Abstract
Aim
There is limited evidence regarding prodromal symptoms of out-of-hospital cardiac
arrest (OHCA). We aimed to describe patient characteristics, prodromal symptoms, and
prognosis of patients contacting emergency medical services (EMS) within 24 hours
before OHCA.
Methods
We identified all OHCA treated by Copenhagen EMS from 2016 through 2018 using the
Danish Cardiac Arrest Registry and linked them to emergency calls. We included all
pre-arrest calls by patients or bystanders if they were performed 1) within 24 hours
before the OHCA call or 2) during the OHCA event for EMS-witnessed OHCA. Calls were
reviewed by healthcare professionals using a survey guide.
Results
Among 4,071 patients, 481 patients (12 %) had 539 calls within 24 hours prior to OHCA
(60 % male, median age 74 years of age). The patient spoke on the phone in 25 % of
calls. The most common symptoms were breathing problems (59 %), confusion (23 %),
unconsciousness (20 %), chest pain (20 %), and paleness (19 %). Patients with breathing
problems compared to chest pain were more likely to be ≤ 75 years of age (55 % versus
35 %), less likely to be male (52 % versus 73 %), have shockable rhythm (10 % versus
38 %), receive bystander defibrillation (6 % versus 19 %) or EMS defibrillation (15 %
versus 65 %), achieve return of spontaneous circulation (37 % versus 68 %) and survive
30 days following OHCA (10 % versus 50 %).
Conclusion
More than 10% of patients with OHCA had a call to EMS within 24 hours before OHCA.
The most common symptom was breathing problems which compared to chest pain had lower
30-day survival.
Keywords
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Article info
Publication history
Published online: November 02, 2022
Accepted:
October 27,
2022
Received in revised form:
October 24,
2022
Received:
September 27,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
