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Article
Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnoea: An observational study.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
  • Anne Maree Kelly, The University of Melbourne
  • Anna Holdgate, University of New South Wales
  • Gerben Keijzers, Bond University
  • Sharon Klim, Joseph Epstein Centre for Emergency Medicine Research
  • Colin A Graham, Chinese University of Hong Kong
  • Simon Craig, Monash University
  • Win Sen Kuan, National University Health System
  • Peter Jones, Auckland City Hospital
  • Charles Lawoko, Victoria University
  • Said Laribi, Tours University Hospital
Date of this Version
9-22-2016
Document Type
Journal Article
Publication Details

Published version

Kelly, A. M., Holdgate, A., Keijzers, G., Klim, S., Graham, C. A., Craig, S., Kuan, W. S., Jones, P., Lawoko, C., Laribi, S., & AANZDEM study group (2016). Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnoea: An observational study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 24(113), 1-7.

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© The Author(s). 2016

Distribution License
Creative Commons Attribution 4.0
Disciplines
Abstract

Background

This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance.

Methods

This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance. The primary outcomes of interest are the epidemiology and outcome of these patients. Analysis was by descriptive statistics and comparisons of proportions.

Results

One thousand seven patients met inclusion criteria. Median age was 74 years (IQR 61-68) and 46.1 % were male. There was a high rate of co-morbidity and chronic medication use. The most common ED diagnoses were lower respiratory tract infection (including pneumonia, 22.7 %), cardiac failure (20.5%) and exacerbation of chronic obstructive pulmonary disease (19.7 %). ED disposition was hospital admission (including ICU) for 76.4 %, ICU admission for 5.6 % and death in ED in 0.9 %. Overall in-hospital mortality among admitted patients was 6.5 %.

Discussion

Patients transported by ambulance with shortness of breath make up a significant proportion of ambulance caseload and have high comorbidity and high hospital admission rate. In this study, >60 % were accounted for by patients with heart failure, lower respiratory tract infection or COPD, but there were a wide range of diagnoses. This has implications for service planning, models of care and paramedic training.

Conclusion

This study shows that patients transported to hospital by ambulance with shortness of breath are a complex and seriously ill group with a broad range of diagnoses. Understanding the characteristics of these patients, the range of diagnoses and their outcome can help inform training and planning of services.

Citation Information
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, et al.. "Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnoea: An observational study." Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Vol. 24 Iss. 113 (2016) p. 1 - 7 ISSN: 1757-7241
Available at: http://works.bepress.com/gerben_keijzers/32/