Non-specific Complaints in the Ambulance; Predisposing Structural Factors

Overview

Journal BMC Emerg Med

Publisher Biomed Central

Specialty Emergency Medicine

Date 2015 May 15

PMID 25971395

Citations 7

Authors

Maaret Castren

Lisa Kurland

Sofia Liljegard

Therese Djarv

Affiliations

Soon will be listed here.

Abstract

Background: The pre-hospital assessment non-specific complaint (NSC) often applies to patients whose diagnosis does not match any other specific assessment correlating to particular symptoms or diseases, though some previous studies have found them to be related to serious underlying conditions. The aim was to identify whether the structural factors such as urgency according to the dispatch priority of the Emergency Medical Communication Centre (EMCC) or work load in the Emergency Medical Services (EMS) are predisposing factors for the assessment of NSC instead of a specific assessment.

Methods: All patients with assessed condition NSCs by the EMS to Södersjukhuset during 2011 (n = 493) were compared with gender- and age-matched controls (n = 493), which were randomly drawn from all patients with specific conditions in the EMS, regarding day of week, time of day and priority set by EMCC with chi-squared tests and multivariate logistic regression models.

Results: Among patients with NSCs, more were females (58 %) and the median age was 82. Almost all patients were categorized with NSCs during the daytime (8 a.m. to 9 p.m.), i.e. 450 (91 %) as compared to 373 (75 %) of those with specific conditions (p < 0.01). The risk of having an EMS dispatched as low priority by the EMCC was almost doubled among patients with NSCs compared to controls (OR 1.97, 95 % CI 1.38-2.79).

Conclusions: Since patients with NSCs appear most frequently during the hours with most transportations for the EMS, i.e. 10 a.m. to 2 p.m., and the risk of having the assessment NSC was doubled if the EMCC dispatched EMS as low priority, structural factors might be predisposing factors for the assessment.

Citing Articles

Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints.

Jousi M, Makinen M, Kaartinen J, Merilainen L, Castren M Scand J Trauma Resusc Emerg Med. 2021; 29(1):150.

PMID: 34656150 PMC: 8520226. DOI: 10.1186/s13049-021-00964-5.

Soluble urokinase plasminogen activator receptor and lactate as prognostic biomarkers in patients presenting with non-specific chief complaints in the pre-hospital setting - the PRIUS-study.

Ivic R, Nurmi J, Kurland L, Vicente V, Lindstrom V, Djarv T Scand J Trauma Resusc Emerg Med. 2021; 29(1):116.

PMID: 34384460 PMC: 8358910. DOI: 10.1186/s13049-021-00908-z.

Which symptoms pose the highest risk in patients calling for an ambulance? A population-based cohort study from Denmark.

Ibsen S, Lindskou T, Nickel C, Klojgard T, Christensen E, Sovso M Scand J Trauma Resusc Emerg Med. 2021; 29(1):59.

PMID: 33879211 PMC: 8056716. DOI: 10.1186/s13049-021-00874-6.

A common definition should be used in future studies of NSC.

Kemp K, Mertanen R, Niemi-Murola L, Lehtonen L, Castren M Scand J Trauma Resusc Emerg Med. 2021; 29(1):33.

PMID: 33593405 PMC: 7885594. DOI: 10.1186/s13049-021-00851-z.

Serious conditions among patients with non-specific chief complaints in the pre-hospital setting: a retrospective cohort study.

Ivic R, Kurland L, Vicente V, Castren M, Bohm K Scand J Trauma Resusc Emerg Med. 2020; 28(1):74.

PMID: 32727586 PMC: 7391698. DOI: 10.1186/s13049-020-00767-0.

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