title: Normal prehospital electrocardiography is linked to long-term survival in patients presenting to the emergency department with symptoms of acute coronary syndrome.
abstract: OBJECTIVE
  We studied 735 patients who activated "911" for chest pain and/or anginal equivalent symptoms and received 12-lead ECG monitoring with specialized ischemia monitoring software in the ambulance. Prehospital electrocardiograms (PH ECG) were analyzed to determine the proportion of patients who present with completely normal PH ECG findings (absence of ischemia/infarction, arrhythmia, or any other abnormality) and to compare outcomes among patients with and without any PH ECG abnormality.
  
  
  RESULTS
  Of 735 patients (mean age 70.5, 52.4% male), 68 (9.3%) patients had completely normal PH ECG findings. They experienced significantly less adverse hospital outcomes (12% vs 37%), length of stay (1.19 vs 3.86 days), and long-term mortality (9% vs 28%) than those with any PH ECG abnormality (p<.05).
  
  
  CONCLUSIONS
  Normal PH ECG findings are associated with better short and long-term outcomes in ambulance patients with ischemic symptoms. These findings may enhance early triage and risk stratification in emergency cardiac care.
authors: School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, Campus Box 7460, Chapel Hill, NC. Electronic address: jzhemsey@email.unc.edu.
authors: Jessica K
authors: JK
authors: Zègre-Hemsey
authors: Physiological Nursing, University of California, San Francisco, 2 Koret Way, N631, San Francisco, CA.
authors: Claire E
authors: CE
authors: Sommargren
authors: School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, Campus Box 7460, Chapel Hill, NC; Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors: Josephine K
authors: JK
authors: Asafu-Adjei
authors: Physiological Nursing, University of California, San Francisco, 2 Koret Way, N631, San Francisco, CA.
authors: Barbara J
authors: BJ
authors: Drew
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000401:mortality*; D000368:Aged; D002140:California / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012016:Reference Values; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D014218:Triage / Q000379:methods / Q000706:statistics & numerical data
keywords: Acute coronary syndrome; Emergency medical services; Prehospital electrocardiography; ST-segment monitoring