally frequently for men and women. There was no difference in age or symptom profile between men and women in relation to allocation. However, the allocation of ALSL was predictive of AMI and LTC only in men. The sensitivity was far lower for women than for men. When a statistical model was used for allocation, the ALSL was predictive for both men and women. Using a separate model for men and women respectively, sensitivity increased, especially for women, and specificity was kept at the same level. CONCLUSION: This exploratory study indicates that women would benefit most from the allocation of LSL using a statistical model and computer-based decision support among patients who call for an ambulance because of acute chest pain. This needs further evaluation.

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