title: Characteristics and outcome among patients who dial for the EMS due to chest pain.
abstract: OBJECTIVE
  This study aims to describe patients who called for the emergency medical service (EMS) due to chest discomfort, in relation to gender and age.
  
  
  METHODS
  All patients who called the emergency dispatch centre of western Sweden due to chest discomfort, between May 2009 and February 2010, were included. Initial evaluation, aetiology and outcome are described as recorded in the databases at the dispatch centre, the EMS systems and hospitals. Patients were divided into the following age groups: ≤50, 51-64 and ≥65 years.
  
  
  RESULTS
  In all, 14,454 cases were enrolled. Equal proportions of men (64%) and women (63%) were given dispatch priority 1. The EMS clinicians gave priority 1 more frequently to men (16% versus 12%) and older individuals (10%, 15% and 14%, respective of age group). Men had a significantly higher frequency of central chest pain (83% versus 81%); circulatory compromise (34% versus 31%); ECG signs of ischaemia (17% versus 11%); a preliminary diagnosis of acute coronary syndrome (40% versus 34%); a final diagnosis of acute myocardial infarction (14% versus 9%) and any potentially life-threatening condition (18% versus 12%). Individuals aged ≥65 years were given a lower priority than individuals aged 51-64 years, despite poorer characteristics and outcome. In all, 78% of cases with a potentially life-threatening condition and 67% of cases that died within 30 days of enrolment received dispatch priority 1. Mortality at one year was 1%, 4% and 18% in each individual age group.
  
  
  CONCLUSIONS
  Men and the elderly were given a disproportionately low priority by the EMS.
authors.affiliation: Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. Electronic address: araz.rawshani@gu.se.
authors.forename: Araz
authors.initials: A
authors.lastname: Rawshani
authors.affiliation: The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Larsson
authors.affiliation: The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
authors.forename: Carita
authors.initials: C
authors.lastname: Gelang
authors.affiliation: Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
authors.forename: Jonny
authors.initials: J
authors.lastname: Lindqvist
authors.affiliation: The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden; University West, School of Business, Economics and IT, Trollhättan, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Gellerstedt
authors.affiliation: The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
authors.forename: Angela
authors.initials: A
authors.lastname: Bång
authors.affiliation: Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D004632:Emergency Medical Services / Q000379:methods* / Q000639:trends; D004636:Emergency Service, Hospital / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Acute coronary syndromes; Chest discomfort; Chest pain; Emergency medical system; Prehospital